www.irs.gov/efile

Filing Season

Supplement

for Authorized IRS e-file Providers

Tax Year 2005
Filing Season Supplement

for

Authorized IRS e-file Providers 

Tax Year 2005 

Publication 1345A 

This documents supplements

Publication 1345 (Rev. 11-2004) 

This revision supercedes 

Publication 1345A (Rev. 11-2004) 
ii

Table of Contents 

Part I – Information Directories 

The IRS e-file Telephone Directory Page 2 

The IRS Web Site Page 3 

The IRS e-file Submission Processing Center 

Relationships 

Page 4 

State e-file Coordinators Page 5

Part II—Tax Year 2005 Filing Season Information 

IRS e-file Calendar for Tax Year 2005 Page 11

IRS e-file Updates Page 12

Accepted Forms and Schedules Page 17

Country Codes Page 19

Form 8453 Page 22

Form 8453-OL Page 24

Form 8878 Page 26

Form 8879 Page 28

Form 9325 Page 30

 

Part III—Error Reject Code Explanations 

Error Reject Code Explanations for Individual 

Income Tax Returns 

Page 33 

Error Reject Code Explanations for Electronically 

Transmitted Documents 

Page 99 

 

Appendix 

Form Field Exhibits Index Page A-1 

Form Field Exhibits Page B-1 
_____________________________

PART I 

Information Directories

_____________________________
The IRS e-file Telephone Directory 

Topic Services Offered Number

APPLICATION AND 

SUITABILITY

Questions and status of application and 

suitability to participate in IRS e-file

1-866-255-0654

CREDIT CARD

PAYMENTS

Pay an actual or estimated balance due of 

individual income tax. 

1-800-2PAYTAX

www.officialpayments.com

1-888-PAY-1040

 www.pay1040.com

e-HELP IRS e-file and e-services questions and 

issues; ALL Transmission problems and 

PATS testing questions 

1-866-255-0654

(If outside of the 50 US states 

or US territories, call the 

international phone number: 

1-512-416-7750)

ELECTRONIC FILING

BULLETIN BOARD

Requires modem; IRS e-file operations and 

administrative information, updated 

periodically; downloadable files 

859-292-0137

ELECTRONIC FEDERAL 

TAX PAYMENT SYSTEM

Make ALL your federal tax payments, 

including income, employment, and excise 

taxes 

 1-800-555-4477

ELECTRONIC FUNDS

WITHDRAWAL (DIRECT

DEBIT) PAYMENTS

Check the status or cancel scheduled 

payments

1-888-353-4537

FINGERPRINT CARDS Obtain cards for principals and Responsible 

Officials for new or revised applications 

1-866-255-0654

FORMS BY FAX Effective October 1, 2005, service no longer 

available

FRAUD Report suspicious activity in IRS e-file, refer 

to www.irs.gov for more information. 

1-800-829-0433

PUBLICATIONS Order IRS publications and forms by phone 1-800-829-3676

SOCIAL SECURITY 

ADMINISTRATION

For assistance if returns reject due to 

problems with SSNs, name controls or dates 

of birth 

1-800-772-1213

TAX FORMS Order IRS forms and publications by phone 1-800-829-3676

TAX HELP IRS tax assistance 1-800-829-1040

REFUND HOT LINE

(refund info) 

Automated refund information – wait at least 

3 weeks after acknowledgment before 

calling

1-800-829-1954

TELETAX

(tax help) 

Automated tax help– see topic numbers in 

tax package 

1-800-829-4477

2
The IRS Web Site 

www.irs.gov

The following areas exist within the IRS Web Site. Areas may vary slightly as revisions are made to this site. 

Go to www.irs.gov/efile to find: 

e-file for Tax Professionals

Get Ready, Get Set, Go! Important notes and dates about IRS e-file for 

the 2006 Filing Season

IRS e-file Application Updates Information on submitting a new or revised e-file 

application

e-Services Suite of Web-based products that allow tax 

professionals and payers to do business with 

the IRS electronically

IRS e-file Made Easy – A Tax Professional’s 

One-Stop e-file and e-Pay shop

One-stop resource center for IRS e-file and epayment information

QuickAlerts Important e-file messages

Electronic Payment Options Information on tax types and processing periods 

for electronic payments

e-file Library The IRS e-file Library

Federal/State e-file Information for Federal/State e-file

e-file Resources for Providers and EROs Includes Marketing Toolkit with e-file

promotional products 

Subscription Services Subscribe to receive QuickAlerts, Digital 

Dispatch, and local IRS information

e-file for Individual Taxpayers

e-file Partners for Individual Taxpayers Lists of e-file partners for: taxpayers, tax 

professionals, financial institutions/employers, 

and electronic payment options

Go to www.irs.gov/taxpros to find:

Current tax information for tax professionals 

Go to www.irs.gov/newsroom to find: 

Latest information from the IRS 

 3 
IRS e-file SUBMISSION PROCESSING CENTER 

Tax Year 2005 Relationships for Individual Income Tax Returns 

If Fed/State return... 

and the State return included is for the following state: 

If Online Federal return only... 

 and the taxpayer’s address on their Federal return is in 

 the following state: 

Send Form(s) 8453/8453-OL to: 

Foreign and U.S. Possession addresses, returns containing 

U.S. Possession forms, or Forms 2555/2555-EZ, 

Forms 8833, Forms 8854 or Forms 8891 

Alabama, Alaska, Arizona, Arkansas, California, 

Colorado, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas,

Kentucky, Louisiana, Mississippi, Missouri, Montana,

Nebraska, Nevada, New Mexico, North Carolina,

North Dakota, Oklahoma, Oregon, South Carolina,

South Dakota, Tennessee, Texas, Utah, Washington, 

Wyoming, APO/FPO Miami, APO/FPO San Francisco 

Internal Revenue Service 

Attn: Shipping and Receiving, 0254 

 Receipt and Control Branch 

Austin, TX 73344-0254 

Connecticut, Delaware, District of Columbia, Illinois,

Indiana, Maine, Maryland, Massachusetts, Michigan,

Minnesota, New Hampshire, New Jersey, New York, Ohio,

Pennsylvania, Rhode Island, Vermont, Virginia,

West Virginia, Wisconsin, APO/FPO New York

Internal Revenue Service 

Attn: Shipping and Receiving, 0254 

 Receipt and Control Operations 

Andover, MA 05544-0254

If Federal return only... 

and the first two digits of the ERO’s Electronic Filing 

 Identification Number (EFIN) are: 

Send Form(s) 8453/8453-OL to:

30, 33, 42, 43, 45, 46, 47, 48, 50, 56, 57, 58, 59, 60, 61, 62, 

63, 64, 65, 66, 67, 68, 71, 72, 73, 74, 75, 76, 77, 80, 81, 82, 

83, 84, 85, 86, 87, 88, 91, 92, 93, 94, 95, 96, 98, 99 

Internal Revenue Service 

Attn: Shipping and Receiving, 0254 

 Receipt and Control Branch 

Austin, TX 73344-0254 

01, 02, 03, 04, 05, 06, 11, 13, 14, 15, 16, 20, 22, 23, 25, 31, 

34, 35, 36, 37, 38, 39, 40, 41, 51, 52, 54, 55, 78 

Internal Revenue Service 

Attn: Shipping and Receiving, 0254 

 Receipt and Control Operations 

Andover, MA 05544-0254 

 Fed/State Participants are shown in bold print. 

Note: Attachments to Tax Year 2005 Form 8453/8453OL may include Form(s) 1098-C, 3115, 3468, 4136, 5713, 8283, 8332, 

8858, 8864 and/or 8885. 

 4
 STATE e-file COORDINATORS 

5

Alabama Department of Revenue 

http://www.ador.state.al.us

Tavares Mathews, Coordinator 

Individual and Corporate Tax Division 

Gordon Persons Bldg. Room 4340 

50 N. Ripley St. 

Montgomery, Al 36104 

E-mail: Tavares.Mathews@revenue.alabama.gov

Telephone (334) 242-1219

Fax: (334) 353-8068 

Arizona Department of Revenue 

www.azdor.gov

Donna Muccilli, E-File Administrator 

Office of Electronic Filing 

1600 West Monroe Ave. 6th Floor 

Phoenix, AZ 85007 

Alternate: Steve Lee, E-File 

E-file: efile@azdor.gov

Telephone (602) 716-6513 

Fax (602) 716-7997 

E-mail: same as above 

Telephone (602) 716-6514 

Arkansas Department of Finance and Administration 

www.state.ar.us/efile

Dan Brown, Coordinator 

P.O. Box 8094 (ZIP 72203-8094) 

7th and Wolfe Streets B440 

Little Rock, AR 72201 

E-mail: dan.brown@rev.state.ar.us

Telephone (501) 682-7070 

Help Desk (501) 682-7925 

Fax (501) 682-7393 

California Franchise Tax Board 

http://www.ftb.ca.gov

Sean McDaniel, Coordinator 

Electronic Processing Section MSA-1 

Franchise Tax Board 

P.O. Box 1468 

Sacramento, CA 95812 

E-mail: efile@ftb.ca.gov 

Telephone (916) 845-0353 

Fax (916) 845-0287 

Colorado Department of Revenue 

http://www.revenue.state.co.us

Steve Asbell, Coordinator 

1375 Sherman St., Rm. 206 

Denver, CO 80261 

E-mail: sasbell@spike.dor.state.co.us

Telephone (303) 866-3889 

Fax (303) 866-3211 

Connecticut Department of Revenue Services 

http://www.drs.state.ct.us

Jim Annino, Coordinator 

25 Sigourney St. 

Hartford, CT 06106 

E-mail: jim.annino@po.state.ct.us

Jim Annino: (860) 297-4713 

Fax (860) 297-4761 

Delaware Division of Revenue 

http://www.state.de.us/revenue

James Stewart, Coordinator 

820 N. French St. 

Wilmington, DE 19801 

E-mail: jastewart@state.de.us

Telephone (302) 577-8170 

Fax (302) 577-8202 

District of Columbia 

http://www.dc.gov

Office of Chief Financial Officer 

Sonja Peterson, Coordinator 

941 North Capital St., 6th Floor 

Washington, DC 20002 

E-mail: sonja.peterson@dc.gov

Telephone (202) 442-6461 

Fax (202) 442-6330 

Georgia Department of Revenue 

http://www.dor.ga.gov 

Charles Edwards, Coordinator 

1800 Century Center Blvd NE 

Atlanta, GA 30354 -3205 

E-mail: gaelf@dor.ga.gov

Help Desk (404) 675-4992 

Fax (404) 675-4997 
 STATE e-file COORDINATORS 

6

Hawaii Department of Taxation 

http://www.hawaii.gov/tax/html

Jessica N. Honbo, Coordinator 

P.O. Box 259 

Honolulu, HI 96809-0259 

E-mail: tax.efile@hawaii.gov 

Telephone: (808) 587-1740 

Fax: (808) 587-1488 

Idaho State Tax Commission 

http://tax.idaho.gov/ 

Dawn Glazier, Coordinator 

800 Park Blvd., Plaza IV 

Boise, ID 83722-0410 

E-mail: dglazier@tax.idaho.gov

Telephone (208) 334-7822 

Fax (208) 334-7650 

Illinois Department of Revenue 

http://www.iltax.com 

Kevin Richards, Coordinator 

101 West Jefferson St., 2-249 

Springfield, IL 62702 

E-mail: krichards@revenue.state.il.us

Help Desk (217) 524-4767 or 4097 

Fax (217) 782-7992 

Indiana Department of Revenue 

http://www.in.gov/dor

Bill Dunbar, Coordinator 

5150 Decatur Blvd 

Indianapolis, IN 46241 

E-mail: bldunbar@dor.in.gov

Telephone (317) 615-2536 

Fax (317) 615-2520 

Iowa Department of Revenue and Finance 

http://www.state.ia.us/government/drf

Richard Jacobs, Coordinator 

1305 East Walnut, 4th Fl. 

Des Moines, IA 50319 

E-mail: Richard.Jacobs@idrf.state.ia.us 

Help Desk (515) 281-4220

Fax (515) 242-6040 

Kansas Department of Revenue 

www.ksrevenue.org 

Terry Hunt, Coordinator 

915 SW Harrison 

Topeka, KS 66625-4066 

E-mail: Terry_hunt@kdor.state.ks.us

Telephone (785) 296-4066 

Fax (785) 296-0153 

Kentucky Revenue Cabinet 

http://revenue.state.gov 

Judy Ritchie, Coordinator 

1266 Louisville Rd. 

Frankfort, KY 40620 

E-mail: Judy.Ritchie@ky.gov 

Telephone (502) 564-5370 

Fax (502) 564-9897 

Louisiana Department of Revenue 

http://www.rev.louisiana.gov 

Kay Wilson, Coordinator 

(P.O. Box 201 Zip 70821-0201) 

617 North 3rd St. 

Baton Rouge, LA 70802 

E-mail: Kay.Wilson@la.gov

Telephone (225) 219-2488 

Help Desk (225) 219-2490 or 2492 

Fax (225) 219-2651 

Maine Revenue Services 

http:/www.state.me.us/revenue

Michael J. Thompson, Coordinator 

State House Station 24 

Augusta, Maine 04333 

E:mail: efile.helpdesk@maine.gov

Telephone (207) 624-9730 

Fax (207) 624-9740. 

Maryland Office of the Comptroller 

http://www.comp.state.md.us 

Jeane Olson, Coordinator 

Van Jones, Assistant 

110 Carroll St. 

Annapolis, MD 21411 

E-mail: : jolson@comp.state.md.us

E-mail: : vjones@comp.state.md.us

Telephone (410) 260-7753 

Fax (410) 974-2967 

Massachussetts Department of Revenue 

http://www.dor.state.ma.us/

Barry White, Coordinator 

(P.O. Box 7013, Boston, MA 02204) 

200 Arlington St. 

Chelsea, MA 02150 

E-mail: whiteb@dor.state.ma.us

Phone: (617) 887-5174 

Fax (617) 887-5029 
 STATE e-file COORDINATORS 

7

Michigan Department of Treasury 

http://www.michigan.gov/treasury

Annette L. Olivier-Wolfe, Manager 

430 W. Allegan 

Lansing, MI 48922 

E-mail: MIefile2D@michigan.gov 

Telephone (517) 636-4450 

Fax (517) 636-4444 

Minnesota Department of Revenue 

http://www.taxes.state.mn.us

William Grewe, Coordinator 

Tax Operations – Electronic Information 

600 N. Robert St., M/S 4130 

St. Paul, MN 55146-4130 

E-mail Help Desk: 

Taxpayers: Efile.Support@state.mn.us

 Paid Preparers: Efile.PrepSupport@state.mn.us

 Software Developers: 

 Efile.DevSupport@state.mn.us 

Help Desk: (651) 556-3070 

Fax: (651) 556-3130 

Mississippi State Tax Commission 

http://www.mstc.state.ms.us 

Niki Meadows, Coordinator 

P.O. Box 1033 

Jackson, MS 39215 

E-mail: nmeadows@mstc.state.ms.us

Help Desk (601) 923-7055 

Fax (601) 923-7039 

Missouri Department of Revenue 

http://dor.state.mo.us

Jerry Wingate, Coordinator 

301 W. High St., Rm. 218 

Jefferson City, MO 65105 

E-mail: Jerry_Wingate@mail.dor.state.mo.us

Telephone (573) 522-4300 

Fax (573) 526-5915 

Montana Department of Revenue 

http://www.mt.gov/revenue

Dave Berg, Coordinator 

(P.O. Box 5805 zip 59620-5805) 

125 North Roberts 

Helena, MT 59601 

E-mail: daberg@state.mt.us 

Telephone (406) 444-6957 

Fax (406) 444-4556 or 406-444-1505

Nebraska Department of Revenue

http://www.revenue.state.ne.us

Larry Chapman, Coordinator 

(P.O. Box 94818, Lincoln, NE 68509-4818) 

301 Centennial Mall South 

Lincoln, NE 68508 

E-mail: lchapman@rev.state.ne.us

Telephone (402) 471-5619 

Fax (402) 471-5608 

New Jersey Division of Revenue 

http://www.state.nj.us/treasury/revenue

Tim Bachman, Coordinator 

(P.O. Box 191 zip 08646-0191) 

847 Roebling Avenue 

Trenton, NJ 08625 

E-mail: Tim.Bachman@treas.state.nj.us

Telephone: (609) 633-1132 

Fax: (609) 292-1777 

New Mexico Taxation and Revenue 

http://www.state.nm.us/tax

Bernie Candelaria, Coordinator 

1100 S. St. Francis Drive #3040 

Santa Fe, NM 87501 

E-mail: Bcandelaria@state.nm.us

Telephone (505) 476-1708 

Fax (505) 827-0469 

New York Department of Taxation and Finance 

http://www.tax.state.ny.us/

Ping Wu, PIT e-file Manager/Coordinator 

W.A. Harriman Campus, B8, Room 700 

Albany, NY 12227 

E-mail: ping_wu@tax.state.ny.us

Help Desk 1-800-353-1096 

Fax (518) 485-0449 

North Carolina Department of Revenue 

http://www.dor.state.nc.us

Johnetta Baugham, Coordinator 

 (P.O. Box 871 Zip 27602) 

501 North Wilmington St. 

Raleigh, NC 27604 

E-mail: Johnetta.Baugham@dornc.com

Telephone (919) 733-3117 

Fax (919) 715-3165 
 STATE e-file COORDINATORS 

8

North Dakota Office of State Tax Commissioner 

http://www.nd.gov/taxdpt/ 

Donna Kohler, Coordinator 

Chuck Picard, Assistant Coordinator 

600 East Boulevard Ave. 

Bismarck, ND 58505-0599 

E-mail: dkohler@state.nd.us

Telephone (701) 328-3102 or 701-328-3129

Fax (701) 328-3700 

Ohio Department of Taxation 

http://www.state.oh.us/tax

Karen Fisk, Coordinator 

4485 Northland Ridge Blvd, 

Columbus, OH 43229 

E-mail: Karen_Fisk@tax.state.oh.us

Help Desk (614) 466-0197 

Fax (614) 466-0019 

Oklahoma Tax Commission 

http://www@tax.ok.gov

Darla Young, Coordinator 

2501 Lincoln Boulevard 

Oklahoma City, OK 73914 

E-mail: dyoung@tax.ok.gov

Help Desk (405) 521-3124 

Fax (405) 522 -1006

Oregon Department of Revenue 

http://www.dor.state.or.us

Stacey Heller Weeks, Coordinator 

955 Center St., N.E. 

Salem, OR 97301 

E-mail: stacey.h.weeks@state.or.us 

Telephone (503) 945-8415 

Fax (503) 945-8649 

Pennsylvania Department of Revenue 

http://www.revenue.state.pa.us

Richard Santo, Coordinator 

Bureau of Individual Taxes 

5th Floor Strawberry Square 

Harrisburg, PA 17128-0605 

E-mail: rsanto@state.pa.us 

Help Desk (717) 787-4017 

Fax (717) 772-4193 

Rhode Island Division of Taxation 

http://www.doa.state.ri.us/tax

Susan Galvin, Coordinator 

Division of Taxation 

One Capitol Hill 

Providence, RI 02908-5800 

M. Paola Laorenza, secondary contact 

E-mail: galvins@tax.state.ri.us

Telephone (401) 222-2263 

Fax (401) 222-6288 

E-mail: mlaorenz@tax.state.ri.us

Telephone: (401) 222-4091 

Fax (401) 222-6288 

South Carolina Department of Revenue 

www.sctax.org

Keith Wicker, Coordinator 

(P.O. Box 125 29214-0401) 

301 Gervais Street 

Columbia, SC 29214 

E-mail: wickerk@sctax.org

Telephone (803) 898-5541 

Fax (803) 898-5339 

Utah State Tax Commission 

http://tax.utah.gov

Douglas D. Hansen, Coordinator 

210 North 1950 West 

Salt Lake City, UT 84134 

E-mail: ddhanse@utah.gov

Telephone (801) 297-7575 

Fax (801) 297-7698 

Vermont Department of Taxes 

http://www.state.vt.us/tax/index.htm

Trilene Roach, Coordinator 

109 State Street 

Montpelier, VT 05609-1401 

E-mail: troach@tax.state.vt.us 

Telephone: (802) 828-3055 

Fax: (802) 828-3754 

Virginia Department of Taxation 

http://www.tax.state.va.us 

Kerry Williams, Coordinator 

P.O. Box 27423 

Richmond, VA 23261-7423 

E-mail: ELFcoordinator@tax.state.va.us 

E-mail: kwilliams@tax.state.va.us 

Help desk (804) 367-6100 

FAX (804) 367-0224 
 STATE e-file COORDINATORS 

9

West Virginia State Tax Department 

http://www.state.wv.us/taxrev

Jeff Anderson, Coordinator 

(P.O. Box 2222 zip 25328) 

1001 Lee Street 

Charleston, WV 25301 

E-mail: janderson@tax.state.wv.us

Help Desk (304) 558-8655 

Fax (304) 558-1991 

Wisconsin Department of Revenue 

http://www.dor.state.wi.us 

Marcia Gray, Coordinator 

(P.O. Box 8933, Zip 53708-8933) 

2135 Rimrock Road 

Madison, WI 53713 

E-mail: marcia.gray@dor.state.wi.us 

Telephone (608) 261-4906 

Fax (608) 264-9923 

Revised November 2005 
PART II 

Tax Year 2005 

Filing Season 

Information
11

Tax Year 2005 IRS e-file Calendar 

For Tax Period January 1 – December 31, 2005 

Transmitting of live IRS Individual Income Tax Returns begins January 13, 2006

Last date for... 

Transmitting timely filed returns 

Transmitting timely filed Forms 4868 

Retransmitting rejected timely filed returns 

Retransmitting rejected timely filed Forms 4868 

Transmitting timely filed Forms 4868 or 2350 to meet overseas exception 

Retransmitting rejected timely filed Forms 4868 or 2350 to meet overseas 

exception 

Transmitting returns on extension from Forms 4868 

Retransmitting rejected late returns or returns on extension from Forms 4868 

Transmitting test transmissions 

Submitting IRS e-file applications 

April 17, 2006

April 17, 2006

April 22, 2006

April 22, 2006

June 15, 2006

June 20, 2006

October 16, 2006

October 20, 2006 

No cut off date

No cut off date
12

IRS e-file Updates for Tax Year 2005

Revenue Procedure 2005-60 

Revenue Procedure 2005-60, effective August 29, 2005, was published in the Internal 

Revenue Bulletin No. 2005-35, and is available on irs.gov. It combines the rules 

governing IRS e-file for (1) Form 1040 and 1040A, U.S. Individual Income Tax Return 

and Form 1040EZ, Income Tax Return for Single and Joint Filers With No Dependents; 

contained in Publication 1345, Handbook for Authorized IRS e-file Providers of Individual 

Income Tax Returns; (2) Form 940, Employer’s Annual Federal Unemployment (FUTA) 

Tax Return contained in Rev. Proc. 2001-9; and (3) the rules governing electronic filing 

for the Form 941, Employer’s Quarterly Federal Tax Return contained in

Rev. Proc. 99-39.

Revenue Procedure 2005-60 also governs IRS e-file for (1) Form 1120, U.S. Corporation 

Income Tax Return; (2) Form 1120S, U.S. Income Tax Return for an S Corporation; (3) 

Form 990, Return of Organization Exempt From Income Tax; and (4) Form 990-PF, 

Return of Private Foundation or Section 4947(a)(1) Trust Treated as a Private 

Foundation.

The revenue procedure also advises Authorized IRS e-file Providers to have security 

systems in place to prevent unauthorized access to taxpayer accounts and personal 

information by third parties.

Security and Unauthorized Access to Taxpayer Information

The security of taxpayer accounts and personal information is a top priority for the IRS.

It is the responsibility of each Authorized IRS e-file Provider to have security systems in 

place to prevent unauthorized access to taxpayer accounts and personal information by 

third parties. The Gramm-Leach-Bliley Act, codified at 15 U.S.C. 6801-6827, includes 

rules applicable to Authorized IRS e-file Providers that are designed to ensure the 

security and privacy of taxpayer information. Violation of the provisions of the GrammLeach-Bliley Act and the implementing rules and regulations promulgated by the Federal 

Trade Commission, or violations of the non-disclosure rules contained in sections 6713 

or 7216 or the regulations promulgated thereunder, are considered violations of revenue 

procedure 2005-60 and may subject an Authorized IRS e-file Provider to the sanctions 

provided in section 7 of this revenue procedure.
13

Record Keeping Requirements 

EROs must retain and make available to the IRS upon request, until the end of the 

calendar year in which a return was filed, the following material at the business address 

from which the return was originated. An ERO may retain the required records at the 

business address of the Responsible Official during any period of time the office is 

closed.

x Copy of signed Form 8453, any supporting documents that are not included in the 

electronic return data. 

x Copies of Forms W-2, W-2G, and 1099-R; 

x Copy of signed IRS e-file consent to disclosure forms for taxpayers who signed 

using an electronic signature; 

x Complete copy of the electronic portion of the return that can be readily and 

accurately converted into an electronic transmission that the IRS can process; 

and

x The acknowledgment file for IRS accepted returns. 

Forms 8879 and 8878 must be available to the IRS in the same manner described 

above, for three years from the due date of the return or the IRS received date, 

whichever is later. 

IRS e-file Application

The definition of a Large Taxpayer as shown in Publication 3112, IRS e-file Application 

and Participation, Rev. 11-04, is changed to read as shown below : 

A Large Taxpayer is a business or other entity with assets of $10 million or more, or a 

partnership with more than 100 partners, that originates the electronic submission of its 

own return(s). A Large Taxpayer continues to not be an Authorized IRS e-file Provider.

New PIN Error Reject Code

ERO and Transmitters must ensure that when their client chooses to use one of the 

electronic signature methods that the PIN Type Code, P, S, or O is present in the 

Authentication Record, if not the return will reject with the new Error Reject Code 1155. 
14

EITC Qualifying Child Certification Test 

For 2006, the IRS will continue testing a certification requirement for certain EITC 

taxpayers. The test will be the same size as previous tests – 25,000 taxpayers. 

However, the 2006 test will differ slightly from the 2005 test in that the IRS will not be 

conducting a sample from a single community. The sample for the 2006 test will be 

drawn randomly from across the nation. The focus for the 2006 test will be to improve 

the selection methodology which will allow the IRS to gain additional insight as it 

continues the certification evaluation process.

Notices for the 2006 test were mailed out in early October 2005 with additional reminders 

forwarded to taxpayers in November 2005. In addition to improving our selection 

methodology for the test, added enhancements to the telephone routing system will 

provide additional levels of service to taxpayers requesting assistance in completing 

certification forms. Taxpayers who are selected for the qualifying child certification test 

will receive an EIC Indicator of “Y” on their acknowledgement record for their e-file 

returns.

As with earlier tests, the goal of the 2006 test is to evaluate the effect of a certification 

requirement both on the level of erroneous payments and participation by eligible 

taxpayers. As the IRS continues its evaluation of this test, it has no plans to impose a 

blanket qualifying child certification requirement until a thorough evaluation of the 2004, 

2005 and 2006 tests are completed. The IRS is committed to actively engaging 

stakeholders through the testing process. 

Form 8453, U.S. Individual Income Tax Declaration for an IRS e-file Return

Two Submission Processing Centers will process Tax Year 2005 Forms 8453. Andover 

will process Tax Year 2005 Forms 8453 for returns transmitted to Andover and Kansas 

City. Austin will process Tax Year 2005 Forms 8453 for returns transmitted to Austin, 

Fresno and Philadelphia. A return accepted with an electronic signature method (PIN) 

does not require submission of a Form 8453.

Acceptable attachments to Tax Year 2005 Form 8453, U.S. Individual Income Tax 

Declaration for an IRS e-file Return, include:

x Form 1098-C, Contributions of Motor Vehicles, Boats, and Airplanes (or

 acceptable documentation/required Donor Documentation) 

x Form 3115, Application for Change in Accounting Method 

x Form 3468, Investment Credit, Historic Structure Certificate 

x Form 4136, Credit for Federal Tax Paid on Fuels (if certificate and/or reseller 

statement is required) 

x Form 5713, International Boycott Report 

x Form 8283, Noncash Charitable Contributions, Section B 

 Appraisal Summary 

x Form 8332, Release of Claim to Exemption for Child of Divorced or 

 Separated Parents 
15

x Form 8858, Information Return of U.S. Persons With Respect To 

 Foreign Disregarded Entities 

x Form 8864, Biodiesel and Renewable Diesel Fuels Credit (if certificate and/or 

reseller statement is required)

x Form 8885, Health Coverage Tax Credit

NOTE: Taxpayers required to file the above forms are not eligible to use a PIN

 signature method. Paper Document Indicator(s) must be entered in the appropriate

 field(s) of the Summary Record.

IRS e-file Signature Authorizations

Form 8879, IRS e-file Signature Authorization, and Form 8878, IRS e-file Signature 

Authorization for Application for Extension of Time to File, have been revised for Tax 

Year 2005 to include the Electronic Funds Withdrawal (EFW) consent language in Part 

II. When a taxpayer completes a Form 8879 or 8878 which includes the EFW 

statement, there is no need to provide them with a separate copy of the EFW language 

as you may have done in the past. Many software products are designed to include 

Form 8879 and/or Form 8879. Note that the EFW statement in Part II of Form 8878 

does not apply to Form 9465 filers. 

As a reminder, when applicable, Forms 8879 and 8878 must be completed and signed 

by the taxpayer before a tax return or application is transmitted, or released for 

transmission to IRS. DO NOT SEND Forms 8879 or 8878 to the IRS unless requested 

to do so. Retain these forms for your records either in hardcopy or electronically. Refer 

to Publication 1345, Handbook for Authorized e-file Providers of Individual Income Tax 

Returns, and Form 8879 and 8878 instructions for additional information.

PIN Presence Indicator (Acknowledgement File) 

The PIN Presence Indicator (SEQ 0065) has been changed in the Acknowledgement 

File Record. The value for “No PIN Present” has been change to “9” (previous value was 

“0”). It is important to check the Acknowledgement File or other documentation received 

to determine if taxpayer PIN(s) was accepted by IRS. If value 9 is received, Form 8453 is 

required to be submitted to the IRS. Individual income tax returns are not considered 

complete unless signed by the taxpayer. 

Self Select PIN/AGI

Electronic Return Originators should encourage their clients who choose to use the SelfSelect PIN method but don’t have their original prior year AGI on hand, to call the tollfree 1-800- 829-1040 line to obtain the AGI amount from the IRS. This will ensure that 

the e-file return is not rejected for a mismatch AGI entry.
16

ITIN Reminders

If a client presents an Individual Taxpayer Identification Number and a Form W-2 

showing a Social Security Number, the tax return must be filed on paper. E-file rules do 

not permit an Electronic Return Originator to alter information on a wage document and 

mismatched taxpayer identification numbers will cause an e-filed return to reject. 

In cases where a current year return has already been filed that excluded a spouse, or 

dependent who needs an ITIN, the taxpayer should complete Form 1040X, Amended 

U.S. Individual Income Tax Return, showing the ITIN applicant’s information, and attach 

it to Form W-7. For more information about filing with ITINs, go to the Tax Professionals 

Corner at www.irs.gov. 

New Form(s)/Schedule(s)

Nine (9) additional forms will be accepted for Electronic Filing of Individual Income Tax Returns 

for Tax Year 2005: 

x Form 5884-A – Hurricane Katrina Employee Retention Credit 

x Form 8609-A – Annual Statement of Low-Income Housing Credit

x Form 8854 – Initial and Annual Expatriation Information Statement

x Form 8864 – Biodiesel and Renewable Diesel Fuels Credit 

x Form 8896 – Low Sulfur Diesel Fuel Production Credit 

x Form 8901 – Information on Qualifying Children Who are not Dependents 

 (For Child Tax Credit Only) 

x Form 8903 – Domestic Production Activities Deduction 

x Form 8914 - Exemption Amount for Taxpayers Housing Individuals 

Displaced by Hurricane Katrina 

x Form 8915 – Qualified Hurricane Katrina Retirement Plan Distributions 

and Repayments 

RAL Indicator Changed

The RAL Indicator is a required field for Forms 1040, 1040A and 1040EZ. The field 

description for the RAL Indicator (SEQ 1465) has changed to the following: 

x “0” = No Bank Product (No bank product was issued) 

x “1” = Pre-Refund Products or a Loan Product similar to RAL

(Money borrowed by a taxpayer, from a lender, based on the taxpayer’s 

anticipated income tax refund) 

x “2” = Post-Refund Products, Non-Loan Product similar to RAC 

(Taxpayers nay choose this product to have preparers and other fees 

deducted from their refund instead of paying them up front. This choice 

uses direct deposit into a bank account usually set up by the preparer at 

a participating bank. The taxpayer is issued their refund after the IRS 

deposits it and the preparer has subtracted his/her fees). 

NOTE: Error Reject Code 0299 has been revised to reflect this change. 
17

Accepted Forms and Schedules Information 

The following chart identifies the forms and schedules accepted for TY2005 IRS e-file

and the maximum number of each that may be submitted with each return or as an 

electronically transmitted document. 

Form/Schedule Maximum # Form/ Schedule Maximum # 

Form 1040 1 Form 3903 2 

 Schedule A&B 1 Form 4136 1 

 Schedule C 8 Form 4137 1 per taxpayer*

 Schedule C-EZ 1 per taxpayer* Form 4255 1 

 Schedule D 1 Form 4562 30 

 Schedule E 15** Form 4563 2 

 Schedule EIC 1 Form 4684 5 

 Schedule F 5 Form 4797 1 

 Schedule H 1 per taxpayer* Form 4835 4 

 Schedule J 1 Form 4952 1 

 Schedule R 1 Form 4970 1 

 Schedule SE 1 per taxpayer* Form 4972 1 per taxpayer*

Form 1040A 1 Form 5074 1 

 Schedule 1 1 Form 5329 1 per taxpayer*

 Schedule 2 1 Form 5471 1 

 Schedule 3 1 Schedule J 1 

Form 1040EZ 1 Schedule M 5 

Form 1099-R 20 Schedule O 5 

Form W-2 50 Form 5713 1 

Form W-2G 30 Schedule A 5 

Form W-2GU 10 Schedule B 5 

Form 970 2 Schedule C 1 

Form 982 2 Form 5884 1 

Form 1116 20 Form 5884-A 1 

Form 1310 2 Form 6198 10 

Form 2106 2 per taxpayer**** Form 6251 1 

Form 2106-EZ 1 per taxpayer* Form 6252 10 

Form 2120 4 Form 6478 1 

Form 2210 1 Form 6765 1 

Form 2210F 1 Form 6781 1 

Form 2439 4 Form 8082 4 

Form 2441 1 Form 8271 2 

Form 2555 1 per taxpayer* Form 8275 1 

Form 2555EZ 1 per taxpayer* Form 8275-R 1 

Form 3468 1 Form 8283 1 

Form 3800 1 Form 8379 1 
18

Accepted Forms and Schedules Information (Cont.)

* Maximum of two per return on 

a joint return (one for each 

taxpayer)

**Maximum of 45 (three rental 

properties on each Schedule E) 

***Up to four forms 8829 for 

each Schedule C 

****Maximum of four per return 

on a Joint Return (two for each 

taxpayer)

Form/Schedule Maximum # Form/ Schedule Maximum # 

 Form 8396 1 Form 8864 1

 Form 8582 1 Form 8865 5

 Form 8582-CR 1 Schedule K-1 10 

 Form 8586 1 Schedule O 5

 Form 8594 1 Schedule P 5

 Form 8606 1 per taxpayer* Form 8866 5

 Form 8609-A 10 Form 8873 10 

 Form 8611 5 Form 8874 1

 Form 8615 1 Form 8880 1

 Form 8621 5 Form 8881 1

 Form 8689 1 Form 8882 1

 Form 8697 4 Form 8885 2

 Form 8801 1 Form 8886 10 

 Form 8812 1 Form 8889 2

 Form 8814 10 Form 8891 10 

 Form 8815 1 Form 8896 1

 Form 8820 1 Form 8901 1 

 Form 8824 5 Form 8903 1

 Form 8826 1 Form 8914 1

 Form 8828 1 Form 8915 1 per taxpayer* 

 Form 8829 32*** 

 Form 8830 1

Authentication 

Record 1

 Form 8833 10 

 Form 8834 5

Allocation 

Record 1

 Form 8835 1 Form Payment 2

 Form 8839 3 Form T 10 

 Form 8844 1 ST 0001 1 

 Form 8845 1 ST 0002 9 

 Form 8846 1

 Form 8847 1 Electronic Transmitted Documents (ETD)

 Form 8853 1

 Form 8854 2

Authentication 

Record 1

 Form 8859 1 Form Payment 3

 Form 8860 1 Form 56 1

 Form 8861 1 Form 2350 1

 Form 8862 1 Form 4868 1

 Form 8863 1 Form 9465 1
19

Country Codes for Forms 2555/2555EZ and Foreign Employer 

Compensation Record (FEC Record) 

If the country is not listed, use Country Code “XX” – Other Countries 

 Country Code Country Code

Afghanistan AF Central African Republic CT 

Albania AL Chad CD 

Algeria AG Chile CI 

Andorra AN China CH 

Angola AO Christmas Islands KT 

Anguilla AV Clipperton Islands IP 

Antarctica AY Cocos (Keeling Islands) CK 

Antigua & Barbuda AC Colombia CO 

Argentina AR Comoros CN 

Armenia AM Congo (Brazzaville) CF 

Aruba AA Congo (Kinshasa) CG 

Ashmore & Cartier Islands AT Cooks Islands CW 

Australia AS Coral Sea Islands CR 

Austria AU Costa Rica CS 

Azerbaijan AJ Cote d’Ivoire IV 

Bahamas The BF Croatia HR 

Bahrain BA Cuba CU 

Bangladesh BG Cyprus CY 

Barbados BB Czech Republic EZ 

Belarus BO Denmark DA 

Belgium BE Djibouti DJ 

Belize BH Dominica DO 

Benin BN Dominican Republic DR 

Bermuda BD Central African Republic CT 

Bhutan BT Chad CD 

Bolivia BL Chile CI 

Bosnia and Herzegovina BK East Timor TT 

Botswana BC Ecuador EC 

Bouvet Island BV Egypt EG 

Brazil BR El Salvador ES 

British Indian Ocean Territory IO Equatorial Guinea EK 

Brunei BX Eritrea ER 

Bulgaria BU Estonia EN 

Burkina Faso UV Ethiopia ET 

Burma BM Falkland Islands FK 

Burundi BY Faroe Islands FO 

Cambodia CB Fiji FJ 

Cameroon CM Finland FI 

Canada CA France FR 

Cape Verde CV French Polynesia FP 

Cayman Islands CJ French Southern & Antarctic Lands FS 
20

Country Codes for Forms 2555/2555EZ and Foreign Employer 

Compensation Record (FEC Record) 

If the country is not listed, use Country Code “XX” – Other Countries 

 Country Code Country Code

Gabon GB Liberia LI 

Gambia The GA Libya LY 

Georgia GG Lichtenstein LS 

Germany GM Lithuania LH 

Ghana GH Luxembourg LU 

Gibraltar GI Macau MC 

Greece GR Macedonia, The Former Yugoslav 

Republic of 

MK

Greenland GL Madagascar MA 

Grenada GJ Malawi MI 

Guatemala GT Malaysia MY 

Guernsey GK Maldives MV 

Guinea GV Mali ML 

Guinea-Bissau PU Malta MY 

Guyana GY Man, Isle of IM

Haiti HA Marshall Islands RM 

Heard Island & McDonald Islands HM Mauritania MR 

Herzegovina and Bosnia BK Mauritius MP 

Holy City VT Mayotte MF 

Honduras HO Mexico MX 

Hong Kong HK Micronesia, Federated States of FM 

Hungary HU Moldova MD 

Iceland IC Monaco MN 

India IN Mongolia MG 

Indonesia ID Montenegro & Serbia YI 

Iran IR Montserrat MH 

Iraq IZ Morocco MO 

Ireland EI Mozambique MZ 

Israel IS Namibia WA 

Italy IT Nauru NR 

Jamaica JM Nepal NP 

Jan Mayen JN Netherlands NL 

Japan JA Netherlands Antilles NT 

Jersey JE New Caledonia NC 

Jordan JO New Zealand NZ 

Kazakhstan KZ Nicaragua NU 

Kenya KE Niger NG 

Kiribati KR Nigeria NI 

Korea, North KN Niue NE 

Korea, South KS Norfolk Island NF 

Kuwait KU Norway NO 

Kyrgyzstan KG Oman MU 

Laos LA Pakistan PK 

Latvia LG Palau PS 

Lebanon LE Panama PM 

Lesotho LT Papua New Guinea PP 
21

Country Codes for Forms 2555/2555EZ and Foreign Employer 

Compensation Record (FEC Record) 

If the country is not listed, use Country Code “XX” – Other Countries 

 Country Code Country Code 

Paraguay PA Svalbard SV 

Peru PE Swaziland WZ 

Pitcairn Islands PC Sweden SW 

Poland PL Switzerland SZ 

Portugal PO Syria SY 

Qatar QA Taiwan TW 

Romania RO Tajikistan TI 

Russia RS Tanzania TZ 

Rwanda RW Thailand TH 

Saint Helena SH Togo TO 

Saint Kitts & Nevis SC Tokelau TL 

Saint Lucia ST Tonga TN 

Saint Pierre & Miquelon SB Trinidad & Tobago TD 

Saint Vincent & The Grenadines VC Tunisia TS 

Samoa WS Turkey TU 

San Marino SM Turkmenistan TX 

Sao Tome and Principe TP Turks and Caicos Islands TK 

Saudi Arabia SA Tuvalu TV 

Senegal SG Uganda UG 

Serbia & Montenegro YI Ukraine UP 

Seychelles SE United Arab Emirates AE 

Sierra Leone SL United Kingdom UK 

Singapore SN Uruguay UY 

Slovakia LO Uzbekistan UZ 

Slovenia SI Vanuatu NH 

Solomon Islands BP Venezuela VE 

Somalia SO Vietnam VM 

South Africa SF Virgin Islands, British VI 

South Georgia & The South Sandwich 

Islands 

SX Wallis & Futuna WF 

Spain SP Yemen YM 

Spratly Islands PG Zambia ZA 

Sri Lanka CE Zimbabwe ZI 

Sudan SU All other countries XX 

Suriname NS 

Note: For electronic filing only, enter alphabetic value “US” (not shown

 in the Country Code Table) for the Country Code, Field No. 0130, 

 of the Foreign Employer Compensation Record (FEC Record) when 

 services for foreign employer were performed in the U.S. 
Declaration Control Number (DCN)

0 6 0 – – –

U.S. Individual Income Tax Declaration OMB No. 1545-0074 8453 for an IRS e-file Return Form

Department of the Treasury

Internal Revenue Service

For the year January 1–December 31, 2005

 See instructions on back.

Use the

IRS label.

Otherwise,

please

print or

type.

Daytime phone number

( )

Tax Return Information (Whole dollars only)

1 Adjusted gross income (Form 1040, line 38; Form 1040A, line 22; Form 1040EZ, line 4) 1

2 Total tax (Form 1040, line 63; Form 1040A, line 38; Form 1040EZ, line 10) 2

3 Federal income tax withheld (Form 1040, line 64; Form 1040A, line 39; Form 1040EZ, line 7) 3

4 Refund (Form 1040, line 73a; Form 1040A, line 45a; Form 1040EZ, line 11a) 4

5 Amount you owe (Form 1040, line 75; Form 1040A, line 47; Form 1040EZ, line 12) 5

Declaration of Taxpayer (Sign only after Part I is completed.) Be sure to keep a copy of your tax return.

Under penalties of perjury, I declare that I have examined a copy of my electronic individual income tax return and accompanying schedules and statements

for the tax year ending December 31, 2005, and to the best of my knowledge and belief, it is true, correct, and complete. I further declare that the amounts

in Part I above are the amounts shown on the copy of my electronic income tax return. I consent to allow my electronic return originator (ERO) to send my

return to the IRS and to receive from the IRS (a) an acknowledgment of receipt or reason for rejection of the transmission, (b) an indication of any refund

offset, (c) the reason for any delay in processing the return or refund, and (d) the date of any refund.

Sign

Here  Your signature Date Spouse’s signature. If a joint return, both must sign. Date

Declaration of Electronic Return Originator (ERO) and Paid Preparer (See instructions.)

I declare that I have reviewed the above taxpayer’s return and that the entries on Form 8453 are complete and correct to the best of my knowledge. If I am

only a collector, I am not responsible for reviewing the return and only declare that this form accurately reflects the data on the return. The taxpayer will have

signed this form before I submit the return. I will give the taxpayer a copy of all forms and information to be filed with the IRS, and have followed all other

requirements in Pub. 1345, Handbook for Authorized IRS e-file Providers of Individual Income Tax Returns. If I am also the Paid Preparer, under penalties

of perjury, I declare that I have examined the above taxpayer’s return and accompanying schedules and statements, and to the best of my knowledge and

belief, they are true, correct, and complete. This Paid Preparer declaration is based on all information of which I have any knowledge.

Date Check ERO’s SSN or PTIN

if selfemployed

ERO’s ERO’s signature

Use

Only

Firm’s name (or

yours if self-employed),

address, and ZIP code

EIN

Phone no. ( )

Under penalties of perjury, I declare that I have examined the above taxpayer’s return and accompanying schedules and statements, and to the best of my

knowledge and belief, they are true, correct, and complete. This declaration is based on all information of which I have any knowledge.

Date Preparer’s SSN or PTIN

Preparer’s Paid signature

Preparer’s

Use Only

Firm’s name (or

yours if self-employed),

address, and ZIP code Phone no. ( )

Part I









 EIN

Cat. No. 62766T Form 8453 (2005)

If I have filed a balance due return, I understand that if the IRS does not receive full and timely payment of my tax liability, I will remain liable for the tax

liability and all applicable interest and penalties. If I have filed a joint Federal and state tax return and there is an error on my state return,

I understand my Federal return will be rejected.

IRS Use Only—Do not write or staple in this space.

I consent that my refund be directly deposited as designated in the electronic portion of my 2005 Federal income tax return. If I have filed a joint

return, this is an irrevocable appointment of the other spouse as an agent to receive the refund.

6a

I do not want direct deposit of my refund or I am not receiving a refund.

Check if

also paid

preparer

b

Your first name and initial Last name Your social security number

L

A

B

E

L

H

E

R

E

If a joint return, spouse’s first name and initial Last name Spouse’s social security number

Home address (number and street). If you have a P.O. box, see instructions. Apt. no. Important!

City, town or post office, state, and ZIP code

You must enter

your SSN(s) above.



I authorize the U.S. Treasury and its designated Financial Agent to initiate an ACH electronic funds withdrawal entry to the financial institution

account indicated in the tax preparation software for payment of my Federal taxes owed on this return and/or a payment of estimated tax. I further

understand that this authorization may apply to future Federal tax payments that I direct to be debited through the Electronic Federal Tax Payment

System (EFTPS). In order for me to initiate future payments, I request that the IRS send me a personal identification number (PIN) to access EFTPS.

This authorization is to remain in full force and effect until I notify the U.S. Treasury Financial Agent to terminate the authorization. To revoke a

payment, I must contact the U.S. Treasury Financial Agent at 1-888-353-4537 no later than 2 business days prior to the payment (settlement)

date. I also authorize the financial institutions involved in the processing of the electronic payment of taxes to receive confidential information

necessary to answer inquiries and resolve issues related to the payment.

c

For Paperwork Reduction Act Notice, see back of form.

Part II

Part III

Check

if selfemployed

2005
Form 8453 (2005) Page 2

Paperwork Reduction Act Notice. We ask

for the information on this form to carry out

the Internal Revenue laws of the United

States. You are required to give us the

information. We need it to ensure that you are

complying with these laws and to allow us to

figure and collect the right amount of tax.

P.O. box. Enter the box number only if the

post office does not deliver mail to the

taxpayer’s home.

Note. The address must match the address

shown on the electronically filed return.

If you have suggestions for making this

form simpler, we would be happy to hear

from you. See the instructions for your

income tax return.

Part II—Declaration of Taxpayer

Taxpayer signatures. An electronically

transmitted return will not be considered

complete, and therefore filed, unless and until

a Form 8453 signed by the taxpayer is

received by the IRS. A Form 8453 signed by

an agent must have a power of attorney

attached that specifically authorizes the agent

to sign the return. To do this, you can use

Form 2848, Power of Attorney and

Declaration of Representative.

If the ERO makes changes to the electronic

return after Form 8453 has been signed by

the taxpayer but before it is transmitted, the

ERO must have the taxpayer complete and

sign a corrected Form 8453 if (a) the amount

on line 1 differs from the amount on the

electronic return by more than $50, or (b) any

amount on lines 2 through 5 differs from the

amount on the electronic return by more than

$14.

Part III—Declaration of Electronic

Return Originator (ERO) and Paid

Preparer

Line Instructions

Declaration control number (DCN). The DCN

is a 14-digit number assigned by the ERO to

each return. Clearly print or type the DCN in

the top left corner of each Form 8453 after the

IRS has acknowledged receipt of the

electronic return. The first two digits are the

file identification number and are always “00”.

The next six digits are the electronic filer

identification number (EFIN) assigned by the

IRS. The next three digits are the batch

number (000 to 999) assigned by the ERO. The

next two digits are the serial number (00 to 99)

assigned by the ERO. The last digit is the year

digit (for returns filed in 2006, the year digit is

“6”).

The IRS requires the ERO’s signature. A paid

preparer must sign Form 8453 in the space

for Paid Preparer’s Use Only. But if the paid

preparer is also the ERO, do not complete

the paid preparer’s section. Instead, check

the box labeled “Check if also paid preparer.”

Refund information. You can check on the

status of a 2005 refund if it has been at least

3 weeks from the date you filed the return. To

check on the status of a 2005 refund, do one

of the following:

Example. The EFIN is 509325. The batch

number is 000. The serial number is 56. The

DCN is 00-509325-00056-6.

Name and address. If the taxpayer received

a peel-off name and address label from the

IRS, put the label in the name area. Cross out

any incorrect information and print the correct

information. Add any missing items, such as

When and Where To File

The ERO must mail Form 8453 to the IRS

within 3 business days after receiving

acknowledgement that the IRS has accepted

the electronically filed return. Mail Form 8453

to the IRS at the applicable address shown in

the chart below.

Use Form 8453 to:

● Authenticate the electronic portion of Form

1040, 1040A, or 1040EZ,

● Send any required paper forms (do not

send Forms W-2, W-2G, or 1099-R),

● Authorize the electronic return originator

(ERO) to transmit via a third-party transmitter,

and

● Provide the taxpayer’s consent to directly

deposit any refund and/or authorize an

electronic funds withdrawal for payment of

federal taxes owed and/or a payment of

estimated tax.

Purpose of Form

You are not required to provide the

information requested on a form that is

subject to the Paperwork Reduction Act

unless the form displays a valid OMB control

number. Books or records relating to a form

or its instructions must be retained as long as

their contents may become material in the

administration of any Internal Revenue law.

Generally, tax returns and return information

are confidential, as required by Internal

Revenue Code section 6103.

Refunds. After the IRS has accepted the

return, the refund should be issued within 3

weeks. However, some refunds may be

delayed because of compliance reviews to

ensure that returns are accurate.

General Instructions

Note. If the paid preparer’s signature cannot

be obtained on Form 8453, you can attach a

copy of Form 1040, 1040A, or 1040EZ

instead. Attach only pages 1 and 2, and enter

“COPY—DO NOT PROCESS” on each page.

Social security number (SSN). Be sure to

enter the taxpayer’s SSN in the space

provided on Form 8453. If a joint return, list

the SSNs in the same order as the first

names.

Note. The taxpayer must check all applicable

boxes on line 6.

● Routing number.

● Account number.

● Type of account (checking or savings).

● Debit amount.

● Debit date (date the taxpayer wants the

debit to occur).

If there is an amount on line 5 and the

taxpayer checks box 6b and is paying by

check or money order, mail the payment by

April 17, 2006, with Form 1040-V to the

applicable address shown on that form.

Part I—Tax Return Information

Line 5. Do not include any payment with

Form 8453. The method of payment depends

on whether the taxpayer checks the box on

line 6b or 6c. For details, see the instructions

for Part II.

If the taxpayer checks box 6c, the taxpayer

must ensure that the following information

relating to the financial institution account is

provided in the tax preparation software.

Instead of filing Form 8453, the

taxpayer may be able to sign the

return electronically using a

self-selected personal identification number

(PIN). For details, go to the IRS website at

www.irs.gov or see Pub. 1345.

● Go to www.irs.gov and click on Where’s

My Refund.

● Call 1-800-829-4477 for automated refund

information and follow the recorded

instructions.

● Call 1-800-829-1954.

TIP

Form 8453 can be faxed between the

taxpayer and the ERO. The ERO must receive

the faxed signed Form 8453 prior to

transmitting the return to the IRS. The

completed Form 8453, with signatures, must

be mailed by the ERO to the IRS.

Note. Do not mail a copy of an electronically

filed Form 1040, 1040A, or 1040EZ to the

Internal Revenue Service (IRS).

IF the electronic return

was transmitted to:

THEN mail Form 8453 to:

Andover or Kansas City

Submission Processing Center

Austin, Fresno, or Philadelphia 

Submission Processing Center

Internal Revenue Service

Attn: Shipping and Receiving, 0254

Receipt and Control Operations

Andover, MA 05544-0254

The average time and expenses required to

complete and file this form will vary

depending on individual circumstances. For

the estimated averages, see the instructions

for your income tax return.

Internal Revenue Service

Attn: Shipping and Receiving, 0254

Receipt and Control Branch

Austin, TX 73344-0254

apartment number. If the taxpayer did not

receive a label, print or type the information in

the spaces provided.
Declaration Control Number (DCN)

0 6 0 – – –

U.S. Individual Income Tax Declaration OMB No. 1545-0074 8453-OL for an IRS e-file Online Return

Department of the Treasury

Internal Revenue Service

For the year January 1–December 31, 2005

 See instructions on back.

Your first name and initial Last name Your social security number L

A

B

E

L

H

E

R

E

Use the

IRS label.

Otherwise,

please

print or

type.

If a joint return, spouse’s first name and initial Last name Spouse’s social security number

Home address (number and street). If you have a P.O. box, see instructions. Apt. no.

Daytime phone number

( )

City, town or post office, state, and ZIP code

For Paperwork Reduction Act Notice, see back of form.

Tax Return Information (Whole dollars only)

1 Adjusted gross income (Form 1040, line 38; Form 1040A, line 22; Form 1040EZ, line 4) 1

2 Total tax (Form 1040, line 63; Form 1040A, line 38; Form 1040EZ, line 10) 2

3 Federal income tax withheld (Form 1040, line 64; Form 1040A, line 39; Form 1040EZ, line 7) 3

4 Refund (Form 1040, line 73a; Form 1040A, line 45a; Form 1040EZ, line 11a) 4

5 Amount you owe (Form 1040, line 75; Form 1040A, line 47; Form 1040EZ, line 12) (see instructions) 5

Declaration of Taxpayer. Be sure to keep a copy of your tax return.

I consent that my refund be directly deposited as designated in the electronic portion of my 2005 Federal income

tax return. If I have filed a joint return, this is an irrevocable appointment of the other spouse as an agent to receive

the refund.

Sign

Here  Your signature Date

Cat. No. 15907C Form 8453-OL (2005)

IRS Use Only—Do not write or staple in this space.

Part II

If I have filed a balance due return, I understand that if the IRS does not receive full and timely payment of my tax liability,

I will remain liable for the tax liability and all applicable interest and penalties. If I have filed a joint Federal and state tax

return and there is an error on my state return, I understand my Federal return will be rejected.

Under penalties of perjury, I declare that I have examined a copy of my electronic individual income tax return and

accompanying schedules and statements for the tax year ending December 31, 2005, and to the best of my knowledge and

belief, it is true, correct, and complete. I further declare that the amounts in Part I above are the amounts shown on the

copy of my electronic income tax return. I consent to allow my intermediate service provider and/or transmitter to send my

return to the IRS and to receive from the IRS (a) an acknowledgment of receipt or reason for rejection of the transmission,

(b) an indication of any refund offset, (c) the reason for any delay in processing the return or refund, and (d) the date of any

refund.

 Spouse’s signature. If a joint return, both must sign. Date

Important!

You must enter

your SSN(s) above.



6a

b I do not want direct deposit of my refund or I am not receiving a refund.

I authorize the U.S. Treasury and its designated Financial Agent to initiate an ACH electronic funds withdrawal entry

to the financial institution account indicated in the tax preparation software for payment of my Federal taxes owed

on this return and/or a payment of estimated tax. I further understand that this authorization may apply to future

Federal tax payments that I direct to be debited through the Electronic Federal Tax Payment System (EFTPS). In

order for me to initiate future payments, I request that the IRS send me a personal identification number (PIN) to

access EFTPS. This authorization is to remain in full force and effect until I notify the U.S. Treasury Financial Agent

to terminate the authorization. To revoke a payment, I must contact the U.S. Treasury Financial Agent at

1-888-353-4537 no later than 2 business days prior to the payment (settlement) date. I also authorize the financial

institutions involved in the processing of the electronic payment of taxes to receive confidential information necessary

to answer inquiries and resolve issues related to the payment.

c

Part I Form

2005
Form 8453-OL (2005) Page 2

Paperwork Reduction Act Notice. We ask for

the information on this form to carry out the

Internal Revenue laws of the United States. You

are required to give us the information. We need

it to ensure that you are complying with these

laws and to allow us to figure and collect the

right amount of tax.

P.O. box. Enter your box number only if the

post office does not deliver mail to your home.

Note. The address must match the address

shown on your electronically filed return.

Part II—Declaration of Taxpayer

● Routing number.

Line Instructions

Declaration control number (DCN). The

DCN is a 14-digit number assigned to your

return by your intermediate service provider

and/or transmitter. It should be included in

your acknowledgment message. Clearly print

or type the DCN in the top left corner of Form

8453-OL. The first two digits are always “00”.

The next six digits are the electronic filer

identification number (EFIN). The next five

digits are the batch number and serial

number. The “6” represents the year the

return is filed (2006).

Refunds. Your refund should be issued within

3 weeks after the IRS has accepted your

return. However, some refunds may be

delayed because of compliance reviews to

ensure that returns are accurate.

Example. The EFIN is 509325. The batch

number is 000. The serial number is 56. The

DCN is 00-509325-00056-6.

Name and address. If you received a

peel-off name and address label from the

IRS, put the label in the name area. Cross out

any incorrect information and print the correct

information. Add any missing items, such as

your apartment number. If you did not receive

a label, print or type the information in the

spaces provided.

When and Where To File

Mail Form 8453-OL to the IRS on the next

working day after you have received

acknowledgment from your intermediate

service provider and/or transmitter that the

IRS has accepted your electronically filed

return. The address should be included in

your acknowledgment message. If not, mail

Form 8453-OL to the IRS at the applicable

address shown in the chart below. If you do

not receive an acknowledgment, you must

contact your intermediate service provider

and/or transmitter.

Who Must File

If you are filing a 2005 Form 1040, 1040A, or

1040EZ through an intermediate service

provider and/or transmitter and you do not

use a self-select PIN, you must file a signed

2005 Form 8453-OL with the IRS.

You are not required to provide the

information requested on a form that is subject

to the Paperwork Reduction Act unless the form

The average time and expenses required to

complete and file this form will vary depending

on individual circumstances. For the estimated

averages, see the instructions for your income

tax return.

IF you live in: THEN mail Form 8453-OL to:

Connecticut, Delaware, District of Columbia, Illinois, Indiana, Maine, Maryland, Massachusetts,

Michigan, Minnesota, New Hampshire, New Jersey, New York, Ohio, Pennsylvania, Rhode Island,

Vermont, Virginia, West Virginia, Wisconsin, APO/FPO New York addresses

Alabama, Alaska, Arizona, Arkansas, California, Colorado, Florida, Georgia, Hawaii, Idaho,

Iowa, Kansas, Kentucky, Louisiana, Mississippi, Missouri, Montana, Nebraska, Nevada, New

Mexico, North Carolina, North Dakota, Oklahoma, Oregon, South Carolina, South Dakota,

Tennessee, Texas, Utah, Washington, Wyoming, APO/FPO addresses (other than APO/FPO

New York addresses) foreign and U.S. possession addresses, returns containing U.S.

possession forms or Forms 2555, 2555-EZ, 8833, 8854, or 8891

Internal Revenue Service

Attn: Shipping and Receiving, 0254

Receipt and Control Operations

Andover, MA 05544-0254

Internal Revenue Service

Attn: Shipping and Receiving, 0254

Receipt and Control Branch

Austin, TX 73344-0254

General Instructions

Social security number (SSN). Be sure to

enter your SSN in the space provided on

Form 8453-OL. If a joint return, list the SSNs

in the same order as the first names.

Note. You must check all applicable boxes

on line 6.

● Account number.

● Type of account (checking or savings).

● Debit amount.

● Debit date (date you want the debit to

occur).

Signatures. Your electronically transmitted

return will not be considered complete, and

therefore filed, unless and until the IRS

receives your signed Form 8453-OL. If a joint

return, your spouse must also sign. A Form

8453-OL signed by an agent must have a

power of attorney attached that specifically

authorizes the agent to sign the return. To do

this, you can use Form 2848, Power of

Attorney and Declaration of Representative.

Part I—Tax Return Information

Line 5. Do not include any payment with

Form 8453-OL. The method of payment

depends on whether you check the box on

line 6b or 6c. For details, see the instructions

for Part II.

If you check box 6c, you must ensure that

the following information relating to the

financial institution account is provided in the

tax preparation software.

If there is an amount on line 5 and you check

box 6b and are paying by check or money

order, do not attach your payment to

displays a valid OMB control number. Books or

records relating to a form or its instructions must

be retained as long as their contents may

become material in the administration of any

Internal Revenue law. Generally, tax returns and

return information are confidential, as required

by Internal Revenue Code section 6103. If you have suggestions for making this form

simpler, we would be happy to hear from you.

See the instructions for your income tax return.

Note. Do not mail a copy of your

electronically filed Form 1040, 1040A, or

1040EZ to the Internal Revenue Service (IRS).

You may be able to file a completely

paperless return! Your tax preparation

software should contain information

about using a self-select personal

identification number (PIN) instead of filing

Form 8453-OL. Or, you can go to the IRS

website at www.irs.gov.

Purpose of Form

Use Form 8453-OL to:

● Authenticate the electronic portion of your

2005 Form 1040, 1040A, or 1040EZ,

● Provide your consent to directly deposit any

refund and/or authorize an electronic funds

withdrawal for payment of federal taxes owed

and/or a payment of estimated tax.

● Send any required paper forms (do not

send Forms W-2, W-2G, or 1099-R), and

Refund information. You can check on the

status of your 2005 refund if it has been at

least 3 weeks from the date you filed your

return. To check on the status of your 2005

refund, do one of the following:

● Go to www.irs.gov and click on Where’s

My Refund.

● Call 1-800-829-1954.

● Call 1-800-829-4477 for automated refund

information and follow the recorded

instructions.

Form 8453-OL. Instead, mail it by April 17,

2006, with Form 1040-V to the IRS at the

applicable address shown on that form. If you

do not have a Form 1040-V, you may be able

to get it from your intermediate service

provider and/or transmitter. You can also see

your tax return instruction booklet for other

ways to get forms or go to the IRS website at

www.irs.gov.

TIP
Form 8878

Department of the Treasury

Internal Revenue Service

IRS e-file Signature Authorization for

Application for Extension of Time To File

OMB No. 1545-0074

Declaration Control Number (DCN)

Taxpayer’s name

Spouse’s name

Social security number

Spouse’s social security number

Information from Extension Form—Tax Year Ending December 31, 2005 (Whole Dollars Only)

Taxpayer Declaration and Signature Authorization

Under penalties of perjury, I declare that I have examined a copy of my electronic application for extension of time to file for the tax year ending December

31, 2005, and to the best of my knowledge and belief, it is true, correct, and complete. I further declare that the information listed above is the information

from my electronic application for extension of time to file. I consent to allow my intermediate service provider, transmitter, or electronic return originator

(ERO) to send this form to the IRS and to receive from the IRS (a) an acknowledgement of receipt or reason for rejection of the transmission and (b) the

reason for any delay in processing the form. If applicable, I authorize the U.S. Treasury and its designated Financial Agent to initiate an ACH electronic funds

withdrawal (direct debit) entry to the financial institution account indicated in the tax preparation software for payment of my Federal taxes, and the financial

institution to debit the entry to this account. I further understand that this authorization may apply to future Federal tax payments that I direct to be debited

through the Electronic Federal Tax Payment System (EFTPS). In order for me to initiate future payments, I request that the IRS send me a personal identification

number (PIN) to access EFTPS. This authorization is to remain in full force and effect until I notify the U.S. Treasury Financial Agent to terminate the

authorization. To revoke a payment, I must contact the U.S. Treasury Financial Agent at 1-888-353-4537 no later than 2 business days prior to the payment

(settlement) date. I also authorize the financial institutions involved in the processing of the electronic payment of taxes to receive confidential information

necessary to answer inquiries and resolve issues related to the payment. I further acknowledge that the personal identification number (PIN) below is my

signature for my electronic application for extension of time to file and, if applicable, my Electronic Funds Withdrawal Consent.



Part I

Part II

1

ERO’s EFIN/PIN. Enter your six-digit EFIN followed by your five-digit self-selected PIN.

ERO Must Retain This Form — See Instructions

Do Not Submit This Form to the IRS Unless Requested To Do So

For Privacy Act and Paperwork Reduction Act Notice, see back of form. Cat. No. 32777M Form 8878 (2005)

Check the box and complete the line(s) for the form you authorize your ERO to sign and file. Check only one box.

Form 4868, Application for Automatic Extension of Time To File U.S. Individual Income Tax Return

Amount you are paying from line 7 of Form 4868

Form 2350, Application for Extension of Time To File U.S. Income Tax Return

I request an extension of time until this date as shown on line 1 of Form 2350

Amount you are paying from line 5 of Form 2350

2a

2b

ERO’s signature  Date 

1

2

a

b

 Do not send to the IRS. This is not an application for an extension of time to file.

 Keep this form for your records. See instructions.

Certification and Authentication—Practitioner PIN Method for Form 4868 Only

Practitioner PIN Method for Form 4868 Only—continue below

do not enter all zeros

I certify that the above numeric entry is my PIN, which is my signature to authorize submission of the electronic Form 4868 and electronic funds withdrawal

for the taxpayer(s) indicated above. I confirm that I am submitting Form 4868 in accordance with the requirements of the Practitioner PIN method and

Publication 1345, Handbook for Authorized IRS e-file Providers of Individual Income Tax Returns.

Part III

Taxpayer’s PIN: check one box only

I authorize to enter my PIN as my signature

for my electronic application for extension of time to file for the tax year ending December 31, 2005.

I will enter my PIN as my signature for my electronic application for extension of time to file for the tax year ending

December 31, 2005. Check this box only if you are entering your own PIN and your extension form is filed using the

Practitioner PIN method. The ERO must complete Part III below.

Your signature  Date 

Spouse’s PIN: check one box only

Spouse’s signature  Date 

ERO firm name

ERO firm name

do not enter all zeros

do not enter all zeros

I authorize to enter my PIN as my signature

for my electronic application for extension of time to file for the tax year ending December 31, 2005.

I will enter my PIN as my signature for my electronic application for extension of time to file for the tax year ending

December 31, 2005. Check this box only if you are entering your own PIN and your extension form is filed using the

Practitioner PIN method. The ERO must complete Part III below.

2005
Form 8878 (2005) Page 2

Purpose of Form

● Provide the taxpayer with a corrected

copy of Form 8878 if changes are made to

the extension form (for example, based on

taxpayer review).

● Enter the taxpayer’s PIN(s) on the input

screen only if the taxpayer has authorized

you to do so. If married filing jointly, it is

acceptable for one spouse to authorize the

ERO to enter his or her PIN, and for the

other spouse to enter his or her own PIN.

It is not acceptable for a taxpayer to select

or enter the PIN of an absent spouse.

● If the taxpayer is making a payment by

electronic funds withdrawal for Form 4868

and the ERO is not using the Practitioner

PIN method, the ERO must enter the

taxpayer’s date of birth and prior year

adjusted gross income amount from the

taxpayer’s originally filed tax return. This

information will be required on the input

screen. Do not use an amount from an

amended return or a math error correction

made by the IRS.

● For more information, see Pub. 1345 and

Pub. 1345A, Filing Season Supplement for

Authorized IRS e-file Providers. Also, go to

www.irs.gov/efile and select e-file For Tax

Professionals.

Privacy Act and Paperwork Reduction Act

Notice. We ask for this information to carry

out the Internal Revenue laws of the United

States. Section 6061(a) of the Internal

Revenue Code requires taxpayers to sign

their tax returns or other documents.

Section 6061(b) permits the IRS to accept

electronic signatures under certain

circumstances. Section 6109 requires you to

provide your social security number. This

form is to permit you to use a personal

identification number (PIN) which will be

your electronic signature for your application

for an extension of time to file, and for you

to authorize an electronic return originator

(ERO) to enter or generate the PIN on your

behalf. You are not required to authorize

your ERO to enter your PIN as your

signature on your behalf; you may personally

enter your PIN at the time of transmission or

file a paper application for an extension of

time to file. Routine uses of this information

include giving it to the Department of

Justice for use in civil and criminal litigation,

and to cities, states, and the District of

Columbia for use in administering their tax

laws. We may also disclose this information

to other countries under a tax treaty, to

federal and state agencies to enforce federal

nontax criminal laws, or to federal law

enforcement and intelligence agencies to

combat terrorism. Providing false or

fraudulent information may subject you to

penalties.

You are not required to provide the

information requested on a form that is

subject to the Paperwork Reduction Act

unless the form displays a valid OMB

control number. Books or records relating

to a form or its instructions must be

retained as long as their contents may

become material in the administration of

any Internal Revenue law. Generally, tax

returns and return information are

confidential, as required by Internal

Revenue Code section 6103.

The average time and expenses required

to complete and file this form will vary

depending on individual circumstances. For

the estimated averages, see the

instructions for your income tax return.

● You should confirm the identity of the

taxpayer(s). For additional guidance, see

Pub. 1345, Handbook for Authorized IRS

e-file Providers of Individual Income Tax

Returns.

● Provide the taxpayer with a copy of the

signed Form 8878 for his or her records

upon request.

If you have suggestions for making this

form simpler, we would be happy to hear

from you. See the instructions for your

income tax return.

The ERO will:

● Enter the name(s) and social security

number(s) of the taxpayer(s) at the top of

the form.

ERO Responsibilities

Taxpayer Responsibilities

Taxpayers have the following

responsibilities: (a) to verify the accuracy of

the prepared application for an extension

of time to file, (b) to check the appropriate

box in Part II to authorize the ERO to enter

or generate their PIN or to do it

themselves, (c) to indicate or verify their

PIN when authorizing the ERO to enter or

generate it (the PIN must be five numbers

other than all zeros), (d) to sign and date

Form 8878, and (e) to return the completed

Form 8878 to the ERO by hand delivery,

U.S. mail, private delivery service, or fax.

Your application for extension of time to

file will not be transmitted to the IRS until

the ERO receives your signed Form 8878.

Important Notes for EROs

● Do not send Form 8878 to the IRS

unless requested to do so. Retain the

completed Form 8878 for 3 years from the

return due date or IRS received date,

whichever is later. Form 8878 may be

retained electronically in accordance with

the recordkeeping guidelines in Rev. Proc.

97-22, which is on page 9 of Internal

Revenue Bulletin 1997-13 at

www.irs.gov/pub/irs-irbs/irb97-13.pdf.

● Enter on the authorization line in Part II

the ERO firm name (not the name of the

individual preparing the return) if the ERO

is authorized to enter the taxpayer’s PIN.

● Enter the 14-digit Declaration Control

Number (DCN) assigned to the taxpayer’s

extension form, after the taxpayer

completes Part II. See Part I of Pub. 1346,

Electronic Return File Specifications and

Record Layouts for Individual Income Tax

Returns.

● Give the taxpayer Form 8878 for

completion and review. This can be done

in person or by using the U.S. mail, a

private delivery service, email, or an

Internet website.

● Complete Part I by entering the required

information from the taxpayer(s) extension

form.

When and How To Complete

See the chart below to determine when

and how to complete Form 8878.

IF e-filing . . . THEN . . .

● Form 4868, and

● Authorizing an electronic

funds withdrawal, and

● The ERO is using the

Practitioner PIN method.

● Form 4868, and

● Authorizing an electronic

funds withdrawal, and

● Authorizing the ERO to

enter or generate the

taxpayer’s PIN, and

● The ERO is not using the

Practitioner PIN method.

● Form 4868, and

● Authorizing an electronic

funds withdrawal, and

● The taxpayer is entering

his or her own PIN, and

● The ERO is not using the

Practitioner PIN method.

● Form 4868, and

● The taxpayer is not

authorizing an electronic

funds withdrawal.

● Form 2350

Complete Form 8878,

Parts I, II, and III.

Complete Form 8878,

Parts I and II.

Do not complete

Form 8878.

Do not complete

Form 8878.

Complete Form 8878,

Parts I and II only if

the taxpayer

authorizes the ERO to

enter or generate the

taxpayer’s PIN.

● Complete Part III only if you are filing

Form 4868 using the Practitioner PIN

method.

Complete Form 8878 when Form 4868 is

filed using the Practitioner PIN method, or

when the taxpayer authorizes the

electronic return originator (ERO) to enter

or generate the taxpayer’s personal

identification number (PIN) on an

application for extension of time to file.

See the chart below for more details.

● Enter or generate, if authorized by the

taxpayer, the taxpayer’s PIN and enter it in

the boxes provided in Part II.

CAUTION

Form 8878 is not an application

for an extension of time to file.

Taxpayers must file the

appropriate extension form

listed in Part I of this form.

CAUTION

You must receive the

completed and signed Form

8878 from the taxpayer before

the application for extension of

time to file is transmitted (or

released for transmission).
Form 8879

Department of the Treasury

Internal Revenue Service

IRS e-file Signature Authorization OMB No. 1545-0074

Declaration Control Number (DCN)

Taxpayer’s name

Spouse’s name

Social security number

Spouse’s social security number

Tax Return Information—Tax Year Ending December 31, 2005 (Whole Dollars Only)

1

2

3

4

5

Adjusted gross income (Form 1040, line 38; Form 1040A, line 22; Form 1040EZ, line 4)

Total tax (Form 1040, line 63; Form 1040A, line 38; Form 1040EZ, line 10)

Federal income tax withheld (Form 1040, line 64; Form 1040A, line 39; Form 1040EZ, line 7)

Refund (Form 1040, line 73a; Form 1040A, line 45a; Form 1040EZ, line 11a)

Amount you owe (Form 1040, line 75; Form 1040A, line 47; Form 1040EZ, line 12)



Part I

1

2

3

4

5

Form 8879 (2005)

 Do not send to the IRS. This is not a tax return.

 Keep this form for your records. See instructions.

Taxpayer Declaration and Signature Authorization (Be sure you get and keep a copy of your return)

Under penalties of perjury, I declare that I have examined a copy of my electronic individual income tax return and accompanying schedules and statements

for the tax year ending December 31, 2005, and to the best of my knowledge and belief, it is true, correct, and complete. I further declare that the amounts

in Part I above are the amounts from my electronic income tax return. I consent to allow my intermediate service provider, transmitter, or electronic return

originator (ERO) to send my return to the IRS and to receive from the IRS (a) an acknowledgement of receipt or reason for rejection of the transmission, (b)

an indication of any refund offset, (c) the reason for any delay in processing the return or refund, and (d) the date of any refund. If applicable, I authorize the

U.S. Treasury and its designated Financial Agent to initiate an ACH electronic funds withdrawal (direct debit) entry to the financial institution account indicated

in the tax preparation software for payment of my Federal taxes owed on this return and/or a payment of estimated tax, and the financial institution to debit

the entry to this account. I further understand that this authorization may apply to future Federal tax payments that I direct to be debited through the Electronic

Federal Tax Payment System (EFTPS). In order for me to initiate future payments, I request that the IRS send me a personal identification number (PIN) to

access EFTPS. This authorization is to remain in full force and effect until I notify the U.S. Treasury Financial Agent to terminate the authorization. To revoke

a payment, I must contact the U.S. Treasury Financial Agent at 1-888-353-4537 no later than 2 business days prior to the payment (settlement) date. I also

authorize the financial institutions involved in the processing of the electronic payment of taxes to receive confidential information necessary to answer

inquiries and resolve issues related to the payment. I further acknowledge that the personal identification number (PIN) below is my signature for my electronic

income tax return and, if applicable, my Electronic Funds Withdrawal Consent.

Part II

ERO’s EFIN/PIN. Enter your six-digit EFIN followed by your five-digit self-selected PIN.

ERO Must Retain This Form — See Instructions

Do Not Submit This Form to the IRS Unless Requested To Do So

For Privacy Act and Paperwork Reduction Act Notice, see back of form. Cat. No. 32778X

ERO’s signature  Date 

Certification and Authentication—Practitioner PIN Method Only

Practitioner PIN Method Returns Only—continue below

do not enter all zeros

I certify that the above numeric entry is my PIN, which is my signature for the tax year 2005 electronically filed income tax return for the taxpayer(s) indicated

above. I confirm that I am submitting this return in accordance with the requirements of the Practitioner PIN method and Publication 1345, Handbook for

Authorized IRS e-file Providers of Individual Income Tax Returns.

Part III

Taxpayer’s PIN: check one box only

I authorize to enter my PIN as my signature

on my tax year 2005 electronically filed income tax return.

I will enter my PIN as my signature on my tax year 2005 electronically filed income tax return. Check this box only if you

are entering your own PIN and your return is filed using the Practitioner PIN method. The ERO must complete Part III

below.

Your signature  Date 

Spouse’s PIN: check one box only

Spouse’s signature  Date 

ERO firm name

ERO firm name

do not enter all zeros

do not enter all zeros

I authorize to enter my PIN as my signature

on my tax year 2005 electronically filed income tax return.

I will enter my PIN as my signature on my tax year 2005 electronically filed income tax return. Check this box only if you

are entering your own PIN and your return is filed using the Practitioner PIN method. The ERO must complete Part III

below.

2005
Form 8879 (2005) Page 2

Purpose of Form

Important Notes for EROs

● Do not send Form 8879 to the IRS unless

requested to do so. Retain the completed

Form 8879 for 3 years from the return due

date or IRS received date, whichever is later.

Form 8879 may be retained electronically in

accordance with the recordkeeping guidelines

in Rev. Proc. 97-22, which is on page 9 of

Internal Revenue Bulletin 1997-13 at

www.irs.gov/pub/irs-irbs/irb97-13.pdf.

● Enter the taxpayer’s PIN(s) on the input

screen only if the taxpayer has authorized you

to do so. If married filing jointly, it is

acceptable for one spouse to authorize you to

enter his or her PIN, and for the other spouse

to enter his or her own PIN. It is not

acceptable for a taxpayer to select or enter

the PIN of an absent spouse.

● You should confirm the identity of the

taxpayer(s). For additional guidance, see Pub.

1345, Handbook for Authorized IRS e-file

Providers of Individual Income Tax Returns.

● Enter, for the Authentication Record of the

taxpayer’s electronically filed return, the

taxpayer(s) date of birth and adjusted gross

income from the taxpayer’s prior year

originally filed return if you are not using the

Practitioner PIN method. Do not use an

amount from an amended return or a math

error correction made by the IRS.

● Complete Part III only if you are filing the

return using the Practitioner PIN method. You

are not required to enter the taxpayer’s date

of birth and prior year adjusted gross income

for the Authentication Record of the

electronically filed return.

Complete Form 8879 when the Practitioner

PIN method is used or when the taxpayer

authorizes the electronic return originator

(ERO) to enter or generate the taxpayer’s

personal identification number (PIN) on his or

her e-filed individual income tax return.

Refund information. You can check on the

status of your 2005 refund if it has been at

least 3 weeks from the date your return was

filed. To check the status of your 2005

refund, do one of the following.

● Go to www.irs.gov and click on “Where’s

My Refund.”

● Call 1-800-829-4477 for automated refund

information and follow the recorded

instructions.

● Call 1-800-829-1954.

● Generally, most taxpayers can use a PIN to

sign their return instead of filing Form 8453,

U.S. Individual Income Tax Declaration for an

● Provide the taxpayer with a copy of the

signed Form 8879 for his or her records upon

request.

● Provide the taxpayer with a corrected copy

of Form 8879 if changes are made to the

return (for example, based on taxpayer

review).

● For more information, see Pub. 1345 and

Pub. 1345A, Filing Season Supplement for

Authorized IRS e-file Providers. Also, go to

www.irs.gov/efile and select e-file For Tax

Professionals.

Privacy Act and Paperwork Reduction Act

Notice. We ask for this information to carry

out the Internal Revenue laws of the United

States. Section 6061(a) of the Internal

Revenue Code requires taxpayers to sign

their tax returns. Section 6061(b) permits the

IRS to accept electronic signatures under

certain circumstances. Section 6109 requires

you to provide your social security number.

This form is to permit you to use a personal

identification number (PIN) as your signature

which will be your electronic signature for

your individual income tax return, and for you

to authorize an electronic return originator

(ERO) to enter or generate the PIN on your

behalf. You are not required to authorize your

ERO to enter your PIN on your behalf; you

may personally enter your PIN at the time of

transmission or complete Form 8453. Routine

uses of this information include giving it to

the Department of Justice for use in civil and

criminal litigation, and to cities, states, and

the District of Columbia for use in

administering their tax laws. We may also

disclose this information to other countries

under a tax treaty, to federal and state

agencies to enforce federal nontax criminal

laws, or to federal law enforcement and

intelligence agencies to combat terrorism.

Providing false or fraudulent information may

subject you to penalties.

You are not required to provide the

information requested on a form that is

subject to the Paperwork Reduction Act

unless the form displays a valid OMB control

number. Books or records relating to a form

or its instructions must be retained as long as

their contents may become material in the

administration of any Internal Revenue law.

Generally, tax returns and return information

are confidential, as required by Internal

Revenue Code section 6103.

The average time and expenses required to

complete and file this form will vary

depending on individual circumstances. For

the estimated averages, see the instructions

for your income tax return.

If you have suggestions for making this

form simpler, we would be happy to hear

from you. See the instructions for your

income tax return.

The ERO will:

● Enter the name(s) and social security

number(s) of the taxpayer(s) at the top of the

form.

ERO Responsibilities

You must receive the completed

and signed Form 8879 from the

taxpayer before the electronic

return is transmitted (or released

for transmission).

● Enter on the authorization line in Part II the

ERO firm name (not the name of the

individual preparing the return) if the ERO is

authorized to enter the taxpayer’s PIN.

● Enter the 14-digit Declaration Control

Number (DCN) assigned to the tax return,

after the taxpayer completes Part II. See Part

I of Pub. 1346, Electronic Return File

Specifications and Record Layouts for

Individual Income Tax Returns.

● Give the taxpayer Form 8879 for

completion and review. This can be done in

person or by using the U.S. mail, a private

delivery service, email, or an Internet website.

● Complete Part I using the amounts (zeros

may be entered when appropriate) from the

taxpayer’s 2005 tax return.

When and How To Complete

See the chart below to determine when and

how to complete Form 8879.

IF the ERO is . . . THEN . . .

Using the Practitioner PIN

method and is authorized

to enter or generate the

taxpayer’s PIN

Complete Form 8879,

Parts I, II, and III.

Complete Form 8879,

Parts I, II, and III.

Complete Form 8879,

Parts I and II.

Do not complete

Form 8879.

Using the Practitioner PIN

method and the taxpayer

enters his or her own PIN

Not using the Practitioner

PIN method and is

authorized to enter or

generate the taxpayer’s

PIN

Not using the Practitioner

PIN method and the

taxpayer enters his or her

own PIN

Taxpayer Responsibilities

Taxpayers have the following responsibilities:

(a) to verify the accuracy of the prepared

income tax return, including direct deposit

information, (b) to check the appropriate box

in Part II to authorize the ERO to enter or

generate their PIN or to do it themselves, (c)

to indicate or verify their PIN when authorizing

the ERO to enter or generate it (the PIN must

be five numbers other than all zeros), (d) to

sign and date Form 8879, and (e) to return the

completed Form 8879 to the ERO by hand

delivery, U.S. mail, private delivery service, or

fax. Your return will not be transmitted to the

IRS until the ERO receives your signed Form

8879.

● Enter or generate, if authorized by the

taxpayer, the taxpayer’s PIN and enter it in

the boxes provided in Part II.

Do not complete

Form 8879.

Submitting Form 8453

Do not send this form to the IRS.

The ERO must retain Form 8879.

CAUTION

CAUTION

IRS e-file Return. However, they cannot use a

PIN signature if they must use Form 8453 to

send attachments to the IRS.
Your federal income tax return/extension for was filed electronically with the

 Submission Processing Center of the IRS by the services of .

Your return was accepted by the IRS on and the Declaration Control Number

(DCN) assigned to your return is .

 Your return was accepted using a PIN. (You entered a PIN or authorized the Electronic Return Originator

 to enter or generate a PIN for you).

 Please contact your Electronic Return Originator if you have not already completed a Form 8453, U.S.

 Individual Income Tax Declaration for an IRS e-file Return.

Your return was 'conditionally' accepted by the IRS on . The Earned Income

Credit or a Dependent's Exemption on your return may be reduced or disallowed due to a Child's Name and

Social Security Number mismatch.

Debt Indicator Code - Part or all of your refund may be offset to a debt owed to the Internal Revenue Service,

the Office of Child Support Enforcement, or other government agency.

Your electronic funds withdrawal payment was accepted.

Your electronic funds withdrawal payment was NOT accepted. Your must pay the balance due by April 17,

2006.

Your Form 4868 extension was accepted by the IRS on

and the Declaration Control Number (DCN) assigned to your extension is .

Department of the Treasury - Internal Revenue Service

Acknowledgement and General Information for

Taxpayers Who File Returns Electronically

Form 9325

Thank you for taking part in the IRS e-file Program.

PLEASE DO NOT SEND A PAPER COPY OF YOUR RETURN TO THE IRS. IF YOU DO, IT WILL DELAY THE

PROCESSING OF THE RETURN.

If You Need to Make a Change to Your Return

If you need to make a change or correct the return you filed electronically, you should send a Form 1040X, Amended U.S.

Individual Income Tax Return, to the IRS submission processing center that processes paper returns for your area. The

address is available at www.irs.gov, or you can call the IRS toll-free at 1-800-829-1040.

If You Need to Ask About Your Refund

The IRS will notify your Electronic Return Originator (ERO) when they accept your return, usually within 48 hours. If your

return wasn't accepted, the IRS will notify your ERO of the reasons for rejection. If it has been more than three weeks

since the IRS accepted your return and you have not received your refund, go to www.irs.gov and click on "Where's My

Refund" then on "Go Get My Refund Status." Exception: If box 3 above is checked, please allow 4 to 6 weeks for

processing of conditionally accepted returns. Also, you can call the IRS toll-free Tele-Tax return information number,

1-800-829-4477, to check the status of your refund. You will need to know the first social security number shown on

your return, your filing status, and the exact amount of the refund you expect. Tele-Tax should give you the date for

mailing or depositing your refund. You should receive your refund check within 30 days of the date given by Tele-Tax, or

within one week of that date if you chose direct deposit. If you don't receive it by then, or if Tele-Tax does not give your

refund information, call the IRS office at 1-800-829-1954.

Catalog Number 12901K

(Taxpayer Name)

(Taxpayer Address optional)

1.

2.

3.

4.

5.

6.

7.

a.

b. Your return was accepted electronically without a PIN. A Form 8453 signature document is required.

Form 9325 (Rev. 11-2005)

(Rev. November 2005)
If You Need to Inquire About Your Electronic Funds Withdrawal Payment

You can call 1-888-353-4537, toll-free, to inquire about the status of an electronic funds withdrawal payment. If there is a

change to the bank account information included on your return, you should call this number to cancel a scheduled

payment. You will need the social security number of the first person listed on the tax return, the payment amount and

the bank account number. Cancellation requests must be received no later than 8:00 p.m. Eastern Time, two business

days prior to the scheduled payment date.

Refund Anticipation Loans

A refund anticipation loan is a loan made to you based on the refund you expect to receive. This loan is a contract

between you and a lender. The IRS is not involved in this contract, can't grant or deny the loan, and can't answer any

questions about it. If you have any questions about a refund anticipation loan, contact your electronic filer or the

lender.

If You Owe Tax

If your e-filed return has a balance due, you must pay the amount you owe by April 17, 2006. If you paid by electronic

funds withdrawal (direct debit) or by credit card while e-filing your return, no voucher is needed. To use your credit card to

pay by phone or Internet, you may call, toll free, 1-800-2PAY-TAX (1-800-272-9829) or 1-888-PAY-1040

(1-888-729-1040), or visit www.officialpayments.com or www.PAY1040.com. You may use a VISA® card, American

Express® Card, Discover Card® or MasterCard® card. The service providers, based on the amount you are paying, will

charge a convenience fee. The fees may vary between providers. You will be told the amount of the fee during the

transaction and you will be given the option to either continue or end the transaction.

If you are not paying electronically, you may use the payment voucher, Form 1040-V, you will receive in the mail or you

can obtain a payment voucher from your electronic filer. If the IRS doesn't receive your payment by April 17, 2006, you

will receive a notice that requests full payment of the tax due, plus penalties and interest. If you can't pay the amount in

full, please complete Form 9465, Installment Agreement Request. You may electronically file Form 9465. To obtain a

paper Form 9465, you may call 1-800-829-3676 or visit www.irs.gov. Mail the paper form to the address in the form's

instructions.

Instructions to EROs

PINS (line 2a) - Check box 2a if the taxpayer entered a PIN or authorized the ERO to enter or generate the PIN for the

taxpayer, and the Acknowledgement File PIN Presence Indicator is a “1” or “2”. Form 8879 is required if the ERO enters

or generates the PIN or if the Practitioner PIN method is used.

PINS (line 2b) - Check box 2b if the Acknowledgment File PIN Presence Indicator is NOT a "1" or "2." If box 2b is

checked, Form 8453 must be completed and submitted to IRS by the ERO.

Exception Processing (line 3) - Check box 3 if the Acknowledgement File Acceptance Code equals "E."

Debt Indicator Code (line 4) - Check box 4 if the Acknowledgement File Debt Code equals "I", "F", or "B."

Electronic Funds Withdrawal (line 5) - Check box 5 if the taxpayer requested to use electronic funds withdrawal to pay the

balance due, and the Acknowledgement File Payment Acknowledgement Literal field equals “PYMNT RQST RECD."

Electronic Funds Withdrawal (line 6) - Check box 6 if the taxpayer requested to use electronic funds withdrawal to pay the

balance due, and the Acknowledgement File Payment Acknowledgement Literal field does NOT equal “PYMNT RQST

Note: EROs can use the Acknowledgement File information, translated by the transmitter, to complete Form 9325.

Catalog Number 12901K

SM SM

Form 9325 (Rev. 11-2005)

RECD." If box 6 is checked, inform the taxpayer that he/she must pay by check, money order, or credit card.
PART III 

Error Reject Code 

Explanations
ERROR REJECT CODE (ERC) EXPLANANTIONS 

For Individual Income Tax Returns 

See Appendix for assistance in indentifying SEQ numbers 

___________________________________________________________________________________________ 

0001 o 

o

Page 1 of Form 1040, Form 1040A, or Form 1040EZ must be present. 

The Summary Record must be present. 

0002 o RESERVED 

0003 o Tax Return Record Identification Page 1 - Tax Period (SEQ 0005) equal "200512". For 

Form 1040/1040A, Tax Period (SEQ 0005) of Tax Return Record Identification Page 2 must also 

equal "200512". 

0004 o 

o

o

o

Tax Form - Primary SSN (SEQ 0010) must be within the valid ranges of SSN/ITIN's and cannot equal 

an ATIN. It must equal all numeric characters and cannot equal all blanks, zeros, or nines. 

Primary SSN (SEQ 0010) is a required field. 

Primary SSN (SEQ 0010) of the Tax Form must equal Taxpayer Identification Number (SEQ 0003) of 

Tax Return Record Identification Page 1. 

Taxpayer Identification Number (SEQ 0003) of Tax Return Record Identification Page 1 must be 

significant. 

0005 o Statement Record - The maximum number of Statement References within a tax return is 30. (A 

Statement Reference is defined as "STMbnn"; the value of "nn" refers to the Statement Number.) 

0006 o 

o

o

o

o

Tax Form - Only the following characters are permitted in the Primary Name Control (SEQ 0050) and 

Spouse's Name Control (SEQ 0055): alpha, hyphen, and space. The Name Control cannot contain 

leading or embedded spaces. The left-most position must contain an alpha character. 

Primary Name Control (SEQ 0050) is a required field. 

Spouse's Name Control (SEQ 0055) is a required field when Filing Status (SEQ 0130) equals "2" 

or "3". On Form 1040EZ, Spouse's Name Control (SEQ 0055) is a required field when Secondary 

SSN (SEQ 0030) is significant. 

Form 8615 - Parent Name Control (SEQ 0045) must be significant and correctly formatted. 

Form 8814 - Child Name Control (SEQ 0015) must be significant and correctly formatted. 

0007 o 

o

o

Tax Form - Street Address (SEQ 0080) is alphanumeric and cannot have leading or consecutive 

embedded spaces. The left-most position must contain an alpha or numeric character. The only 

special characters permitted are space, hyphen (-), and slash (/). 

Street Address (SEQ 0080) is a required field. 

Exception: This check is not performed when Address Ind 

(SEQ 0097) is equal to “3”, indicating a foreign address.”)

0008 o 

o

Form 1040/1040A - Total Box 6a and 6b (SEQ 0167) must equal the number of boxes checked for 

Exempt Self (SEQ 0160) and Exempt Spouse (SEQ 0163). 

Filing Status (SEQ 0130) is a required field. 

0009 o State Record - The size of the fixed unformatted state record exceeds the maximum length. 
0010 o 

o

o

o

o

o

Each field can contain only the type of data specified in its Field Description in Part II Record 

Layouts. 

Significant money amount fields must be right-justified (and zero-filled when transmitting in fixed 

format). Money amount fields must contain whole dollars (no cents). When a field is defined as "N 

(positive only)", the field must be present and must contain an amount greater than or equal to zero. 

For numeric fields that can contain a literal value, entries must be left-justified and blank-filled when 

transmitting in fixed format. When transmitting in variable format, only significant characters are 

transmitted.

When transmitting in fixed or variable format, significant date fields must contain numeric characters 

in the following formats, unless otherwise specified in Part II Record Layouts: 

Year fields with a length of four positions = YYYY, date fields with six positions = YYYYMM, date 

fields with eight positions = YYYYMMDD unless otherwise specified.

All alphanumeric fields must be left-justified (and blank-filled when transmitting in fixed format) unless 

otherwise specified. 

Form Payment - Taxpayer's Day Time Phone Number (SEQ 0090) is a required field and cannot 

equal all zeros or all blanks. 

0011 o Form 1040/1040A - When Exempt Self (SEQ 0160) equals "X", Total Exemptions (SEQ 0355) must 

be greater than zero. 

0012 o Form 1040/1040A - If Overpaid (SEQ 1260) is significant and ES Penalty Amount (SEQ 1300) is 

greater than Overpaid, then Amount Owed (SEQ 1290) must be significant. If Overpaid (SEQ 1260) 

is significant and ES Penalty Amount (SEQ 1300) is not greater than Overpaid, then Amount Owed 

(SEQ 1290) cannot be significant. 

0013 o RESERVED 

0014 o When there is an entry in a field defined as "NO ENTRY", the return will be rejected. 

0015 o Schedule A - The following literal values cannot be present in Other Expenses Type (SEQ 0420, 

0432) or in Other Expense Type (SEQ 0475): "CASUALTY", "CHILD CARE", "CHILD-CARE", 

"CHILDCARE", "DEPENDENT CARE", "MEDICAL", "THEFT". 

0016 o 

o

Tax Form - Zip Code (SEQ 0095) must be within the valid ranges of zip codes listed for the 

corresponding State Abbreviation (SEQ 0087). The zip code cannot end in "00", with the exception 

of 20500 (the White House zip code). 

Exception: This check is not performed when Address Ind 

(SEQ 0097) is equal to “3”, indicating a foreign address.”) 

0017 o Form 4137 - Tip Income Name (SEQ 0010) and Tip Income SSN (SEQ 0020) must be significant. 

0018 o Form 5329 - Name of Person Subject to Penalty Tax (SEQ 0010) 

and SSN of Person Subject to Penalty Tax (SEQ 0020) must be significant. 

0019 o 

o

o

Tax Form - When Direct Deposit information is present, Routing Transit Number (SEQ 1272) (RTN) 

must contain nine numeric characters. The first two positions must be 01 through 12, or 21 

through 32; the RTN must be present on the Financial Organization Master File (FOMF); and the 

banking institution must process Electronic Funds Transfer (EFT). 

Depositor Account Number (SEQ 1278) must be alphanumeric (i.e., only alpha characters, numeric 

characters, and hyphens), must be left-justified with trailing blanks if less than 17 positions, and 

cannot equal all zeros. 

If Routing Transit Number (SEQ 1272) or Depositor Account Number (SEQ 1278) is significant, then 

Checking Account Indicator (SEQ 1274) or Savings Account Indicator (SEQ 1276) must equal "X". 

Both cannot equal "X". 
0020 o 

o

o

Tax Form - Name Line 1 (SEQ 0060) cannot have leading or consecutive embedded spaces. The 

only characters permitted are alpha, space, ampersand (&), hyphen (-), and less-than sign (<). The 

left-most position must be alpha. The less-than sign replaces the intervening space to identify the 

primary taxpayer's last name and cannot be preceded by or followed by a space. 

Name Line 1 (SEQ 0060) is a required field. 

If the primary and the spouse have two different last names, the second less-than sign ("<") after the 

primary last name must be followed by an ampersand ("&"). 

0021 o Tax Form - Name Line 2 (SEQ 0070) is alphanumeric and cannot have leading or consecutive 

embedded spaces. The only special characters permitted are space, ampersand (&), hyphen (-), 

slash (/), and percent (%). 

0022 o 

o

o

Tax Form - State Abbreviation (SEQ 0087) must be significant and consistent with the standard state 

abbreviations issued by the Postal Service. 

State Abbreviation (SEQ 0087) is a required field. 

Exception: This check is not performed when Address Ind 

(SEQ 0097) is equal to “3”, indicating a foreign address.”) 

0023 o 

o

o

Tax Form - City (SEQ 0083) must be left-justified and must contain a minimum of three alpha 

characters. This field cannot contain consecutive embedded spaces and must contain only 

alphabetic characters and spaces. Do not abbreviate the city name. 

City (SEQ 0083) is a required field. 

Exception: This check is not performed when Address Ind 

(SEQ 0097) is equal to “3”, indicating a foreign address.”) 

0024 o Tax Form - If Address Ind (SEQ 0097) equals "1" (APO/FPO Address), then City (SEQ 0083) must 

equal "APO" or "FPO", and State Abbreviation (SEQ 0087) must equal "AA", "AE", or "AP" with the 

appropriate Zip Code (SEQ 0095). If State Abbreviation (SEQ 0087) equals "AA", "AE", or "AP", 

then Address Ind (SEQ 0097) must equal "1". 

0025 o 

o

o

Authentication Record - For Online returns only when PIN Type Code (SEQ 0008) is blank (No PIN 

used), the following fields must be present on the Authentication Record: Primary Date of Birth 

(SEQ 0010), the Taxpayer Signature Date (SEQ 0070) and Jurat/Disclosure Code (SEQ 0075) must 

be “B”. 

When the Primary Date of Death (0020) “AND” the Secondary Date of Death (0030) on the Tax 

Return are significant, only the Primary Fields (SEQ 0010, 0070, 0075) are required on the 

Authentication Record. 

Exception: When the Filing Status (SEQ 0130) equals “2”, AND the Primary Date of Death (SEQ 

0020) is significant and the Secondary Date of Death (SEQ 0040) on the Tax Return is “NOT” 

significant, the Primary Date of Birth (SEQ 0010) is not required on the Authentication Record. 

Note: Only the Spouse Fields (SEQ 0040, 0070, 0075) are required. 

0026 o 

o

Authentication Record - For Online returns only when PIN Type Code (SEQ 0008) is blank (No PIN 

used), if Filing Status 

(SEQ 0130) of the Tax Form equals "2", then the following 

fields must be present on the Authentication Record: Spouse Date of Birth (SEQ 0040), Taxpayer 

Signature Date (SEQ 0070) and Jurat/Disclosure Code (SEQ 0075) must be “B”. 

Exception: When the Secondary Date of Death (SEQ 0040) on the Tax Return is significant and the 

Primary Date of Death (SEQ 0020) is “NOT” significant, the Spouse Date of Birth (0040) is not 

required on the Authentication Record. 

Note: Only the Primary Fields (SEQ 0010, 0070, 0075) are required on the Authentication Record. 
0027 o 

o

Summary Record - Electronic Return Originator Name (SEQ 0010) must be significant. 

Electronic EFIN of ERO (SEQ 0020) must be significant and equal to EFIN of Originator (SEQ 

0008b) of Tax Return Record Identification Page 1. 

0028 o Tax Return Record Identification Page 1 – EFIN of Originator (SEQ 0008b) must contain a valid 

two-digit EFIN prefix code. 

0029 o Tax Return Record Identification Page 1 - EFIN of Originator (SEQ 0008b) must be for a valid 

electronic filer. 

0030 o

o

o

o

o

Taxpayer Identification Number (SEQ 0003) of all data records in a tax return must contain the same 

Primary SSN. 

Schedule Occurrence Number (SEQ 0005 of the Schedule Record Identification) and Form 

Occurrence Number (SEQ 0005 of the 

Form Record Identification) must be significant and in ascending, consecutive numerical sequence 

beginning with "0000001". 

Note: For multiple occurrences of a schedule or form, the Page Number (SEQ 0002 of the Schedule 

or Form Record Identifications) must be sequential within each occurrence of a Schedule or Form. 

All pages of a multiple-page schedule or form must be present. Listed below are exceptions to this 

rule:

-Page 2 may be present without Page 1 and vice versa for the following: Schedule E, Form 4684, 

Form 4797, Form 8283, 

Form 8824 and Form 8853. 

-Page 2 need not be transmitted if there are no entries for 

that page (but Page 2 cannot be present without Page 1) for the following: Schedule C, Schedule C 

(5713), Schedule D, Schedule F, Schedule H, Schedule O (5471), Schedule 2, Form 2441, 

Form 4562, Form 5329, Form 6251, 

Form 6765, Form 8275, Form 8275-R, Form 8582-CR, Form 8606, 

Form 8621, Form 8697, Form 8801, Form 8839, and Form 8915. 

-Pages 2, 3 and 4 are optional for Form 2210 but Page 2, 3 and 4 can not be present without Page 1.

-Pages 2 and 3 are optional for Form 8582 but page 2 or 3 can not be present without Page 1.

-Form 4136 Page 1 need not be transmitted if there are no entries for that page (but Page 1 

cannot be present without Page 2). 

-Pages 2-4 need not be transmitted if there are no entries for those pages (but these pages cannot 

be present without page 1) for the following: Form 5471, Form 5713 

-Form 8865 Pages 3-7 need not be transmitted if there are no entries for those pages. But these 

pages cannot be present without pages 1 and 2. 

-State Record ST 0001 may be present without ST 0002, but ST 0002 cannot be present without 

ST 0001. 

For Form 1040, Pages 1 and 2 must be present (Exception: State Only returns), and the following 

cannot be present: Form 1040A Pages 1 and 2, Schedule 1, Schedule 2, Schedule 3, Form 1040EZ.

For Form 1040A, Pages 1 and 2 must be present, and the following cannot be present: Form 1040 

Pages 1 and 2, Form 1040EZ. 

For Form 1040EZ, must be present, and the following cannot be present: Form 1040 Pages 1 and 2, 

Form 1040A Pages 1 and 2. 

Schedule K-1 (Form 8865) will not be accepted without a 

Form 8865 being filed.

0031 o Tax Return Record Identification Page 1 - Return Sequence Number (RSN) (SEQ 0007) must be 

numeric.

0032 o Tax Return Record Identification Page 1 - Declaration Control Number (DCN) (SEQ 0008) must be 

numeric.

0033 o

o

Fields within a record cannot be longer than specified in Part II Record Layouts. 

Name Line 1 (SEQ 0060) of the Tax Form can have a maximum of 35 characters; any more than 35 

will be dropped. 
0034 o Record ID Group - For each record, significant data must be present in the Record ID Group. 

0035 o Field Sequence Numbers within each record must be in ascending order and must be valid for that 

record.

0036 o Schedule C-EZ - Only one Schedule C-EZ is allowed for the Primary SSN and one for the Secondary 

SSN (a total of two Schedules C-EZ per tax return when Filing Status (SEQ 0130) equals "2"). When 

a taxpayer files Schedule C-EZ, no Schedule C is allowed for that taxpayer. 

0037 o Form 1040/1040A - The number of Dependent Name Controls (SEQ 0172, 0182, 0192, 0202 or in 

the related Statement Record), must equal the total of the following fields: Number of Children Who 

Lived with You (SEQ 0240), Number of Children Not Living with You (SEQ 0247), and Number of 

Other Dependents Listed (SEQ 0350). 

0038 o Form 1040A - Taxable Income (SEQ 0820) must be less than $100,000 and only the following can 

be present: Schedule 1, Schedule 2, Schedule 3, Schedule EIC, Form W-2, W-2GU, Form 1099-R, 

Form 1310, Form 2120, Form 2210, Form 8379, 

Form 8606, Form 8615, Form 8812, Form 8815, Form 8833, Form 8839, Form 8862, Form 8863, 

Form 8880, Form 8901, Form 8914, Form 8915 Form 9465, FEC Record, Authentication Record, 

Preparer Note Record, Election Explanation Record, Regulatory Explanation Record and 

Form Payment. 

0039 o Form 1040EZ - Primary taxpayer (and secondary taxpayer when Secondary SSN (SEQ 0030) is 

significant) must be under age 65. If born January 01, 1941, taxpayer is considered to be age 65 at 

the end of 2005. Taxable Interest (SEQ 0380) cannot exceed $1,500, Taxable Income (SEQ 0820) 

must be less than $100,000, and only the following can be present: Form W-2, W-2GU, 

Form 1310, Form 8379, Form 8833, Form 8862, Form 9465, FEC Record, Authentication Record, 

Preparer Note Record, Election Explanation Record, Regulatory Explanation Record and 

Form Payment. 

0040 o 

o

State-Only – If the State Abbreviation (SEQ 0087) is equal to “SO” in variable format of the Form 

1040 Page 1 record, then the highest sequence number present cannot be greater than the Address 

Indicator (SEQ 0097). 

If the State Abbreviation field is equal to “SO” in fixed format of the Form 1040 Page 1 record, then 

all fields beyond the Address Indicator field must be blank. 

0041 o Form 1040/1040A - Dependent entries must start on Line 1 of the dependent information. No lines 

may be skipped when completing the dependent information. 

0042 o State Only Returns – No other records, other than the following must be present: Form 1040 Page 1, 

State Generic Record, Unformatted Record and Summary Record. 

0043 o 

o

Form 1040/1040A – When Filing Status (SEQ 0130) equals "4", at least one of the following fields 

must be significant: 

Qualifying Name for H of Household (SEQ 0150) and SSN for Qual Name (SEQ 0153); Number of 

Children Who Lived with You (SEQ 0240); Number of Other Dependents Listed (SEQ 0350). 

When Qualifying Name for H of Household (SEQ 0150) is significant, SSN for Qual Name 

(SEQ 0153) must be significant and within the valid ranges of SSN/ITIN/ATIN's and cannot equal 

Primary SSN (SEQ 0010) or Secondary SSN (SEQ 0030). 

0044 o Record ID Group - The record has an invalid field in one of the Record ID Group. The error may be 

one of the following: 

-The Taxpayer Identification Number (SEQ 0003) within the Record ID does not match Primary SSN 

(SEQ 010) of the Tax Form. 

-The schedule or form is invalid for electronic filing or the page number is incorrect or duplicated. 

-Each record must be followed by a record terminus character (#). 

0045 o 

o

Record ID Group - The format and content of the Record ID Group that begins each record must be 

exactly as defined in Part II Record Layouts and must not duplicate another Record ID Group. 

If the Schedule/Form Occurrence Number (SEQ 0005) of Record ID is invalid, or is a duplicate, or 

exceeds the maximum number permitted for that record the return will be rejected. 
0046 o Schedule SE - SSN of Self-Employed (SEQ 0020) on the first Schedule SE must be significant and 

equal to Primary SSN (SEQ 0010) or Secondary SSN (SEQ 0030) of Form 1040. 

0047 o Schedule SE - SSN of Self-Employed (SEQ 0020) on the second Schedule SE must be significant 

and equal to Secondary SSN (SEQ 0030) of Form 1040 and must not be equal to SSN of 

Self-Employed (SEQ 0020) on the first Schedule SE. When both spouses are filing Schedule SE, 

the Schedule SE for the primary taxpayer must precede the Schedule SE for the secondary . 

0048 o Form 2106 - A maximum of two Forms 2106 may be present per individual (primary or secondary) on 

the return. SSN of Taxpayer with Employee Business Expense (SEQ 0009) of each Form 2106 

must be significant and must equal the appropriate SSN, either Primary SSN (SEQ 0010) or 

Secondary SSN (SEQ 0030) of Form 1040. When two or more Forms 2106 are present, the primary 

spouse’s form(s) must precede the secondary spouse’s form(s). 

0049 o Form 2106-EZ – A maximum of one Form 2106-EZ may be present per individual (primary or 

secondary) on the return. SSN of Taxpayer with Employee Business Expense (SEQ 0009) of each 

Form 2106-EZ must be significant and must equal the appropriate SSN, either Primary SSN (SEQ 

0010) or Secondary SSN (SEQ 0030) of Form 1040. When two Forms 2106-EZ are present, the 

primary spouse’s form must precede the secondary spouse’s form. 

0050 o 

o

o

Statement Record - The only valid entry in a Required Statement Record field (identified by an 

at-sign (@) in Part II Record Layouts) is a Statement Reference, i.e., "STMbnn". 

For Required Statement Records, Line 02 must be blank. Line 03 must be present and must contain 

significant data. 

For Required Statement Records, any Statement Reference number "STMbnn" occurring within a tax 

return must have a corresponding Statement Record. 

0051 o Statement Record - For Optional Statement Records (identified by an asterisk (*) in Part II Record 

Layouts), any Statement Reference number "STMbnn" occurring within a tax return must have a 

corresponding Statement Record. 

0052 o 

o

Statement Record - Optional Statement Records (identified by an asterisk (*) in Part II Record 

Layouts) are used only when the lines of data to be entered exceed spacing allowed on a schedule 

or form. 

For Optional Statement Records, Lines 01, 02, 03, and 04 must be present and must contain 

significant data. 

0053 o Statement Record - The number of Statement Records cannot exceed the number of Statement 

References within a tax return. 

0054 o Form 4137 - Tip Income SSN (SEQ 0020) on the first Form 4137 must equal Primary SSN 

(SEQ 0010) or Secondary SSN (SEQ 0030) 

of Form 1040. 

0055 o Form 8606 - SSN of Taxpayer with IRAs (SEQ 0010) must be significant and equal to Primary SSN 

(SEQ 0010) or Secondary SSN (SEQ 0030) of Form 1040/1040A. 

0056 o Form 8606 - SSN of Taxpayer with IRAs (SEQ 0010) on the second Form 8606 must be significant 

and equal to Secondary SSN (SEQ 0030) of Form 1040/1040A and must not be equal to SSN of 

Taxpayer with IRAs (SEQ 0010) on the first Form 8606. When both spouses are filing Form 8606, 

the Form 8606 for the primary taxpayer must precede the Form 8606 for the secondary taxpayer. 

0057 o Form 5329 - SSN of Person Subject to Penalty Tax (SEQ 0020) on the first Form 5329 must be 

significant and equal to Primary SSN (SEQ 0010) or Secondary SSN (SEQ 0030) of Form 1040. 

0058 o Form 5329 - SSN of Person Subject to Penalty Tax (SEQ 0020) on the second Form 5329 must be 

significant and equal to Secondary SSN (SEQ 0030) of Form 1040 and must not be equal to SSN of 

Person Subject to Penalty Tax (SEQ 0020) on the first Form 5329. When both spouses are filing 

Form 5329, the Form 5329 for the primary taxpayer must precede the Form 5329 for the secondary 

taxpayer. 
0059 o Form 4137 - Tip Income SSN (SEQ 0020) on the second Form 4137 must equal Secondary SSN 

(SEQ 0030) of Form 1040 and must not be equal to Tip Income SSN (SEQ 0020) on the first 

Form 4137. When both spouses are filing Form 4137, the Form 4137 for the primary taxpayer must 

precede the Form 4137 for the secondary taxpayer. 

0060 o Tax Return Record Identification Page 1 - Return Sequence Number (RSN) (SEQ 0007) must be in 

ascending numerical sequence within a transmission. However, the RSN's within the transmission 

do not have to be consecutive. 

0061 o Tax Return Record Identification Page 1 - Declaration Control Number (DCN) (SEQ 0008) must be in 

ascending numerical sequence within the transmission. However, the DCN's within the transmission 

do not have to be consecutive. 

0062 o Tax Return Record Identification Page 1 - The first two digits of the Declaration Control Number 

(DCN) (SEQ 0008) must be zeros. 

0063 o Tax Form - When Filing Status (SEQ 0130) equals "2", "3", or “4” and Exempt Spouse (SEQ 0163) 

equals “X”, both Primary SSN (SEQ 0010) and Secondary SSN (SEQ 0030) must be numeric. (The 

Filing Status of Form 1040EZ is considered to be "2" when Secondary SSN (SEQ 0030) is 

significant.) 

0064 o Tax Return Record Identification Page 1 - The Year Digit of Declaration Control Number (DCN) (SEQ 

0008) must be "6". 

0065 o Form 1040/1040A - When Exempt Spouse Ind (SEQ 0163) equals "X", Filing Status (SEQ 0130) 

must equal "2", “3”, or “4”.

0066 o

o

Form 1040/1040A - If any field of the following "dependent group" is significant, then all fields in that 

group must be significant: Dependent First Name, Dependent Last Name, Dependent Name Control, 

Dependent's SSN, and Relationship. 

Dependent Name Control (SEQ 0172, 0182, 0192, 0202) must be in the correct format. 

0067 o Form 1040/1040A - Dependent First Name (SEQ 0170, 0180, 0190, 0200) and Dependent Last 

Name (SEQ 0171, 0181, 0191, 0201) must contain only alpha characters and spaces. A space 

cannot be in the first position of either Dependent First Name or Dependent Last Name. 

0068 o Form 1040/1040A - When Dependent's SSN (SEQ 0175, 0185, 0195, 0205) is significant, it must be 

within the valid ranges of SSN/ITIN/ATIN's and cannot equal Primary SSN (SEQ 0010) or Secondary 

SSN (SEQ 0030) or another Dependent's SSN. It must equal all numeric characters and cannot 

equal all zeros or all nines. 

0069 o

o

Form 1040/1040A - When Filing Status (SEQ 0130) equals "2", 

Name Line 1 (SEQ 0060) must contain an ampersand (&). 

Form 1040EZ - When Secondary SSN (SEQ 0030) is significant, 

Name Line 1 (SEQ 0060) must contain an ampersand (&). 

0070 o Form 1040 - If Other Adjustments Literal (SEQ 0720) equals 

"JURY PAY", then at least one Type of Other Income (SEQ 0560) must equal "JURY PAY". 

0071 o Tax Form - When Secondary SSN (SEQ 0030) is significant, it must be within the valid ranges of 

SSN/ITIN's, cannot equal an ATIN, and cannot equal Primary SSN (SEQ 0010). It must equal all 

numeric characters and cannot equal all zeros or all nines. 

0072 o

o

Tax Form - When EIC Eligibility (SEQ 1183) equals "NO", Earned Income Credit (SEQ 1180) cannot 

be significant. 

Form 1040/1040A – When Schedule EIC is present, Earned Income Credit SEQ (1180) must be 

significant. 

0073 o Form 1040/1040A – When Filing Status (SEQ 0130) equals “5”; Number of Children who Lived with 

You (SEQ 0240) must be significant. 
0074 o Form 2441/Schedule 2 - Qualifying Person SSN (SEQ 0214, 0223) cannot equal another Qualifying 

Person SSN on the same Form 2441/Schedule 2 or in the related Statement Record. 

0075 o

o

o

o

Tax Form - If Earned Income Credit (SEQ 1180) is significant, then at least one of the following must 

be present for the 

Forms listed below. 

Form 1040: Household Help Literal (SEQ 0366) and Household Help Amt (SEQ 0367); Type of Other 

Income (SEQ 0560) and Amount of Other Income (SEQ 0570); Form W-2; Form W-2GU; 

Form 1099-R; Schedule C; Schedule C-EZ; Schedule E with Part/S-Corp Ind (SEQ 1172, 1210, 

1270, 1330) equal to "P"; Schedule F. 

Form 1040A: Household Help Literal (SEQ 0366) and Household 

Help Amt (SEQ 0367); Form W-2; Form W-2GU and Form 1099-R. 

Form 1040EZ: Household Help Literal (SEQ 0366) and Household Help Amt (SEQ 0368); Form W-2; 

Form W-2GU. 

0076 o Form 1040/1040A - If Taxable Interest (SEQ 0380) is greater 

than $1,500, or if Taxable Interest (SEQ 0290) of Schedule B/Schedule 1 is significant, then Taxable 

Interest (SEQ 0380) of Form 1040/1040A must equal Taxable Interest (SEQ 0290) from 

Schedule B/Schedule 1. 

0077 o Form 1040/1040A - If Total Ordinary Dividends (SEQ 0394) is greater than $1,500, or if Total 

Ordinary Dividends (SEQ 0525) of Schedule B/Schedule 1 is significant, then Total Ordinary 

Dividends (SEQ 0394) of Form 1040/1040A must equal Total Ordinary Dividends (SEQ 0525) from 

Schedule B/Schedule 1. 

0078 o Form 1040 - Capital Gain/Loss (SEQ 0450) must equal one of the following fields from Schedule D: 

Combined Net Gain/Loss (SEQ 2400) or Allowable Loss (SEQ 2540). 

0079 o Form 1040 - Rent/Royalty/Part/Estates/Trusts Inc (SEQ 0510) must equal Total Income or Loss 

(SEQ 1150) or Total Supplemental Income (Loss) (SEQ 2010) from Schedule E. 

0080 o Form 1040 - Current Year Moving Expenses (SEQ 0637) must equal Moving Exp Deduction 

(SEQ 0180) from Form(s) 3903. 

0081 o Form 1040 - If F4684 Literal (SEQ 0460) is not significant, then Other Gain/Loss (SEQ 0470) of 

Form 1040 must equal Redetermined Gain/Loss (SEQ 1030) from Form 4797. 

0082 o Form 1040 - If Schedule A is present, then Total Itemized or Standard Deduction (SEQ 0789) of 

Form 1040 must equal Total Deductions (SEQ 0520) from Schedule A. 

0083 o Form 1040/1040A - Credit for Child & Dependent Care (SEQ 0925) must equal Credit for Child & 

Dependent Care (SEQ 0339) from Form 2441/Schedule 2. 

0084 o Form 1040/1040A - Credit for Elderly or Disabled (SEQ 0930) of Form 1040 or 1040A must equal 

Credit (SEQ 0290, Schedule 3) and SEQ 0290, Schedule R. 

0085 o Schedule R/Schedule 3 - Taxable Disability (SEQ 0150) must be significant when one of the 

following fields equals "X": Retire/Disabled (SEQ 0020); Both Under 65, One Retired (SEQ 0040); 

Both Under 65, Both Retired (SEQ 0050); One Over 65, Other Retired (SEQ 0060); Under 65, Did 

Not Live With Spouse (SEQ 0090). 

0086 o Form 1040 - If Exempt/Form 4361 Box (SEQ 0025) of Schedule(s) SE and Exempt SE Tax Indicator 

(SEQ 1035) of Form 1040 are blank, then Self Employment Tax (SEQ 1040) of Form 1040 must 

equal Self-Employment Tax (SEQ 0160) from Schedule(s) SE. 

0087 o Form 1040 - Alternative Minimum Tax (SEQ 0918) must equal Alternative Minimum Tax (SEQ 0340) 

from Form 6251. 
0088 o Form 1040/1040A - Overpaid (SEQ 1260) must equal the total of the following fields: Refund 

(SEQ 1270), Applied to ES Tax (SEQ 1280), and ES Penalty Amt (SEQ 1300). 

0089 o 

o

Form 1040 - When Total Alimony Paid (SEQ 0697) is significant, Recip Soc Sec No. (SEQ 0693) 

must be significant, and vice versa. 

When Recip Soc Sec No. (SEQ 0693) is significant, it must be within the valid ranges of SSN/ITIN's, 

cannot equal an ATIN, and cannot equal Primary SSN (SEQ 0010). 

0090 o Form 2441/Schedule 2 - When Form 2441/Schedule 2 is present, at least one of the following fields 

must be significant: Dependent Care Benefits Literal (SEQ 0371) of Form 1040/1040A; Dependent 

Care Benefits (SEQ 0210) of Form W-2; Credit for Child & Dependent Care (SEQ 0339) of 

Form 2441/Schedule 2 or if Form 1040/1040A (SEQ 0915/0860) is not significant,then the Credit for 

Child & Dependent Care (SEQ 0339) ofForm 2441/Schedule 2 must be zero. 

0091 o Form 1040/1040A – If Filing Status (SEQ 0130) equals “3”, Exempt Spouse Name (SEQ 0164) or 

Exempt Spouse Name Control (SEQ 0165) cannot be present. 

0092 o RESERVED 

0093 o 

o

Form 2441/Schedule 2 - EIN/SSN Type (SEQ 0045) of 

Form 2441/Schedule 2 must equal "S" or "E". 

Exception: If SSN/EIN (SEQ 0040) equals "TAXEXEMPT" then EIN/SSN Type (SEQ 0045) may 

equal blank. 

0094 o Form 6252 - If Line 24 Minus Line 25 (SEQ 0290) or Line 35 Minus Line 36 (SEQ 0460) is significant, 

then Schedule D or Form 4797 must be present. 

0095 o 

o

Form 2441/Schedule 2 - If Total Qualified Expenses or Limit (SEQ 0230), or Credit for Child & 

Dependent Care (SEQ 0339), or Net Allowable Amount (SEQ 0600) is greater than zero, then 

Qualifying Person SSN - 1 (SEQ 0214) must be significant. The Qualifying Person information on 

Line 2 is not required when Prior Year Expense Literal (SEQ 0318), Prior Year Qualifying Person 

Name (SEQ 0324), and Prior Year Qualifying Person SSN (SEQ 0326) are present and there are no 

current year expenses. 

If Credit for Child & Dependent Care (SEQ 0339) is significant, and Total Qualified Expenses or Limit 

(SEQ 0230) or Net Allowable Amount (SEQ 0600) is greater than zero, then Primary Earned Income 

(SEQ 0260) (and Spouse's Earned Income (SEQ 0270) when Filing Status (SEQ 0130) of 

Form 1040/1040A equals "2") must be significant. 

0096 o RESERVED 

0097 o 

o

Form 1040 – When Capital Distribution Box (SEQ 0447) equals to “X”, Capital Gain/Loss (SEQ 0450) 

must be significant, Schedule D must not be present. 

When Capital Distribution Box (SEQ 0447) is not equal to “X” and Capital Gain/Loss (SEQ 0450) is 

significant, Schedule D must be present. 

0098 o Schedule C – Gross Receipts Less Returns Allowances (SEQ 0220) must equal Gross 

Receipts/Sales (SEQ 0200) minus Returns/Allowances (SEQ 0210). 

0099 o Form 1040 - Business Income/Loss (SEQ 0440) must equal the total of Net Profit (Loss) (SEQ 0710) 

from Schedule(s) C plus Net Profit (SEQ 0710) from Schedule(s) C-EZ. 

0100 o Schedule C - When Net Profit (Loss) (SEQ 0710) is less than zero and Some Is Not At Risk 

(SEQ 0730) equals "X", Form 6198 must be present. 

0101 o Form 4952 - At least one of the following fields must be greater than zero: Investment Interest 

Expense (SEQ 0010), Carryover Disallowed Interest Expense (SEQ 0020), Investment Interest 

Expense Deduction (SEQ 0170). 
0102 o Schedule E - If Any Amount is Not At Risk (SEQ 1180, 1238, 1298, 1358) equals "X" on any 

Schedule E, and the corresponding Part/S-Corp Nonpassive Sch K-1 Loss (SEQ 1192, 1253, 1313, 

1373) is significant, then Form 6198 must be present. 

0103 o 

o

o

o

Tax Form – If Withholding (SEQ 1160) is greater than $500, then at least one of the following must 

be present for the forms listed below. 

Form 1040: Other 1099 Withholding Literal (SEQ 1155); Withholding (SEQ 0130) on Form W-2 or 

Form W-2GU; Withholding (SEQ 0160) on Form 1099-R; Withholding (SEQ 0050) on Form W2-G. 

Form 1040A: Other 1099 Withholding Literal (SEQ 1155); Withholding (SEQ 0130) on Form W-2 or 

Form W-2GU; Withholding (SEQ 0160) on Form 1099-R. 

Form 1040EZ: Other 1099 Withholding Literal (SEQ 1155); Withholding (SEQ 0130) on Form W-2 or 

Form W-2GU. 

0104 o 

o

o

o

o

Form 1040/1040A/1040EZ - The wages on Form W-2(s) (SEQ 0120) must equal or be less than the 

Wages of Forms 1040/1040A/1040EZ (SEQ 0375). 

Exceptions:

a. If SEQ (0375) of Forms 1040/1040A/1040EZ is within $5.00 (< or >) of the total W-2s then do not 

reject the return. 

b. If Statutory Employee (SEQ 0265) of Form W-2 equal “X”, and no withholding in (SEQ 0130) 

then bypass this check. 

c. If Statutory Employee (SEQ 0265) of Form W-2 equal “X”, and Schedule C or Schedule C-EZ is 

attached, then bypass this check. 

d. If Form 1040/1040A Wages (SEQ 0375) are less the Wages of the Form W-2(s) and Form 8839 

Adoption Literal (SEQ 0368) equals “SNE” or “PYAB”, then do not reject the return. 

0105 o Tax Form - When Direct Deposit information is present, the following fields must be significant: 

Routing Transit Number (SEQ 1272); Checking Account Indicator (SEQ 1274) or Savings Account 

Indicator (SEQ 1276); Depositor Account Number (SEQ 1278); and RAL Indicator (SEQ 1465). 

0106 o Schedule E - If more than one Schedule E is present, only the first occurrence of Schedule E can 

contain entries in the following fields: SEQ 0125, 0155, 0380, 1000, 1040, 1110, 1120, 1150, 1445, 

1455, 1475, 1485, 1495, 1750, 1755, 1765, 1913, 1917, 1923, 1927, 1933, 1937, 1939, 1943, 1945, 

1977, 1991, 2010, and 2020. 

0107 o 

o

Schedule SE - If SST Wages/RRT Comp (SEQ 0088) or Unreported Tips (SEQ 0090) is significant, 

then Total Wages/Unreported Tips (SEQ 0100) must be significant. 

Exception: This check is not performed when SST Wages/RRT Comp (SEQ 0088) is equal to or 

greater than $90,000. 

0108 o 

o

Form 1040/1040A - If Overpaid (SEQ 1260) is greater than zero, then Total Payments (SEQ 1250) 

must be greater than Total Tax (SEQ 1150). 

Form 1040EZ - If Refund (SEQ 1270) is greater than zero, then Total Payments (SEQ 1250) must be 

greater than Total Tax (SEQ 1256). 

0109 o 

o

Form 1040/1040A - If Primary SSN (SEQ 0010) or Secondary SSN (SEQ 0030) is equal to an ITIN, 

then Earned Income Credit (SEQ 1180) cannot be significant and Schedule EIC cannot be present. 

Form 1040EZ - If Primary SSN (SEQ 0010) or Secondary SSN (SEQ 0030) is equal to an ITIN, then 

Earned Income Credit (SEQ 1180) cannot be significant. 

0110 o Form 1040 – If both Schedule D and Schedule J are present, thenTax (SEQ 0915) of Form 1040 

must equal or be greater than Subtract Line 21 from Line 17 (SEQ 0220) of Schedule J. 
0111 o Form 1040/1040A- When Must Itemize Indicator (SEQ 0786) equals "X", Filing Status (SEQ 0130) 

must equal "3". 

0112 o 

o

Form 1040 - When Retirement Tax Plan Literal (SEQ 1095) is blank, Tax on Retirement Plans 

(SEQ 1100) must equal the total of the following fields from Form(s) 5329: Total Section 72 

Additional Tax on Early Distributions (SEQ 0078), Additional Tax on Certain Distr from Educ Accts 

(SEQ 0091), Excess Contributions Tax on Traditional IRA (SEQ 0160), Excess Contributions Tax on 

Roth IRA (SEQ 0280), Excess Contribution Tax on Ed IRA (SEQ 0570), Excess Contributions Tax on 

MSA (SEQ 0660), Excess Contributions Tax on HSA (SEQ 0750), and Tax on Excess Accumulations 

(SEQ 0850). 

When Retirement Tax Plan Literal (SEQ 1095) equals "NO", Form 5329 does not have to be present, 

but Tax on Retirement Plans (SEQ 1100) of Form 1040 must be significant. 

0113 o Schedule A - When Non-Cash/Check Contribution (SEQ 0360) is greater than $500, Form 8283 must 

be present. 

0114 o Form 1040/1040A - If Taxable Amount of Social Security (SEQ 0557) is significant, then Social 

Security Benefits (SEQ 0553) must be significant. 

0115 o Form 1040 - If Railroad Retire Indicator (SEQ 1070) is blank, then Social Security & Medicare Tax on 

Tips (SEQ 1080) of Form 1040 must equal F1040 Social Security Medicare Tax on Tips (SEQ 0200) 

from Form(s) 4137. 

0116 o Form 1040/1040A - If Total Payments (SEQ 1250) is not equal to Total Tax (SEQ 1150), then at least 

one of the following fields must be significant: Overpaid (SEQ 1260), Refund (SEQ 1270), Applied to 

ES Tax (SEQ 1280), Amount Owed (SEQ 1290). 

0117 o Schedule C - At least one of the following fields must be significant: Gross Receipts/Sales 

(SEQ 0200), Gross Income (SEQ 0270), Total Expenses (SEQ 0700), Tentative Profit/Loss 

(SEQ 0702), Net Profit (Loss) (SEQ 0710). 

0118 o 

o

Form 5329 - Name of Person Subject to Penalty Tax (SEQ 0010) must contain a less-than sign 

immediately preceding the last name. If the name includes a suffix, another less-than sign is entered 

between the last name and the suffix. Allowable characters are: Alpha, hyphen (-), less-than (<), and 

space.

The following cannot be present: Two or more consecutive embedded spaces, a space or less-than 

sign in the first position, a less-than sign in the last position, more than two less-than signs, a space 

preceding or following a less-than sign. 

0119 o 

O

Form 1040A - If Filing Status (SEQ 0130) equals "3", then State Abbreviation (SEQ 0087) cannot 

equal any of the following states: AZ (Arizona), CA (California), ID (Idaho), LA Louisiana), NM (New 

Mexico), NV (Nevada), TX (Texas),WA (Washington), and WI (Wisconsin). 

Exception: If Filing Status equals "3" and Address Ind (SEQ 0097) equals "2" (Stateside Military 

Address), then the State Abbreviation (SEQ 0087) may equal one of the Community Property states 

listed above. 

0120 o RESERVED 

0121 o Form 1040/1040A - Pensions Annuities Received (SEQ 0485) cannot equal Taxable Pensions 

Amount (SEQ 0495). 

0122 o 

o

Form W-2 - Employer Identification Number (SEQ 0040) must be numeric, the first two digits of 

Employer Identification Number (SEQ 0040) must equal a valid District Office Code, Employer Name 

Control (SEQ 0045) must be significant, and W-2 Indicator (SEQ 0590) must equal "N" or "S." 

Note: The value "N" (Non-Standard) indicates that the Form W-2 was altered, handwritten, or typed, 

or that a cumulative Earnings Statement or a substitute Form W-2 was used. The value "S" 

(Standard) identifies a Form W-2 that is a computer-produced print, an IRS form, or an IRS-approved 

facsimile.
0123 o 

o

o

Form W-2 - The following fields must be significant: Employer Name (SEQ 0050), Employer Address 

(SEQ 0060), Employee Name (SEQ 0090), Employee Address (SEQ 0100); Employee City 

(SEQ 0110), Employee State (SEQ 0113), Employee Zip Code (SEQ 0115), and Wages 

(SEQ 0120). 

Exception: The check for Wages (SEQ 0120) is bypassed when Combat Pay has been excluded 

from Wages. 

Exception: When a period (.) is present in the Employee State (SEQ 0113) on Form W-2, the checks 

for Employee City (SEQ 0110) and Employee Zip Code (SEQ 0115) are bypassed. 

0124 o Form W-2G - The following fields must be significant: Payer Name Control (SEQ 0015), Payer Name 

(SEQ 0020), and Payer Identification Number (SEQ 0026). 

0125 o Form 1099-R - The following fields must be significant: Payer Name Control (SEQ 0015), Payer 

Name (SEQ 0020), and Payer Identification Number (SEQ 0050). 

0126 o 

o

o

o

Tax Form – If any Paid Preparer information (SEQ 1340, 1350, 1360, 1370, 1380, 1390, 1400, 1410) 

is significant, then either Preparer SSN/Preparer TIN (SEQ 1360) or Preparer Firm EIN (SEQ 1380) 

must be significant. 

If Preparer SSN/Preparer TIN (SEQ 1360) is significant, it must equal all numeric characters and 

cannot equal all zeros or all nines; or the first position must equal “P” or “S” and the last positions 

must be numeric characters and cannot equal all zeros or all nines. 

If Preparer Firm EIN (SEQ 1380) is significant, it must equal all numeric characters and cannot equal 

all zeros or all nines. 

When Paid Preparer information (SEQ 1340-1420) is significant, Non-Paid Preparer (SEQ 1338) 

cannot be significant, and vice versa. 

0127 o Form 1040/1040A - If Total Payments (SEQ 1250) is greater than Total Tax (SEQ 1150), and the 

total of Applied to ES Tax (SEQ 1280) plus ES Penalty Amount (SEQ 1300) is equal to Overpaid 

(SEQ 1260), then Refund (SEQ 1270) cannot be significant. 

0128 o Form 1040/1040A - If Total Payments (SEQ 1250) is greater than Total Tax (SEQ 1150), and the 

total of Applied to ES Tax (SEQ 1280) plus ES Penalty Amount (SEQ 1300) is less than Overpaid 

(SEQ 1260), then Refund (SEQ 1270) must be greater than zero. 

0129 o Form 1040/1040A - If Total Payments (SEQ 1250) equals Total Tax (SEQ 1150), then the following 

fields cannot be significant: Overpaid (SEQ 1260), Refund (SEQ 1270), and Applied to ES Tax 

(SEQ 1280).

0130 o 

o

Form 1040/1040A - If Total Itemized or Standard Deduction (SEQ 0789) contains one of the following 

amounts: $6,000, 7,000, 6,250, 7,500, 8,550, 11,000, 9,800, 12,000, 13,000, or 14,000; and Modified 

Standard Deduction Ind (SEQ 0787) of Form 1040 is blank; then at least one of following fields must 

equal "X": Self 65 or Over Box (SEQ 0772), Self Blind Box (SEQ 0774), Spouse 65 or Over Box 

(SEQ 0776), Spouse Blind Box (SEQ 0778). 

Exception for Form 1040: This check is not performed when one or more of the following forms are 

present: Schedule A, Form 4563. 

0131 o Form 1040/1040A - If Number of Children Not Living with You (SEQ 0247) is significant, then at least 

one Relationship (SEQ 0177, 0187, 0197, 0207) must equal "CHILD", "DAUGHTER", 

"GRANDCHILD", or "SON". 

0132 o Form 1040 – When Capital Distribution Box equals to “X”, Capital Gain/Loss (SEQ 0450) must 

contain a positive amount. 

0133 o Schedule R/Schedule 3 - If Nontaxable SSB/RRB (SEQ 0163) or Nontaxable Other (SEQ 0167) is 

significant, then Pensions & Annuities (SEQ 0170) must be significant. 
0134 o 

o

o

Form 1040 - If Exempt Self (SEQ 0160) equals "X", and Must Itemize Indicator (SEQ 0786), and 

Modified Standard Deduction Ind (SEQ 0787) and Itemize Election Ind (SEQ 0788) are blank, and 

Schedule A and Form 4563 are not present; then Total Itemized or Standard Deduction (SEQ 0789) 

must equal a valid standard deduction. 

Form 1040 – When MFJ, and Exempt Self (SEQ 0160) and Exempt Spouse (SEQ 0163) equals “X” and 

Must Itemize Indicator (SEC 0786) and Modified Standard Deduction Ind (SEQ 0787) are blank; then 

Total Itemized or Standard Deduction (SEC 0789) must equal a valid standard deduction 

Form 1040A – If Exempt Self (SEQ 0160) equals "X", and Must Itemize Indicator (SEQ 0786) and 

Modified Standard Deduction Ind (SEQ 0787) are blank; then Total Itemized or Standard Deduction 

(SEQ 0789) must equal a valid standard deduction. 

 o Form 1040A – When MFJ, and Exempt Self (SEQ 0160) and Exempt Spouse (SEQ 0163) equals “X” 

and Must Itemize Indicator (SEC 0786) and Modified Standard Deduction Ind (SEQ 0787) are blank; 

then Total Itemized or Standard Deduction (SEC 0789) must equal a valid standard deduction. 

0135 o Form 1040 - When F4684 Literal (SEQ 0460) equals "F4684", Form 4684 must be present. 

0136 o 

o

Form 1040 - If Form 2210 or Form 2210F is present, then ES Penalty Amount (SEQ 1300) of 

Form 1040 must equal Underpayment Penalty/Short Method (SEQ 0245) or Total Underpayment 

Penalty (SEQ 0671) from Form 2210, or Underpayment Penalty/Farmers Fishermen (SEQ 0180) 

from Form 2210F. 

Form 1040A - If Form 2210 is present, then ES Penalty Amount (SEQ 1300) of Form 1040A must 

equal Underpayment Penalty/Short Method (SEQ 0245) or Total Underpayment Penalty (SEQ 0671) 

from Form 2210. 

0137 o Form 2441/Schedule 2 - When SSN/EIN 1 or 2 (SEQ 0040, 0090) is significant, the corresponding 

Amount Paid 1 or 2 (SEQ 0050, 0100) must be significant. 

0138 o Form 1040/1040A – Total Exemptions (SEQ 0355) must equal the total of the following fields: Total 

Box 6a and 6b (SEQ 0167); Number of Children Who Lived with You (SEQ 0240); Number of 

Children Not Living with You (SEQ 0247); and Number of Other Dependents Listed (SEQ 0350). 

0139 o Form W-2 - Employee SSN (SEQ 0080) must equal Primary SSN (SEQ 0010) or Secondary SSN 

(SEQ 0030) of the Tax Form.

0140 o Form 1040 - Farm Income (SEQ 0520) must equal Net Farm Profit or Loss (SEQ 0680) from 

Schedule(s) F. 

0141 O Schedule F – At least one of the following fields must be significant: Gross Income Amount 

(SEQ 0280), Total Expenses (SEQ 0650), Net Farm Profit or Loss (SEQ 0680). 

0142 o Schedule F – Accounting Method Cash Indicator (SEQ 0050) or Accounting Method Accrual 

Indicator (SEQ 0060) must equal "X". Both indicators cannot equal "X". 

0143 o Schedule F – Materially Participate Yes Indicator (SEQ 0100) and Materially Participate No Indicator 

(SEQ 0110) cannot both equal "X" and cannot both equal blank. 

0144 o RESERVED 

0145 o If Line 24 of Form 1040, Bus Expenses Reservists & others (SEQ 0624) is significant, then Form 

2106/2106-EZ must be attached, else reject the return. 

0146 o Tax Form - When Unemployment Compensation (SEQ 0552) is significant, it must be numeric and 

greater than zero. 

0147 o Form 2210 – One of the following fields must equal "X": Waiver Entire Penalty Box (SEQ 0135), 

Waiver of Part of Penalty Box (SEQ 0145), Annualized Income Installment Method Box (SEQ 0155), 

Actually Withheld Box (SEQ 0165) or Joint Return Box (SEQ 0173). 
0148 o 

o

Form 2210 - When Waiver of Entire Penalty Box (SEQ 0135) or Waiver of Part Penalty Box (SEQ 

0145) equals "X", either Waived Explanation/Short Method (SEQ 0233) or Waiver Explanation 

(SEQ 0669) must equal "STMbnn". 

Form 2210F - When Waiver of Penalty Box (SEQ 0013) equals "X", Waiver Explanation (SEQ 0177) 

must equal "STMbnn". 

0149 o Schedule C - When Other Clos Inv Method (SEQ 0744) equals "X", Other Meth Explanation 

(SEQ 0746) must equal "STMbnn". 

0150 o

o

Form 1040 - When F4255 Literal (SEQ 1121) and F4255 Amount (SEQ 1122) are significant, 

Form 4255 must be present and Total Increase Tax (SEQ 0530) of Form 4255 must be significant. 

When Form 4255 is present, F4255 Literal (SEQ 1121) and F4255 Amount (SEQ 1122) of 

Form 1040 must be significant. 

0151 o Summary Record - Number of Logical Records in Tax Return 

(SEQ 0040) must equal the total logical record count computed by the IRS. 

0152 o Summary Record - Number of Forms W-2 (SEQ 0050) must equal the number of Forms W-2 

computed by the IRS. 

0153 o Summary Record - Number of Forms W-2G (SEQ 0060) must equal the number of Forms W-2G 

computed by the IRS. 

0154 o Summary Record - Number of Forms 1099-R (SEQ 0070) must equal the number of Forms 1099-R 

computed by the IRS. 

0155 o Summary Record - Number of Schedule Records (SEQ 0080) must equal the number of schedule 

records computed by the IRS. 

0156 o Summary Record - Number of Form Records (SEQ 0090) must equal the number of form records 

computed by the IRS. 

0157 o Summary Record - Number of Statement Record Lines (SEQ 0100) must equal the number of 

statement record lines computed by the IRS. 

0158 o Form 1040/1040A - If Credit for Elderly or Disabled (SEQ 0930) is significant, and Self 65 or Over 

Box (SEQ 0772) and Spouse 65 or Over Box (SEQ 0776) are blank, then one of the following fields 

from Schedule R/Schedule 3 must be significant: Retire/Disabled (SEQ 0020); Both Under 65, One 

Retired (SEQ 0040); Both Under 65, Both Retired (SEQ 0050); Under 65, Did Not Live with Spouse 

(SEQ 0090). 

0159 o Form 1040EZ – When the Self Claimed Dependent Ind (SEQ 0770) and the Spouse Claimed 

Dependent Ind (SEQ 0775) are blank, then Combined Standard Deduction and Personal Exemption 

(SEQ 0815) must equal $8,200 when Secondary SSN (SEQ 0030) is not significant, and must equal 

$16,400 when Secondary SSN (SEQ 0030) is significant. 

0160 o 

o

Form 1040EZ - When the Self Claimed Dependent Ind (SEQ 0770) and the Spouse Claimed 

Dependent Ind (SEQ 0775) equals "X", then Combined Standard Deduction and Personal 

Exemption (SEQ 0815) cannot exceed $10,000 when Secondary SSN (SEQ 0030) is significant. 

When the Self Claimed Dependent Ind (SEQ 0770) equals "X", then Combined Standard Deduction 

and Personal Exemption (SEQ 0815) cannot exceed $5,000 when the Secondary SSN (SEQ 0030) 

is NOT significant. 

0161 o RESERVED 

0162 o 

o

Form 1040EZ - Earned Income Credit (SEQ 1180) cannot exceed $399 and Adjusted Gross Income 

(SEQ 0750) must be less than $11,750 if single, and cannot exceed $13,750 if Married Filing Jointly. 

When the Self Claimed Dependent Ind (SEQ 0770) or the Spouse Claimed Dependent Ind (SEQ 

0775) equals "X", Earned Income Credit (SEQ 1180) cannot be significant. 

0163 o Schedule R/Schedule 3 – Only one of the following fields must be significant: SEQ 0010, 0020, 

0030, 0040, 0050, 0060, 0070, 0080, 0090. 
0164 o

o

o

o

Form 1040/1040A – If Credit for Retirement Savings Contribution (SEQ 0937) is significant, then all 

of the following apply: 

Form 8880 must be attached. 

Credit for Retirement Savings Contribution (SEQ 0937) cannot exceed the maximum possible credit 

for the Filing Status 

(SEQ 0130). The maximum possible credit is $1000 for "Head of Household", "Single", “Married 

Filing Separate”, and “Qualifying Widow(er)”, and $2000 for "Married Filing Joint". 

Adjusted Gross Income (SEQ 0750) cannot exceed the applicable AGI limit for the Filing Status 

(SEQ 0130). The applicable limits are $50,000 for "Married Filing Joint", $37,500 for 

"Head of Household", and $25,000 for "Single", “Married Filing Separate”, and “Qualifying 

Widow(er)”. 

0165 o Form 8880 – If Credit Contributions (SEQ 0200) is significant, then it must equal Credit for 

Retirement Savings Contribution 

(SEQ 0937) of Tax Form. 

0166 o Form 8880 – Total Line 6a and 6b (SEQ 0130) must be greater than zero. 

0167 o Form 9465 – Monthly Payment Date (SEQ 0310) must be significant and must be within the 01 to 28 

range. 

0168 o Form 9465 – Monthly Payment (SEQ 0300) must be equal to or greater than $25. 

0169 o Schedule E - At least one of the following fields must be significant on the first occurrence of 

Schedule E: Total Rents Received (SEQ 0125); Total Royalties Rec'd (SEQ 0155); Rental & Royalty 

Deduction (SEQ 1000); Total Income (SEQ 1110); Total Losses (SEQ 1120); Part/S-Corp Name A 

(SEQ 1170); Tot Part/S-Corp Income (SEQ 1750); Tot Part/S-Corp Loss and Sec 179 Deduction 

(SEQ 1755); Tot Estate/Trust Inc (SEQ 1933); Tot Estate/Trust Loss (SEQ 1937); Total REMIC 

Income (SEQ 1977); Net Farm Rental Income/Loss (SEQ 1991); Farming/Fishing Share 

(SEQ 2020); Net Rental Real Estate Income/Loss (SEQ 2030). 

0170 o Schedule A - Casualty/Theft Loss (SEQ 0390) must equal Line16 (SEQ 0430) or Line 21 

(SEQ 0453) from Form 4684. 

0171 o Form 4797 - When Form 4684 is present, Gain/Loss for Entire Year (Form 4684 Sec B Gain) 

(SEQ 0440) of Form 4797 must equal Loss Equal to or Smaller than Gain (SEQ 1120) from Form 

4684. 

0172 o Form 9465 - Amount Owed on Tax Return (SEQ 0280) cannot be greater than $25,000. 

0173 o RESERVED 

0174 o RESERVED 

0175 o Form 1040 - When Other Adjustment Amount (SEQ 0730) or Total Other Adjustments (SEQ 0735) is 

significant, Total Adjustments (SEQ 0740) must be significant. 

0176 o Form 1040 - Total Other Adjustments (SEQ 0735) must equal the total of Other Adjustment Amount 

(SEQ 0730 or amounts from corresponding statement record) plus MSA Amount (SEQ 0733). 

0177 o Tax Form - If Earned Income Credit (SEQ 1180) is significant and Schedule E is not present, then 

the total of the following fields cannot exceed $2,700 unless Form 4797 is attached: Taxable Interest 

(SEQ 0380), Tax-Exempt Interest (SEQ 0385), Total Ordinary Dividends (SEQ 0394) of 

Form 1040/1040A, and Capital Gain/Loss (SEQ 0450) (when greater than zero) of Form 1040. 

0178 o Form 1040 – When Specify Other Credit Block (SEQ 1006) equals “X”, one of the following forms 

must be present: Form 3468, Form 5884, Form 5884-A, Form 6478, Form 6765, Form 8586, Form 

8820,Form 8826, Form 8830, Form 8834, Form 8835, Form 8844,Form 8845, Form 8846, Form 

8847, Form 8860, Form 8861, Form 8864, Form 8874, Form 8881, Form 8882 or Form 8896 unless 

Specify Other Credit Literal (Seq. 1010) contains "TRANS ALASKA". 

0179 o RESERVED 
0180 o 

o

o

Form 4835 - When one Form 4835 is present, Net Farm Rental Income/Loss (SEQ 1991) of 

Schedule E must equal one of the following fields from Form 4835: Net Farm Rent Profit (SEQ 0610) 

or Net Farm Rent (Loss) (SEQ 0630). 

When multiple Forms 4835 are present, Net Farm Rental Income/Loss (SEQ 1991) of Schedule E 

must equal the sum of the following from Forms 4835: Net Farm Rent Profit (SEQ 0610) (when 

greater than zero) minus Net Farm Rent (Loss) (SEQ 0630). 

Note: Net Farm Rent (Loss) (SEQ 0630) of Form 4835 is assumed to be a loss; the minus sign is not 

transmitted.

0181 o Form 4835 - If Some is Not at Risk (SEQ 0620) equals "X" on one or both Form(s) 4835, then 

Form 6198 or Form 8582 must be present. 

0182 o Schedule F - When Net Farm Profit or Loss (SEQ 0680) is less than zero and Some Is Not at Risk 

Indicator (SEQ 0700) equals "X", Form 6198 must be present. 

0183 o Schedule C - If Car/Truck Expenses (SEQ 0293) is significant, then Vehicle Service Date 

(SEQ 0820) must be significant, or Form 4562 must be present. 

0184 o 

o

o

o

Schedule E - If Net Farm Rental Income/Loss (SEQ 1991) on the first occurrence of Schedule E is 

present, then Form 4835 must be present. 

When one Form 4835 is present, Net Farm Rental Income/Loss (SEQ 1991) of Schedule E must 

equal one of the following fields from Form 4835: Net Farm Rent Profit (SEQ 0610) or Net Farm 

Rent (Loss) (SEQ 0630). 

When multiple Forms 4835 are present, Net Farm Rental Income/Loss (SEQ 1991) of Schedule E 

must equal the sum of the following from Forms 4835: Net Farm Rent Profit (SEQ 0610) (when 

greater than zero) minus Net Farm Rent (Loss) (SEQ 0630). 

Note: Net Farm Rent (Loss) (SEQ 0630) of Form 4835 is assumed to be a loss; the minus sign is not 

transmitted.

0185 o Schedule C - When Business Miles (SEQ 0830) is significant, then Vehicle Service Date (SEQ 0820) 

must be present. 

0186 o Form 8829 – Total of “Home Business Expense” (SEQ 0703) of all Schedules C present must equal 

total of “Schedule C Allowable Expenses” (SEQ 0450) from all Forms 8829 present. 

0187 o Schedule C - Employer ID Number (SEQ 0060) cannot equal Primary SSN (SEQ 0010) or 

Secondary SSN (SEQ 0030) of Form 1040. 

0188 o Form 1040/1040A - When Filing Status (SEQ 0130) equals "3", Earned Income Credit (SEQ 1180) 

cannot be significant. 

0189 o Form 1040 - If Total Adjustments (SEQ 0740) is significant, then at least one of the following fields 

must be significant: SEQ 0623, 0624, 0635, 0637, 0640, 0645, 0650, 0670, 0680, 0697, 0700, 0702, 

0705, 0710, 0730, 0733, 0735. 

0190 o RESERVED

0191 o 

o

Form 1040 - Total Credits (SEQ 1020) must equal the total of the following fields: Credit for Child & 

Dependent Care (SEQ 0925), Credit for Elderly or Disabled (SEQ 0930), Education Credits (F8863) 

(SEQ 0935), Credits from F8396 & F8859 (SEQ 0995), Foreign Tax Credit (SEQ 0922), Child tax 

Credit (SEQ 0940), Credit for Retirement Savings Contribution (SEQ 0937), Adoption Credit 

(SEQ 0960) and Other Credits (SEQ 1015). 

Form 1040A - Total Credits (SEQ 1020) must equal the total of the following fields: Credit for Child & 

Dependent Care (SEQ 0925), Credit for Elderly or Disabled (SEQ 0930), Education Credits (F8863) 

(SEQ 0935), Child Tax Credit (SEQ 0940), Credit for Retirement Savings Contribution (SEQ 0937) 

and Adoption Credit (SEQ 0960). 
0192 o 

o

o

Tax Form - At least one of the following fields must be significant for the forms listed below. 

Form 1040/1040A: Total Income (SEQ 0600), Adjusted Gross Income (SEQ 0750), AGI Repeated 

(SEQ 0770), Tax (SEQ 0915/0860), Total Credits (SEQ 1020), Total Tax (SEQ 1150), Total 

Payments (SEQ 1250). 

Form 1040EZ: Adjusted Gross Income (SEQ 0750), Taxable Income (SEQ 0820), Withholding 

(SEQ 1160), Total Tax (SEQ 1256), Refund (SEQ 1270) and Amount Owed (SEQ 1290). 

0193 o Form 8829 - Total Hours Available (SEQ 0065) cannot exceed the maximum number of available 

hours (24 hrs multiplied by the number of days in the year). 

0194 o Form 1040EZ - If Taxable Interest (SEQ 0380) is not significant, then Adjusted Gross Income 

(SEQ 0750) must equal the total of Wages, Salaries, Tips (SEQ 0375) plus Unemployment 

Compensation (SEQ 0552). 

0195 o 

o

Schedule SE - When Self-Employment Tax (SEQ 0160) is significant, Deduction for 1/2 of Self 

Employment Tax (SEQ 0165) must be significant, and vice versa. 

If Self-Employed Deduction Schedule SE (SEQ 0640) of Form 1040 is significant, it must equal 

Deduction for 1/2 of Self Employment Tax (SEQ 0165) from Schedule(s) SE. If Deduction for 1/2 of 

Self Employment Tax (SEQ 0165) of Schedule SE is significant, and Exempt-Notary Literal 

(SEQ 0050) is not significant, then Self-Employed Deduction Schedule SE (SEQ 0640) of 

Form 1040 must be significant. 

0196 o 

o

Form 1040 - When Social Security & Medicare Tax on Tips (SEQ 1080) is significant, Form 4137 

must be present. 

When F1040 Social Security Medicare Tax on Tips (SEQ 0200) of Form 4137(s) is significant, Social 

Security & Medicare Tax on Tips (SEQ 1080) of Form 1040 must be significant. 

0197 o Schedule A - When Other Expense Amount (SEQ 0485) is significant, Total Other Expenses Limit 

(SEQ 0495) must be significant. 

0198 o 

o

Form 1040 - Total Payments (SEQ 1250) must equal the total of the following fields: Withholding 

(SEQ 1160), ES Payments (SEQ 1170), Earned Income Credit (SEQ 1180), Additional Child Tax 

Credit (SEQ 1192), F4868 Amount (SEQ 1197), Excess SS Tax (SEQ 1188), and Other Payments 

(SEQ 1210).

Form 1040A – Total Payments (SEQ 1250) must equal the total of the following fields: Withholding 

(SEQ 1160), ES Payments (SEQ 1170), Earned Income Credit (SEQ 1180), Additional Child Tax 

Credit (SEQ 1192), F4868 Amount (SEQ 1197), and Excess SS Tax (SEQ 1200). 

0199 o Form 1040/1040A – Educator Expenses (SEQ 0623) cannot be greater than $500 if filing status is “2” 

and $250 for all other filing statuses. 

0200 o Form 1040/1040A - When Earned Income Credit (SEQ 1180) is greater than $399, Schedule EIC 

must be present. 

0201 o

o

Schedule EIC - If any field of the following “qualifying child group” is significant, then all fields in that 

group must be significant: Qualifying Child Name Control (SEQ 0007, 0077; Qualifying Child First 

Name (SEQ 0010, 0080); Qualifying Child Last Name (SEQ 0011, 0081); Year of Birth (SEQ 0020, 

0090); Qualifying SSN (SEQ 0015, 0085); Relationship (SEQ 0060, 0130); and Number of Months 

(SEQ 0070, 0140). 

Qualifying Child Name Control (SEQ 0007, 0077) must be in the correct format. 

0202 o Schedule EIC – Year of Birth (SEQ 0020, 0090) cannot be greater than current tax year. 

0203 o Schedule EIC - Relationship (SEQ 0060, 0130) must equal one of the following: "CHILD", 

"DAUGHTER", "FOSTERCHILD", "GRANDCHILD", or "SON", “SISTER”, “BROTHER”, “NIECE” or 

“NEPHEW”.
0204 o 

o

Form 1040/1040A - If Earned Income Credit (SEQ 1180) is significant and Schedule EIC is not 

present, then the primary taxpayer and/or the secondary taxpayer must be at least age 25 but under 

age 65. If either taxpayer is born January 01, 1981, the taxpayer is considered to be age 25 at the 

end of 2005. 

Form 1040EZ - If Earned Income Credit (SEQ 1180) is significant, then the primary taxpayer and/or 

the secondary taxpayer must be at least age 25 but under age 65. If either taxpayer is born January 

01, 1981, the taxpayer is considered to be age 25 at the end of 2005.

0205 o Schedule EIC - When Qualifying SSN (SEQ 0015, 0085) is significant, it must be within the valid 

ranges of SSN's. It must equal all numeric characters and cannot equal all zeros or all nines. 

0206 o Schedule EIC - If Year of Birth (SEQ 0020, 0090) is less than "1987" (age 19 and older) and greater 

than "1981", then the corresponding Student "Yes" Box (SEQ 0030, 0100) or the corresponding 

Disabled "Yes" Box (SEQ 0040, 0110) must equal "X". 

0207 o Schedule EIC - If Relationship (SEQ 0060, 0130) equals "CHILD", "DAUGHTER", "GRANDCHILD", 

“SON", “SISTER”, “BROTHER”, “NIECE”, “NEPHEW” or “FOSTERCHILD” and Year of Birth 

(SEQ 0020, 0090) does not equal "2005", then Number of Months (SEQ 0070, 0140) must be equal 

to or greater than "07". 

0208 o Schedule H - Cash Wages Over $1,400 Paid Yearly - Yes (SEQ 0040) and Cash Wages Over 

$1,400 Paid Yearly – No (SEQ 0045) cannot both equal "X" and cannot both equal blank. 

0209 o Schedule H - Employer SSN (SEQ 0020) on the first Schedule H must be significant and equal to 

Primary SSN (SEQ 0010) or Secondary SSN (SEQ 0030) of Form 1040. 

0210 o Schedule H - Employer SSN (SEQ 0020) on the second Schedule H must be significant and equal to 

Secondary SSN (SEQ 0030) of Form 1040 and must not be equal to Employer SSN (SEQ 0020) on 

the first Schedule H. When both spouses are filing Schedule H, the Schedule H for the primary 

taxpayer must precede the Schedule H for the secondary taxpayer. 

0211 o Schedule H - Employer Identification Number (SEQ 0030) cannot equal Primary SSN (SEQ 0010) or 

Secondary SSN (SEQ 0030) of Form 1040. 

0212 o Schedule H - Name of State Where Unemployment Contr Paid (SEQ 0200) must equal a standard 

state abbreviation for one of the fifty United States, District of Columbia, Puerto Rico, or U.S. Virgin 

Islands.

0213 o Schedule H - Employer SSN (SEQ 0020) and Employer Identification Number (SEQ 0030) must be 

significant, must equal all numeric characters and cannot equal all blanks or all zeros. 

0214 o Schedule H - When two Schedules H are present, Employer Identification Number (SEQ 0030) of 

the second Schedule H cannot equal Employer Identification Number of the first Schedule H. 

0215 o 

o

o

Schedule H - Federal Income Tax Withheld - Yes (SEQ 0050) and Federal Income Tax Withheld – 

No (SEQ 0055) cannot both equal "X". 

Cash Wage Over $1,000 Paid Qtrly - No (SEQ 0060) and Cash Wage Over $1,000 Paid Qtrly - Yes 

(SEQ 0065) cannot both equal "X". 

Cash Wages Over $1,000 Paid Qtrly - No (SEQ 0150) and Cash Wages Over $1,000 Paid Qtrly - 

Yes (SEQ 0155) cannot both equal "X". 

0216 o Schedule EIC - Qualifying SSN - 1 (SEQ 0015) cannot equal Qualifying SSN - 2 (SEQ 0085). 

Qualifying SSN - 1 and - 2 (SEQ 0050, 0120) cannot equal Primary SSN (SEQ 0010) or Secondary 

SSN (SEQ 0030) of Form 1040/1040A. 

0217 o Schedule EIC – When Year of Birth (SEQ 0020, 0090) is less than "1982", the corresponding 

Disabled "Yes" Box (SEQ 0040, 0110) must equal "X". 

0218 o Schedule EIC – When Year of Birth (SEQ 0020, 0090) equals "2005", the corresponding Number of 

Months (SEQ 0070, 0140) must equal "12". 
0219 o Schedule H - Page 2 must be present when all of the following fields equal "X": Cash Wage Over 

$1,400 Paid Yearly - No (SEQ 0045), Federal Income Tax Withheld – No (SEQ 0055), and Cash 

Wage Over $1,000 Paid Qtrly - Yes (SEQ 0065). 

0220 o Schedule H - When all of the following fields equal "X", Schedule H cannot be filed: Cash Wage 

Over $1,400 Paid Yearly - No (SEQ 0045), Federal Income Tax Withheld - No (SEQ 0055), and 

Cash Wage Over $1,000 Paid Qtrly - No (SEQ 0060). 

0221 o Form 1040/1040A - Advanced EIC Payments (SEQ 1105) must equal the total of Advance EIC 

Payment (SEQ 0200) from Form(s) W-2 and/or W-2GU.

0222 o 

o

Schedule EIC - If Qualifying SSN - 1 (SEQ 0015) is significant and Qualifying SSN - 2 (SEQ 0085) is 

not significant, then Earned Income Credit (SEQ 1180) of Form 1040/1040A cannot exceed $2,662 

and Adjusted Gross Income (SEQ 0750) of Form 1040/1040A must be less than $31,030 if Single, 

Head of Household or Qualifying Widow(er) and less than $33,030 if Married Filing Jointly. 

If Qualifying SSN - 1 (SEQ 0015) and Qualifying SSN – 2 (SEQ 0085) are significant, then Earned 

Income Credit (SEQ 1180) of Form 1040/1040A cannot exceed $4,400 and Adjusted Gross Income 

(SEQ 0750) of Form 1040/1040A must be less than 

$35,263 if Single, Head of Household or Qualifying Widow(er) and less than $37,263 if Married Filing 

Jointly. 

0223 o Schedule H - When Federal Income Tax Withheld – Yes (SEQ 0050) equals "X", Federal Income 

Tax Withheld (SEQ 0110) must be significant. 

0224 o Schedule H - If Cash Wage Over $1,400 Paid Yearly - No (SEQ 0045) and Federal Income Tax 

Withheld - Yes (SEQ 0050) equal "X", then Cash Wage Over $1,000 Paid Qtrly - No (SEQ 0060) 

and Cash Wage Over $1,000 Paid Qtrly - Yes (SEQ 0065) must be blank. 

0225 o Schedule H - When Cash Wage Over $1,400 Paid Yearly - Yes (SEQ 0040) equals "X", Social 

Security Wages (SEQ 0070) and Medicare Wages (SEQ 0090) must each be equal to or greater 

than $1,400. 

0226 o Schedule H - When Cash Wage Over $1,400 Paid Yearly - Yes (SEQ 0040) equals "X", the following 

fields must be blank: Federal Income Tax Withheld - Yes (SEQ 0050), Federal Income Tax 

Withheld - No (SEQ 0055), Cash Wage Over $1,000 Paid Qtrly - No (SEQ 0060), and Cash Wage 

Over $1,000 Paid 

Qtrly - Yes (SEQ 0065). 

0227 o 

o

Schedule H - When Page 2 is present, Cash Wages Over $1,000 Paid Qtrly - No (SEQ 0150) cannot 

equal "X". 

When Page 2 is not present, Cash Wages Over $1,000 Paid Qtrly - Yes (SEQ 0155) cannot 

equal "X". 

0228 o Schedule H - Social Security Wages (SEQ 0070) cannot be greater than Medicare Wages 

(SEQ 0090). 

0229 o Schedule H - When Page 2 is present, Total Taxes from Line 8 (SEQ 0520) must equal Total Taxes 

Less Advance EIC Payments (SEQ 0140) from Page 1. 

0230 o Form 1116 – When only one Form 1116 is present, Smaller of Tax From Return or Foreign Tax 

Credit (SEQ 1185) must equal Gross Foreign Tax Credit (SEQ 1090) and the following fields must 

be blank: SEQs 1100, 1110, 1120, 1130, 1135, 1160, 1175, 1177 and 1180. 

0231 o Form 1116 – If more than one Form 1116 is present, then only the first occurrence of Form 1116 can 

have significant data in Foreign Tax Credit (SEQ 1200). For subsequent occurrences of Form 1116, 

significant data can be present in Foreign Tax Credit (SEQ 1200) only when Alt. Min. Tax Literal 

(SEQ 0010) of that occurrence is equal to “AMT”. 
0232 o 

o

o

Form 1116 - On each Form 1116, only one of the following fields can equal "X": SEQ 0020, 0030, 

0040, 0050, 0060, 0070, 0080, 0093, 0096, 0098. 

When more than one Form 1116 is present, the same box (SEQ 0020 through 0098) cannot equal 

"X" on more than one Form 1116. 

Exception: The same box (SEQ 0020 through 0098) can equal "X" on two Forms 1116 if Alt. Min. 

Tax Literal (SEQ 0010) is significant on one of the two Forms 1116. 

0233 o Tax Form - If Direct Deposit “No” (SEQ 1263) is equal to "X", the Direct Deposit Information must not 

be present, if present, reject the return. 

0234 o Tax Form - One of the following must equal "X": Direct Deposit “Yes” (SEQ 1262) or Direct Deposit 

“No” (SEQ 1263) and both cannot be blank and both cannot equal "X". 

0235 o Schedule H - When Page 2 is present, Total Taxable Wages for FUTA (Section A) (SEQ 0230) must 

be significant. 

0236 o Form 1040 - Household Employment Taxes (SEQ 1107) must equal the total of the following fields 

from Schedule(s) H: Total Taxes Less Advance EIC Payments (SEQ 0140) plus FUTA Tax 

(SEQ 0240). 

0237 o

o

When only one Form 2106 is present for an individual (primary or secondary), Page 2 need not be 

transmitted if there are no entries for that page, but Page 2 cannot be present without Page 1. 

When two Forms 2106 are present for an individual (primary or secondary), Page 1 must be present 

for the first form, Page 1 may not be present for the second form, and Page 2 must be present for 

both forms. (The second form is for additional vehicles only. Refer to Form 2106 Instructions for 

possible allocation from one Form 2106 in the case of expenses of reservists, Qualified Performing 

Artists, etc.) 

0238-0239 RESERVED 

0240 o Schedule C-EZ - Total Expenses (SEQ 0700) cannot be greater than $5,000 and Net Profit 

(SEQ 0710) cannot be less than zero. 

0241 o Schedule C-EZ - At least one of the following fields must be significant: Gross Receipts/Sales 

(SEQ 0200), Total Expenses (SEQ 0700), Net Profit (SEQ 0710). 

0242 o Schedule C-EZ - Employer ID Number (SEQ 0060) cannot equal Primary SSN (SEQ 0010) or 

Secondary SSN (SEQ 0030) of Form 1040. 

0243 o 

o

Form 1040 - If Schedule A is not present and Must Itemize Indicator (SEQ 0786) equals "X" then 

Total Itemized or Standard Deduction (SEQ 0789) must equal zero. 

Form 1040A - If Must Itemize Indicator (SEQ 0786) equals "X", then Total Itemized or Standard 

Deduction (SEQ 0789) must equal zero. 

0244 o RESERVED. 

0245 o 

o

Form 1040 - When Form 8396 Block (SEQ 0985) equals "X", Form 8396 must be present. 

Form 1040 - When Form 3800 Block (SEQ 1000) equals "X", Form 3800 must be present. 

0246 o RESERVED 

0247 o Schedule A - When State & Local Taxes (SEQ 0090) is significant, Income Taxes Box (SEQ 0092) 

and General Sales Taxes Box 

(SEQ 0094) cannot both equal “X”, and cannot both equal blank. 

0248-0249 RESERVED 

0250 o RESERVED 
0251 o Form 8615 - Child Taxable Income (SEQ 0100) must equal Taxable Income (SEQ 0820) from 

Form 1040/1040A. 

0252 o Form 1040/1040A - When Form 8615 is present, Tax (SEQ 0915) of Form 1040 or Tax (SEQ 0860) 

of Form 1040A must equal Form 8615 Tax (SEQ 0290) from Form 8615. 

0253 o Form 8615 - Parent Filing Status (SEQ 0060) must equal "1", "2", "3", "4", or "5". 

0254 o RESERVED 

0255 o Form 8615 - Gross Unearned Income (SEQ 0070) must be greater than $1,600. 

0256 o Form 8615 - Child Name (SEQ 0010) must equal Name Line 1 (SEQ 0060) of Form 1040/1040A. 

0257 o Form 8615 - Parent Name (SEQ 0040) and Parent SSN (SEQ 0050) must be significant. 

0258 o Form 8615 - Child SSN (SEQ 0020) must be significant and within the valid ranges of SSN/ITIN's. 

0259 o RESERVED 

0260 o Form 1040 - When Form 8814 is present, Form 8814 Block (SEQ 0853) of Form 1040 must equal 

"X" and Form 8814 Amount (SEQ 0857) of Form 1040 must be significant. When Form 8814 Block 

(SEQ 0853) equals "X", Form 8814 must be present and Form 8814 Amount (SEQ 0857) must be 

significant. 

0261 o 

o

Form 8814 - When one Form 8814 is present, Multiple F8814 Indicator (SEQ 0030) cannot be 

significant. When more than one Form 8814 is present, Multiple F8814 Indicator (SEQ 0030) of the 

first Form 8814 must be significant. 

Form 8814 Amount (SEQ 0857) of Form 1040 must equal Form 8814 Tax (SEQ 0220) from 

Form(s) 8814. 

0262 o Form 8814 - Child Taxable Unearned Income (SEQ 0170) must be greater than $800 and less than 

$8,000. 

0263 o Form 1040 - If Form 1040 Other Income (SEQ 0200) of Form 8814 is significant, then Type of Other 

Income (SEQ 0560) of Form 1040 must equal "FORM 8814" and Total Other Income (SEQ 0590) of 

Form 1040 must be significant. 

0264 o 

o

o

Form 8814 - When Tax Exempt Literal (SEQ 0040) is significant, Tax Exempt Amount (SEQ 0050) 

must be significant. 

When Nominee Dist. Literal 1 (SEQ 0060) is significant, Nominee Dist. Amount 1 (SEQ 0070) must 

be significant. 

When Non-Taxable Literal (SEQ 0080) is significant, Non-Taxable Amount (SEQ 0090) must be 

significant. 

0265 o Form 8814 - When Nominee Dist. Literal 2 (SEQ 0120) is significant, Nominee Dist. Amount 2 

(SEQ 0130) must be significant. 

0266 o Form 8814 - Child Name (SEQ 0010) must be significant. Child SSN (SEQ 0020) must be must be 

significant and within the valid ranges of SSN/ITIN/ATIN's. 

0267 o Form 8814 - Tax Amount Basis (SEQ 0210) cannot be less than zero. When Tax Amount Basis 

(SEQ 0210) is greater than zero and less than $800, Form 8814 Tax (SEQ 0220) must be 

significant. When Tax Amount Basis (SEQ 0210) is equal to or greater than $800, Form 8814 Tax 

(SEQ 0220) must equal $80. 

0268-0269 RESERVED 

0270 o Form 1040 - When Form 4972 Block (SEQ 0880) equals "X", Form 4972 must be present. 
0271 o 

o

Form 4972 - None of the following fields can equal "X": Distribution of Qualified Plan No Box 

(SEQ 0026), Rollover Yes Box (SEQ 0030), Prior Yr Distribution Yes Box (SEQ 0190), and 

Beneficiary Distribution Yes Box (SEQ 0201). 

All of the following fields must equal "X": Distribution of Qualified Plan Yes Box (SEQ 0024), Rollover 

No Box (SEQ 0040), and Prior Yr Distribution No Box (SEQ 0200). 

0272 o Form 4972 - Only one of the following fields can equal "X": Beneficiary of Qual Participant No Box 

(SEQ 0044) or Qual 

Age - Five Yr Member No Box (SEQ 0086). 

0273-0274 RESERVED 

0275 o Form 4972 – At least one of the following fields must be significant: Capital Gain Election 

(SEQ 0220), Ordinary Income (SEQ 0240), 10 Yr Method Average Tax (SEQ 0690). 

0276 o Form 4972 - Recipient SSN (SEQ 0020) from the second Form 4972 cannot equal Recipient SSN 

(SEQ 0020) of the first Form 4972. 

0277 o Form 1040 - When Other Tax Literal (SEQ 1110) equals "ADT", Form 4970 must be present, and 

vice versa. 

0278 o RESERVED 

0279 o Form 4972 - For each of the following, one box must equal "X", but both cannot equal "X": 

Beneficiary of Qual Participant Yes Box (SEQ 0042)/Beneficiary of Qual Participant No Box 

(SEQ 0044); Qual Age - Five Yr Member Yes Box (SEQ 0084)/Qual Age - Five Yr Member No Box 

(SEQ 0086). 

0280 o Schedule B/Schedule 1 - When Excludable Savings Bond Interest (SEQ 0289) is significant, 

Form 8815 must be present. Excludable Savings Bond Interest (SEQ 0289) of 

Schedule B/Schedule 1 must equal Excludable Savings Bond Interest (SEQ 0290) from Form 8815. 

0281 o Form 1040/1040A - When Filing Status (SEQ 0130) equals "3", Form 8815 cannot be present. 

0282 o Form 8815 - Taxable Expenses (SEQ 0190) must be greater than zero. 

0283 o Form 8815 - If Filing Status (SEQ 0130) of Form 1040/1040A equals "2" or "5", then Modified AGI 

(SEQ 0240) of Form 8815 must be less than $121,850. If Filing Status equals "1" or "4", then 

Modified AGI (SEQ 0240) must be less than $76,200. 

0284 o RESERVED 

0285 o RESERVED 

0286 o Schedule E - When Non Passive Activity Literal (SEQ 1130) is present, Non Passive Activity Amount 

(SEQ 1140) must be present, and vice versa. 

0287 o 

o

Form 1040 - When F8828 Literal (SEQ 1123) equals "FMSR", Form 8828 must be present. 

When F8828 Amount (SEQ 1124) is significant, Recapture Tax Due (SEQ 0280) of Form 8828 must 

be significant, and vice versa. 

0288 o Form 8828 - Original Loan Closing Date (SEQ 0100) cannot be before January 1, 1991 (19910101). 

0289 o Form W-2 - When Advance EIC Payment (SEQ 0200) is significant, taxpayer cannot file 

Form 1040EZ. 
0290 o 

o

o

o

o

Form W-2 - Employer State (SEQ 0073) and Employer Zip Code (SEQ 0075) must be significant 

and valid. Employer Zip Code (SEQ 0075) must be consistent with Employer State (SEQ 0073). 

Form W-2G - Payer's State (SEQ 0024) and Payer's Zip Code (SEQ 0025) must be significant and 

valid. Payer's Zip Code (SEQ 0025) must be consistent with Payer's State (SEQ 0024). 

Form W-2GU - Employer State (SEQ 0073) and Employer Zip Code (SEQ 0075) must be significant 

and valid. Employer Zip Code (SEQ 0075) must be consistent with Employer State (SEQ 0073). 

Form 1099-R - Payer's State (SEQ 0042) and Payer's Zip Code (SEQ 0044) must be significant and 

valid. Payer's Zip Code (SEQ 0044) must be consistent with Payer's State (SEQ 0042). 

Exception: This check is not performed when Employer State (SEQ 0073) of Form W-2 and/or W2GU, Payer’s State (SEQ 0024) of Form W-2G, and/or Payer’ State (SEQ 0042) of Form 1099-R 

contain a period (.), indicating a foreign address. 

0291 o Form W-2 - Employer City (SEQ 0070) must contain at least three characters. 

0292 o Form W-2G - Payer Identification Number (SEQ 0026) must be numeric, the first two digits of Payer 

Identification Number (SEQ 0026) must equal a valid District Office Code, Payer Name 

Control (SEQ 0015) must be significant, and W-2G Indicator (SEQ 0220) must equal "N" or "S". 

Note: The value "N" (Non-Standard) indicates that the Form 

W-2G was altered, handwritten, or typed, or that a cumulative earnings statement or a substitute 

Form W-2G was used. The value "S" (Standard) identifies a Form W-2G that is a 

computer-produced print, an IRS form, or an IRS-approved facsimile. 

0293 o Form 1099-R - Payer Identification Number (SEQ 0050) must be numeric, the first two digits of 

Payer Identification Number (SEQ 0050) must equal a valid District Office Code, Payer Name 

Control (SEQ 0015) must be significant, and 1099-R Indicator (SEQ 0340) must equal "N" or "S". 

Note: The value "N" (Non-Standard) indicates that the Form 1099-R was altered, handwritten, or 

typed, or that a cumulative earnings statement or a substitute Form 1099-R was used. The value "S" 

(Standard) identifies a Form 1099-R that is a computer-produced print, an IRS form, or an IRSapproved facsimile. 

0294 o RESERVED

0295 o 

o

o

Form W-2 – Neither Withholding (SEQ 0130) nor Social Security Tax (SEQ 0150) of the combined 

W-2(s) and/or W-2GU(s) can be greater than 1/2 (50%) of Wages (SEQ 0120). 

Exception: This check is bypassed when Combat Pay has been excluded from Wages. 

Form W-2G – Withholding (SEQ 0050) cannot be greater than 1⁄2 (50%) of Gross Winnings, etc. 

(SEQ 0040). 

Form 1099-R – Withholding (SEQ 0160) cannot be greater than 1/2 (50%) of Gross Distribution 

(SEQ 0110). 

0296 o Form 2441/Schedule 2 - If any field of the following "qualifying person group" is significant, then all 

fields in that group must be significant: Qualifying Person First Name (SEQ 0110, 0217); Qualifying 

Person Last Name (SEQ 0115, 0218); Qualifying Person Name Control (SEQ 0120, 0221); 

Qualifying Person SSN (SEQ 0214, 0223). 

0297 o If Primary or Secondary SSN (SEQ 0010, 0030) of Form 1040 equal the SSN/EIN (SEQ 0040 or 

0090) of Form 2441, reject the return. 

0298 o Form 2441/Schedule 2 - When Qualifying Person SSN (SEQ 0214, 0223) is significant, it must be 

within the valid ranges of SSN/ITIN/ATIN's. 

0299 o 

o

Tax Form - RAL Indicator (SEQ 1465) must equal "0", “1”, or "2". 

RAL Indicator (SEQ 1465) is a required field. 

0300-0302 RESERVED 
0303 o 

o

Form 1040/1040A - If Amount Owed (SEQ 1290) is greater than zero and ES Penalty Amount 

(SEQ 1300) is not significant, then Total Tax (SEQ 1150) must be greater than Total Payments 

SEQ 1250). 

Form 1040EZ - If Amount Owed (SEQ 1290) is greater than zero, then Total Tax (SEQ 1256) must 

be greater than Total Payments (SEQ 1250). 

0304-0349 RESERVED for Electronically Transmitted Documents (ETD) 

0350 o 

o

Form 8853 - Policyholder SSN (SEQ 0289) must be numeric and within the valid range for an SSN 

or an ITIN. 

Insured SSN (SEQ 0310) must be numeric and within the valid range for an SSN or an ITIN. 

0351 o Form 8853 - MSA Acct Holder SSN (SEQ 0009) must equal either the Primary SSN (SEQ 0010) or 

the Secondary SSN (SEQ 0030) of Form 1040. 

0352 o Form 8853 – Policyholder SSN (SEQ 0289) must equal either the Primary SSN (SEQ 0010) or the 

Secondary SSN (SEQ 0030) of Form 1040. 

0353 o 

o

Form 1040 – If Type of Other Income (SEQ 0560) equals "MEDMSA" and the corresponding Amount 

of Other Income (SEQ 0570) is present, then Form 8853 must be present. 

If Taxable Medicare Advantage MSA Distributions (SEQ 0276) of Form 8853 is significant, then Type 

of Other Income (SEQ 0560) of Form 1040 must equal "MEDMSA" and the corresponding Amount of 

Other Income (SEQ 0570) of Form 1040 must be present. 

0354 o 

o

Form 1040 – If Other Tax Literal (SEQ 1110) equals "MEDMSA" and the corresponding Other Tax 

Amount (SEQ 1112) is present, then Form 8853 must be present. 

If Additional 50% Tax (SEQ 0279) of Form 8853 is significant, then Other Tax Literal (SEQ 1110) of 

Form 1040 must equal "MEDMSA" and the corresponding Other Tax Amount (SEQ 1112) of Form 

1040 must be present. 

0355 o RESERVED 

0356 o RESERVED 

0357 o 

o

If MSA Literal (SEQ 0732) is significant, then MSA Amount (SEQ 0733) must be significant and vice 

versa.

Form 1040 – If MSA Literal (SEQ 0732) and MSA Amount (SEQ 0733) is significant then, Form 8853 

must be attached. 

0358 o Form 8853 - If Taxable Medicare Advantage MSA Distributions 

(SEQ 0276) is significant, the following SEQs cannot both be blank; Exceptions to 50% Tax Box 

(SEQ 0278) and Additional 50% Tax (SEQ 0279). 

0359 o Form 8853 - One box of the following pairs must equal "X", both cannot equal "X", and both cannot 

equal space: 

- Payments or Death Benefits - Yes (SEQ 0320) 

- Payments or Death Benefits - No (SEQ 0330) and 

- Insured Terminally Ill - Yes (SEQ 0340) 

- Insured Terminally Ill - No (SEQ 0350). 

0360 o 

o

Form 1040 - If Type of Other Income (SEQ 0560) equals "MSA" and the corresponding Amount of 

Other Income (SEQ 0570) is present, then Form 8853 must be present. 

If Taxable Archer MSA Distributions (SEQ 0250) of Form 8853 is significant, then Type of Other 

Income (SEQ 0560) of Form 1040 must equal "MSA" and the corresponding Amount of Other 

Income (SEQ 0570) of Form 1040 must be present. 

0361 o 

o

Form 1040 - If Other Tax Literal (SEQ 1110) equals "MSA" and the corresponding Other Tax 

Amount (SEQ 1112) is present, then Form 8853 must be present. 

If Additional 15% Tax (SEQ 0270) of Form 8853 is significant, then Other Tax Literal (SEQ 1110) of 

Form 1040 must equal "MSA" and the corresponding Other Tax Amount (SEQ 1112) of Form 1040 

must be present. 
0362 o RESERVED 

0363 o Form 8853 - If Taxable Archer MSA Distributions (SEQ 0250) is significant, the following SEQs 

cannot both be blank; Exceptions to 15% Tax Box (SEQ 0260) and Additional 15% Tax (SEQ 0270). 

0364 o 

o

Form 1040 - If Type of Other Income (SEQ 0560) equals "LTC" and the corresponding Amount of 

Other Income (SEQ 0570) is present, then Form 8853 must be present. 

If Taxable Payments (SEQ 0450) of Form 8853 is greater than zero, then Type of Other Income 

(SEQ 0560) must equal "LTC" and the corresponding Amount of Other Income (SEQ 0570) must be 

present. 

0365 o RESERVED 

0366 o Form 8853 - If Primary Archer Contribution for Current TY - Yes (SEQ 0019) equals "X"; then for each of 

the following, one box must equal "X", both cannot equal "X", and both cannot equal space: 

 - Primary Uninsured Acct Holder - Yes (SEQ 0030) or Primary 

 Uninsured Acct Holder - No (SEQ 0040) must equal "X", and 

 - Primary Self HDHP Coverage Box (SEQ 0050) or Primary Family 

 HDHP Coverage Box (SEQ 0060) must equal "X". 

0367 o Form 8853 - If Spouse Archer Contribution for Current TY - Yes (SEQ 0070) equals "X"; then for each of 

the following, one box must equal "X", both cannot equal "X", and both cannot equal space: 

 - Spouse Uninsured Acct Holder - Yes (SEQ 0090) or Spouse 

 Uninsured Acct Holder - No (SEQ 0100) must equal "X", and 

 - Spouse Self HDHP Coverage Box (SEQ 0110) or Spouse Family 

 HDHP Coverage Box (SEQ 0120) must equal "X". 

0368 o Form 8853 - If Primary Archer Contribution for Current TY - No (SEQ 0020) equals "X"; then none of the 

following can equal "X": Primary Archer Contribution for Current TY - Yes (SEQ 0019), Primary 

Uninsured Acct Holder - Yes (SEQ 0030), Primary Uninsured Acct Holder - No (SEQ 0040), Primary 

Self HDHP Coverage Box (SEQ 0050), and Primary Family HDHP Coverage Box (SEQ 0060). 

0369 o Form 8853 - If Spouse Archer Contribution for Current TY - No (SEQ 0080) equals "X"; then none of the 

following can equal "X": Spouse Archer Contribution for Current TY - Yes (SEQ 0070), Spouse 

Uninsured Acct Holder - Yes (SEQ 0090), Spouse Uninsured Acct Holder - No (SEQ 0100), Spouse Self 

HDHP Coverage Box (SEQ 0110), and Spouse Family HDHP Coverage Box (SEQ 0120). 

0370 o 

o

Form 1040/1040A - When any occurrence of Eligibility for Child Tax Credit (SEQ 0178, 0188, 0198, 

0208) is significant, the corresponding Relationship (SEQ 0177, 0187, 0197, 0207) must equal either 

CHILD, SON, DAUGHTER, GRANDCHILD, SISTER, BROTHER, NIECE, NEPHEW, or 

FOSTERCHILD and the Dependent's age must be under 17. 

Form 8901 - When any occurrence of a qualifying child (SEQ 0010, 0060, 0110, 0160) is significant, 

the qualifying child’s age must be under 17.

0371 o RESERVED 

0372 o Form 1040/1040A - When either Child Tax Credit (SEQ 0940) or Additional Child Tax Credit (SEQ 

1192) is significant, the sum of the two fields cannot exceed an amount equal to $1000 multiplied by 

the number of qualifying children. A qualifying child is either a dependent for whom Eligibility for 

Child Tax Credit (SEQ 0178, 0188, 0198, 0208) equals "X", or a Form 8901 qualifying child (SEQ 

0010, 0060, 0110, 0160). Form 8901 must be attached for any qualifying children who are not 

dependents. 

0373 o Form 1040/1040A - When Additional Child Tax Credit (SEQ 1192) is significant, Form 8812 must be 

present.

0374 o Form 1040/1040A - When Form 8812 is present, Additional Child Tax Credit (SEQ 1192) of Form 

1040/1040A must equal Additional Child Tax Credit (SEQ 0140) from Form 8812. 

0375 o RESERVED 

0376 o Form 8812 – Bona fide residents of Puerto Rico should file Form 1040-PR or Form 1040-SS to claim 

Additional Child Tax Credit. 
0377-0378 RESERVED 

0379 o Form 8863 - The student entries in Part I and in Part II must begin on Line 1 in each part. No lines 

may be skipped when completing the student information in either part. 

0380 o Form 8863 - Student's SSN (SEQ 0035, 0105, 0175, 0275, 0315, 0355) may be used only once to 

claim an education credit (Hope or Lifetime Earning). No Student's SSN may be used in Part I 

(Hope Credit) and Part II (Lifetime Learning Credit). Student's SSN must be within the valid ranges 

of SSN/ITIN/ATIN's. 

0381 o Form 8863 -If any field of a student line in Part I or Part II, including statements, is significant then all 

fields of the student line must be significant. Each Hope Credit student line includes Student’s First 

Name, Student’s Last Name, Student’s Name Control, Student’s SSN, Qualified Expenses Paid in 

Current Tax Year, Smaller of Exp Paid in Current TY or $1000, Add Columns c and d, and Enter 1/2 

of the Amt in Column e. Each Lifetime Learning Credit student line includes Student’s First Name, 

Student’s Last Name, Student’s Name Control, Student’s SSN, and Qualified Expenses. 

0382 o Form 1040/1040A - If Education Credits (SEQ 0935) is significant, Form 8863 must be present. If 

Form 8863 is present, Education Credits (SEQ 0590) on Form 8863 must equal Education Credits 

(SEQ 0935) on Form 1040/1040A. 

0383 o Form 8863 - Each Student's SSN (SEQ 0035, 0105, 0175, 0275, 0315, 0355) must equal either the 

Primary SSN (SEQ 0010), the Secondary SSN (SEQ 0030) or a Dependent SSN (SEQ 0175, 0185, 

0195, 0205) on Form 1040/1040A. 

0384 o

o

Form 1040/1040A – When Education Credits (SEQ 0935) is significant, Adjusted Gross Income 

(SEQ 0750) must be less than the applicable amount for the Filing Status (SEQ 0130). The 

applicable amounts are $107,000 for "Married Filing Joint" and $53,000 for "Single", "Head of 

Household", and “Qualifying Widow(er)”. 

When Filing Status (SEQ 0130) is “Married Filing Separate”, Education Credits (SEQ 0935) cannot 

be claimed. 

0385 o Form 8863 - The following limits apply to each Hope Credit student in Part I. Qualified Expenses 

Paid in the Current Tax Year (SEQ 0040, 0110, 0180 statement) cannot exceed $2000. Smaller of 

Exp Paid in Current TY or $1000 (SEQ 0050, 0120, 0190, statement) cannot exceed $1000. Enter 

1/2 of the Amt in Column e (SEQ 0070, 0140, 0210, statement) cannot exceed $1500.

0386 o Form 1040/1040A - When Adjusted Gross Income (SEQ 0750) plus Student Loan Interest Deduction 

(SEQ 0628) is more than $130,000 for "Married Filing Joint" or is more than $65,000 for "Single" or 

"Head of Household" or "Qualifying Widow(er)", the Student Loan Interest Deduction (SEQ 0628) is 

not allowed. 

0387 o

o

o

Form 8863 – Tentative Hope Credit (SEQ 0240) cannot exceed an amount equal to $1500 multiplied 

by the number of Hope Credit students in Part I. If the number of Hope Credit students is 

zero, Tentative Hope Credit (SEQ 0240) cannot be positive. 

Tentative Lifetime Learning Credit (SEQ 0470) cannot exceed $2000 regardless of the number of 

Lifetime Learning Credit students. If the number of Lifetime Learning Credit students is zero, 

Tentative Lifetime Learning Credit (SEQ 0470) cannot be positive. 

Education Credits (SEQ 0590) cannot exceed the sum of Tentative Hope Credit (SEQ 0240) and 

Tentative Lifetime Learning Credit (SEQ 0470). 

0388 o Form 1040/1040A - When Student Loan Interest Deduction (SEQ 0628) is significant, the filing 

status cannot equal "Married Filing Separately". 

0389 o Form 1040/1040A - Student Loan Interest Deduction (SEQ 0628) must not exceed $2,500.

0390 o 

o

Schedule J – Amount from Line 6 (SEQ 0100) must equal One-third Elected Farm Income 

(SEQ 0060). 

One-third Elected Farm Income (SEQ 0140) must equal One-third Elected Farm Income (SEQ 0060).
0391 o Schedule J – The following fields must contain an amount greater than or equal to zero: SEQ 0040, 

SEQ 0060, SEQ 0070, 

SEQ 0080, SEQ 0120, SEQ 0160, SEQ 0180, SEQ 0190, SEQ 0200, and SEQ 0210. 

0392 o Schedule J – Taxable Income (SEQ 0010) must equal Taxable Income (SEQ 0820) of Form 1040. 

0393 o Schedule J - When Add Lines 4, 8, 12, and 16 (SEQ 0170) is greater than zero, then one of the 

following fields must be greater than zero: Tax on Line 3 (SEQ 0040) or Tax on Line 7 (SEQ 0080) 

or Tax on Line 11 (SEQ 0120) or Tax on Line 15 

(SEQ 0160). 

0394 o RESERVED 

0395 o 

o

Form Payment - Primary SSN (SEQ 0010) must equal Primary SSN (SEQ 0010) of the Tax Form. 

When Filing Status (SEQ 0130) equals "2", Secondary SSN (SEQ 0020) must equal Secondary SSN 

(SEQ 0030) of the Tax Form. 

0396 o 

o

o

Form Payment - Routing Transit Number (SEQ 0030) (RTN) must contain numeric characters. The 

first two positions must be 01 through 12, or 21 through 32; the RTN must be present on the 

Financial Organization Master File (FOMF); and the banking institution must process Electronic 

Funds Transfer (EFT). 

Bank Account Number (SEQ 0040) must be present, must be alphanumeric (i.e., only alpha 

characters, numeric characters, and hyphens), must be left-justified with trailing blanks if less 

than 17 positions, and cannot equal all zeros or all blanks. 

Type of Account (SEQ 0050) must equal "1" or "2". 

0397 o 

o

o

o

Form Payment – (Balance Due Payments) When the return is transmitted to the IRS on or before 

April 17 of the current processing year, the Requested Payment Date (SEQ 0080) cannot be later 

than April 17.

When the return is transmitted to IRS after April 17, the Requested Payment Date (SEQ 0080) 

cannot be later than the current processing date. 

The year of the Requested Payment Date (SEQ 0080) must equal 

the current processing year.

The Requested Payment Date cannot be prior to the current processing date minus five days. 

0398 o 

o

o

o

o

o

Form Payment (Estimated Payments) – The Requested Payment Date (SEQ 0080) must be one of 

the following: 20060417 or 20060615, or 20060915. 

If the process date is prior to April 25th of the current processing year, the Requested Payment Date 

(SEQ 0080) must be 20060417, or 20060615, or 20060915. 

If the process date is April 25, 2006 through June 22, 2006 

of the current processing year, the Requested Payment Date 

(SEQ 0080) must be 20060615, or 20060915. 

If the current process date is June 23, 2006 through 

September 22, 2006 of the current processing year, the 

Requested Payment Date (SEQ 0080) must be 20060915. 

The process date cannot be greater than September 22, 2006. 

The year of the Requested Payment Date (SEQ 0080) must equal the current processing year. 
0399 o State Record (State Only Returns) – The Primary SSN (SEQ 0010) must match the Primary SSN 

(SEQ 0010) of Form 1040. 

0400 o 

o

State Record – The Generic Record must be present in the state data packet. 

An Unformatted Record was present without the Generic Record, or the Unformatted Record 

preceded the Generic Record. 

0401 o

o

State Record – The State Code (SEQ 0010) in the Header Section of the Generic Record must be 

valid for the processing service center. 

The State Code must be consistent throughout Generic and associated Unformatted Records for the 

return.

0402 o State Record – All “Required Entry” fields in the Entity Section of the Generic Record (SEQ 0060, 

0075, 0085, 0095, 0100) must be present. 

0403 o State Record – Any entry present in the Consistency Section of the Generic Record must equal the 

corresponding federal Tax Form entry. 

0404 o

o

State Record – The DCN (SEQ 0020) of the Generic Record must equal the DCN of the federal 

Tax Form. 

The DCN (SEQ 0020) of the Generic Record must equal the DCN (SEQ 0020) of the Unformatted 

Record. 

0405 o State Record Form W-2 – Each Form W-2 associated with a State Record must contain a valid State 

Abbreviation in State Name (SEQ 0370, 0440, 0490, 0540) when there is a significant entry in State 

Income Tax (SEQ 0400, 0470, 0520, 0570). 

0406 o

o

The first two-digits contained in the EFIN of Originator (SEQ 0008b) must be valid for the Processing 

Site (SEQ 0040) of the TRANS Record A (TRANA) of the transmission. 

Exception: A valid two-digit EFIN Prefix Code is permitted, if not assigned to a processing site, when 

State Data is present; or when Processing Site equals “G” (Philadelphia) and at least one of the 

following is present: Form 2555, Form 2555-EZ, Form 4563, Form 5074, Form 8689, Form 8833, 

Form 8854, Form 8891 and/or Form W-2GU; an Address Ind (SEQ 0097) of the Tax Form equal 

to “3”; a State Abbreviation (SEQ 0087) of the Tax Form equal to “AS”, “GU”, “MP”, “PR”, or “VI”. 

0407 o State Record – The Return Sequence Number (RSN) (SEQ 0023) of the Generic Record must equal 

the RSN of the Federal Tax Form. 

0408 o State Record – When Online-State-Return (SEQ 0049) of the Generic Record is equal to “O”, the 

Transmission Type Code (SEQ 0170) of the TRANS Record A (TRANA) must equal “O”, and vice 

versa.

0409 o 

o

Tax Form – When Foreign Employer Compensation Literal (SEQ 0378) equals “FEC”, then Foreign 

Employer Compensation Total (SEQ 0379) must be significant and the FEC Record must be present.

When the FEC Record is present, then Foreign Employer Compensation Literal (SEQ 0378) must 

equal “FEC” and Foreign Employer Compensation Total (SEQ 0379) must be significant. 

0410 o State Only Record – If the RTN is present, it must be present on the Financial Organization Master 

File (FOMF). 

0411 o FEC Record – The SSN or ITIN of Employee of Foreign Employer (SEQ 0010) must match the 

Primary SSN (SEQ 0010) of the Tax Form and the Employee Name Control (SEQ 0020) must match 

the Primary Name Control (SEQ 0050) of the Tax Form or The SSN or ITIN of Employee of Foreign 

Employer (SEQ 0010) must match the Secondary SSN (SEQ 0030) of the Tax Form and the 

Employee Name Control (SEQ 0020) must match the Spouse’s Name Control (SEQ 0055) of the 

Tax Form. 
0412 o FEC Record – The following fields must be significant: Street Address (SEQ 0050) and City 

(SEQ 0060), and the following fields must be significant: State Abbreviation (SEQ 0070) and Zip 

Code (SEQ 0080) or Foreign Country (SEQ 0110). 

0413 o FEC Record – The Foreign Employer's Name (SEQ 0140) and the Foreign Employer's Street 

Address (SEQ 0160), Foreign Employer's City (SEQ 0170), and Foreign Employer's Country (SEQ 

0200) must be significant. 

0414 o FEC Record – The Country Code (SEQ 0130) must be significant and either equal to a valid Country 

Code or “US”. 

0415 o FEC Record – If Services Performed While Residing in U.S. Yes Ind (SEQ 0120) is equal to “X”, then 

the Country Code 

(SEQ 0130) must equal “US” 

and

If the Country Code (SEQ 0130) is equal to “US”, then Services Performed While Residing in U.S. 

Yes Ind (SEQ 0120) must equal “X”. 

0416 o Summary Record – Number of FEC Records (SEQ 0075) must equal the number of FEC Records 

computed by the IRS. 

0417 o Tax Form – If Earned Income Credit (SEQ 1180) is significant, then the FEC Record cannot be 

present and Foreign Employer Compensation Literal (SEQ 0378) and Foreign Employer 

Compensation Total (SEQ 0379) must be blank. 

0418 o Tax Form – Foreign Employer Compensation Total (SEQ 0379) 

must equal the total of Foreign Employer Compensation Amount (SEQ 0220) from the FEC 

Record(s). 

0419 o 

o

State Record – If Address Ind (SEQ 0097) on the Tax Return is equal to “3” (indicating a foreign 

country), then the following fields must be present: Foreign Street Address (SEQ 0077), Foreign 

City, State or Province, Postal Code (SEQ 0087), and Foreign Country (SEQ 0098); and the 

following fields cannot be present: Street Address (SEQ 0080), City (SEQ 0085), State Abbreviation 

(SEQ 0095) and Zip Code (SEQ 0100). 

If Address Ind (SEQ 0097) on the Tax Return is not equal to “3”, then the following fields cannot be 

present: Foreign Street Address (SEQ 0077), Foreign City, State or Province, Postal Code (SEQ 

0087), and Foreign Country (SEQ 0098). 

0420 o Form 1040 – When Form 4136 Block (SEQ 1205) is equal to “X”, Form 4136 must be present, and 

vice versa. 

0421 o RESERVED 
0422 o

o

o

o

o

o

o

o

o

o

o

o

o

o

o

o

o

o

o

o

Form 4136 – When any of the “amount of credit” fields is greater than zero, then at least one of the 

associated “gallons” fields must be significant. For example: 

When Nontaxable Use of Gasoline Credit Amount (SEQ 0070) is greater than zero, at least one of 

the following must be significant: SEQ 0010 or 0020 or 0040. 

When Nontaxable Use of Commercial Aviation Gas Tax Credit Amt (SEQ 0180) is greater than zero, 

then Commercial Aviation Gasoline Gallons (SEQ 0170) must be significant. 

When Nontaxable Use of Aviation Gas Tax Credit Amount (SEQ 0230) is greater than zero, then 

Nontaxable Use Aviation Gasoline Gallons (SEQ 0200) must be significant. 

When Nontaxable Use of Diesel Fuel Credit Amount (SEQ 0300) is greater than zero, then 

Nontaxable Use of Diesel Fuel Gallons (SEQ 0270) must be significant. 

When Nontaxable Diesel Fuel Train Use Credit Amount (SEQ 0320) is greater than zero, then Diesel 

Fuel Train Use Gallons 

(SEQ 0310) or Diesel Fuel Train Use End 2005 Gallons (SEQ 0315) must be significant. 

When Diesel Fuel Certain Intercity and Local Bus Use Credit Amount (SEQ 0340) is greater than 

zero, then Diesel Fuel Certain Intercity and Local Bus Use Gallons (SEQ 0330) must be significant. 

When Diesel Fuel Farm After Sept. 2005 Amount (SEQ 0347) is greater than zero, then Diesel Fuel 

Farm After Sept. 2005 Gal. (SEQ 0343) must be significant. 

When Nontaxable Use of Kerosene Credit Amount (SEQ 0395) is greater than zero, then SEQ 0380 

(Nontaxable Use of Kerosene Gallons) must be significant. 

When Kerosene Use in Buses Credit Amount (SEQ 0410) is greater than zero, then Kerosene Use in 

Buses Gallons (SEQ 0400) must be significant. 

When Kerosene Use Farm After Sept. 2005 Amount (SEQ 0412) is greater than zero, then Kerosene 

Use Farm After Sept. 2005 Gal. (SEQ 0411) must be significant. 

When Nontaxable Use of Aviation Fuel Tax Credit Amount (SEQ 0423) is greater than zero, then 

Nontaxable Use of Aviation Fuel Gallons – 2 (SEQ 0421) must be significant. 

When Sales by Vendors of Undyed Diesel Credit Amount (SEQ 0439) is greater than zero, then at 

least one of the following must be significant: (SEQ 0435 or 0437). 

When Sales by Vendors of Undyed Kerosene Credit Amount (SEQ 0680) is greater than zero, then 

at least one of the following must be significant: (SEQ 0650, 0660, or 0670). 

When Use of LPG in Certain Intercity Buses Credit Amt (SEQ 0890) is greater than zero, then 

Certain Intercity and Local Buses Gallons (SEQ 0880) must be significant. 

When Use of LPG in Qualified Local & School Buses (SEQ 0910) is greater than zero, then Qualified 

Local and School Buses Gallons (SEQ 0900) must be significant. 

When Commercial Aviation Kerosene Amount (SEQ 0417) is greater than zero, then Commercial 

Aviation Kerosene Gallons (SEQ 0415) must be significant. 

When AGK Use in Foreign Trade Credit Amount (SEQ 0427) is greater than zero, then AGK Use in 

Foreign Trade Gallons (SEQ 0425) must be significant. 

When Use Undyed Diesel Intercity Buses Amount (SEQ 0445) is greater than zero, then Use Undyed 

Diesel Intercity Buses Gallons (SEQ 0443) must be significant. 

When Undyed Kerosene Use in Certain Buses Amount (SEQ 0695) is greater than zero, then 

Undyed Kerosene Use in Certain Buses Gallons (SEQ 0685) must be significant. 
o

o

o

o

o

o

o

o

o

o

o

When AGK Used in Commercial Aviation Amount (SEQ 0725) is greater than zero, then AGK Used 

in Commercial Aviation Gallons (SEQ 0715) must be significant. 

When AGK Noncommercial Use Amount (SEQ 0775) is greater than 

zero, then AGK Other Nontaxable Use Gallons (SEQ 0745) or AGK Use on Farm Gallons (SEQ 

0755) or AGK Use by Government Gallons (SEQ 0765) must be significant. 

When Use by Nonprofit Amount (SEQ 0805) is greater than zero, then Use by Nonprofit Gallons 

(SEQ 0795) must be significant. 

When Use by State or Local Government Amount (SEQ 0825) is greater than zero, then Uses by 

State or Local Government Gallons (SEQ 0815) must be significant. 

When Use AG by Nonprofit Amount (SEQ 0850) is greater than zero, then Use AG by Nonprofit 

Gallons (SEQ 0840) must be significant. 

When Use AG by Government Amount (SEQ 0870) is greater than zero, then Use AG by 

Government Gallons (SEQ 0860) must be significant. 

When LPG Other Nontaxable Use Amount (SEQ 0940) is greater than zero, then LPG Other 

Nontaxable Use Gallons (SEQ 0930) must be significant. 

When Alcohol Mixtures Ethanol Amount (SEQ 0970) is greater than zero, then Alcohol Mixtures 

Ethanol Gallons (SEQ 0960) must be significant. 

When Alcohol Mixtures Other Than Ethanol Amount (SEQ 0990) is greater than zero, then Alcohol 

Mixtures Other Than Ethanol Gallons (SEQ 0980) must be significant. 

When Biodiesel Mix Amount (SEQ 1020) is greater than zero, then Biodiesel Mix Gallons (SEQ 

1010) must be significant. 

When Agri-biodiesel Mix Amount (SEQ 1040) is greater than zero, then Agri-biodiesel Mix Gallons 

(SEQ 1030) must be significant. 

0423 o Form 4136 – If Evidence of Dyed AGK Exception Box (SEQ 0414) equals “X”, Evidence of Dyed 

AGK Explanation (SEQ 0413) must equal “STMbnn” and vice versa. 

0424 o 

o

o

o

o

Form 4136 – If Evidence of Dyed Diesel Fuel Exception Box (SEQ 0433) equals “X”, then the Evidence 

of Dyed Diesel Fuel Explanation (SEQ 0431) must equal “STMbnn” and the Undyed Diesel Fuel UV 

Registration No (SEQ 0429) must be significant. 

If Evidence of Dyed Diesel Fuel Explanation (SEQ 0431) equal “STMbnn”, then the Evidence of Dyed 

Diesel Fuel Exception Box (SEQ 0433) must equal “X”, and the Undyed Diesel Fuel UV Registration No 

(SEQ 0429) must be significant. 

If Evidence of Dyed Kerosene Exception Box (SEQ 0640) equals “X”, then Evidence of Dyed Kerosene 

Explanation (SEQ 0630) must equal “STMbnn” and Undyed Kerosene UV Registration No (SEQ 0610), 

must be significant. 

If Evidence of Dyed Kerosene Explanation (SEQ 0630) equals “STMbnn”, then Evidence of Dyed 

Kerosene Exception Box (SEQ 0640) must equal “X”, and Undyed Kerosene UV Registration No (SEQ 

0610) must be significant. 

Note: For Error Code 0424 only; when both an Explanation and the Exception Box are met, then there 

must be a Registration Number.

0425 o Form 4136 – If Total Income Tax Credit Amount (SEQ 1050) is significant, then at least one of the 

“credit amounts” (SEQ 0070, 0180, 0230, 0300, 0320, 0340, 0347, 0395, 0410, 0412, 0417, 0423, 0427, 

0439, 0445, 0680, 0695, 0725, 0775, 0805, 0825, 0850, 0870, 0890, 0910, 0940, 0970, 0990, 1020, 

1040,1042 or 1046) must be significant. 

0426 o Form 1040 – Other Payments (SEQ 1210) must equal the total of Tax Paid by Regulated Investment 

Company (SEQ 0230) from Form 2439 plus Total Income Tax Credit Amount (SEQ 1050) from 

Form 4136 plus Health Coverage Tax Credit (SEQ 0250) from Form 8885. 
0427 o 

o

o

o

o

o

o

o

Form 4136 – When any of the “gallons” fields is greater than zero, then the associated “type of use” 

field must be significant. For example: 

When Nontaxable Use of Gasoline Gallons (SEQ 0040) is greater than zero, then Nontaxable Use of 

Gasoline Type (SEQ 0030)must be significant. 

When Nontaxable Use of Aviation Gasoline Gallons (SEQ 0200) is greater than zero, then 

Nontaxable Use of Aviation Gasoline Type (SEQ 0190) must be significant. 

When Nontaxable Use of Diesel Fuel Gallons (SEQ 0270) is greater than zero, then Nontaxable Use 

of Diesel Fuel Type (SEQ 0260) must be significant. 

When Nontaxable Use of Kerosene Gallons (SEQ 0380 or 0400) is greater than zero, then 

Nontaxable Use of Kerosene Type (SEQ 0370) must be significant. 

When Nontaxable Use of Aviation Fuel Gallons (SEQ 0421 or 0425) is greater than zero, then 

Nontaxable Use of Aviation Fuel Type (SEQ 0419) must be significant. 

When AGK Other Nontaxable Use Gallons (SEQ 0745) or AGK Use on Farm Gallons (SEQ 0755) or 

AGK Use by Government Gallons (SEQ 0765) is greater than zero, then AGK Other Nontaxable Use 

Type (SEQ 0735) must be significant. 

When LPG Other Nontaxable Use Gallons (SEQ 0930) is greater than zero, then LPG Other 

Nontaxable Use Type (SEQ 0920) must be significant. 

0428-0429 RESERVED 

0430 o State Record - If State Abbreviation (SEQ 0095) equals "AS", "GU", "MP", "PR", or "VI"; or Address 

Ind SEQ (0097) on the State Only 1040 equals "3" it must be processed at Philadelphia. 

0431 o RESERVED

0432 o Form 8271 – When Form 8271 is present, one of the following Tax Shelter group items must be 

present on the first occurrence: Tax Shelter Name – 1 (SEQ 0030) or Tax Shelter Registration 

Number –1 (SEQ 0040) or Name of Person Who Applied for Registration –1 (SEQ 0050) or Tax 

Shelter Identifying Number –1 (SEQ 0060). 

0433-0434 RESERVED 

0435 o 

o

Form 8582-CR - When Multiply Line 11 by 50% (SEQ 0200) is significant, it cannot be greater then 

$25,000. 

When Multiply Line 23 by 50% (SEQ 0330) is significant, it cannot be greater then $25,000. 

0436 o 

o

Form 8582-CR - When Special Allowance for Rental Activity 

(SEQ 0210) is significant, Form 8582 must be present. 

When Special Allowance for Rental Activity (SEQ 0340) is significant, Form 8582 must be present. 

0437 o Form 8582-CR – Modified Adjusted Gross Income (SEQ 0310) cannot be less than zero. 

0438 o Summary Record – For Online Returns, the IP Address (SEQ 0190) cannot contain an IPv4 address 

where any of its 4 parts is not a number from 0 to 255 and there are not 3 periods. 

0439 o If the Transmission Type Code (SEQ 0170) of the TRANA Record is equal to "O", the following fields 

must be significant: IP Address (SEQ 0190), IP Date (SEQ 0200), IP Time (SEQ 0210) and IP Time 

Zone (SEQ 0215). 

0440 o RESERVED 

0441 o Summary Record - For Online Returns, IP Address (SEQ 0190) cannot contain an IPv6 address where 

any of its 8 parts is not a number from 0 to FFFF (hexadecimal) and there are not 7 colons. 
0442-0445 RESERVED 

0446 o Form 4136 – When Undyed Diesel Fuel UV Registration No (SEQ 0429) is present, then Use of 

Undyed Diesel for Farming Purpose Gallons (SEQ 0435) or Use of Undyed Diesel by State or Local 

Gov Gallons (SEQ 0437) must be present, and vice versa. 

0447 o 

o

o

o

o

o

Form 4136 – When Undyed Kerosene UV Registration No (SEQ 0610) is present, then Use of 

Undyed Kerosene for Farming Purpose Gallons (SEQ 0650) or Use of Undyed Kero by State or Local 

Gov Gallons (SEQ 0660) must be present, and vice versa. 

When Aviation Grade Kerosene UV Registration No. (SEQ 0705) is significant, then AGK Used in 

Commercial Aviation Gallons (SEQ 0715) or AGK Other Nontaxable Use Gallons (SEQ 0745) or AGK 

Use on Farm Gallons (SEQ 0755) or AGK Use by Government (SEQ 0765) must be significant and 

vice versa. 

When Ultimate Vendors of Gasoline Registration No. (SEQ 0785) is significant, then Use by Nonprofit 

Gallons (SEQ 0795) or Use by State or Local Government Gallons (SEQ 0815) must be significant 

and vice versa. 

When Vendors of Aviation Gas Registration No. (SEQ 0830) is significant, then Use AG by Nonprofit 

Gallons (SEQ 0840) or Use AG by Government Gallons (SEQ 0860) must be significant and vice 

versa.

When Alcohol Fuel Mixture Registration No. (SEQ 0950) is significant, then Alcohol Mixtures Ethanol 

Gallons (SEQ 0960) or Alcohol Mixtures Other Than Ethanol Gallons (SEQ 0980) must be significant 

and vice versa. 

When Biodiesel Mixture Registration No. (SEQ 1000) is significant, then Biodiesel Mix Gallons 

SEQ 1010) or Agri-biodiesel Mix Gallons (SEQ 1030) must be significant and vice versa. 

0448 RESERVED 

0449 o Form 8606 - The “Qualified First-Time Homebuyer Distr” 

(SEQ 0353) can not be greater than $10,000. 

0450 o Form 8606 – Nondeductible IRA Name (SEQ 0009) and SSN of Taxpayer with IRAs (SEQ 0010) 

must be significant. 

0451 o 

o

Form 8606 – Nondeductible IRA Name (SEQ 0009) must contain a less-than sign immediately 

preceding the last name. If the name includes a suffix, another less-than sign is entered between the 

last name and the suffix. Allowable characters are: Alpha, hyphen (-), less-than (<), and space. 

Nondeductible IRA Name (SEQ 0009) cannot contain the following: Two or more consecutive 

embedded spaces, a space or less-than sign in the first position, a less-than sign in the last position, 

more than two less-than signs, a space preceding or following a less-than sign. 

0452 o 

o

Form 2555/2555EZ – When only one Form 2555/2555EZ is present, SSN of Taxpayer with Foreign 

Earned Income (SEQ 0007) must equal Primary SSN (SEQ 0010) or Secondary SSN (SEQ 0030) of 

Form 1040. 

When two Forms 2555/2555EZ are present, SSN of Taxpayer with Foreign Earned Income 

(SEQ 0007) of the first Form 2555/2555EZ must equal Primary SSN (SEQ 0010) of Form 1040 and 

SSN of Taxpayer with Foreign Earned Income (SEQ 0007) of the second Form 2555/2555EZ must 

equal Secondary SSN (SEQ 0030) of Form 1040. One occurrence of either Form 2555 or 

Form 2555EZ can be present for the Primary SSN (SEQ 0010). One occurrence of either Form 2555 

or Form 2555EZ can be present for the Secondary SSN (SEQ 0030). 

0453 o Form 2555EZ – Total Foreign Earned Income (SEQ 1210) cannot exceed $80,000. 

0454 o Form 1040 – Earned Income Credit (SEQ 1180) cannot be significant when Form 2555 or 

Form 2555EZ is present. 
0455 o 

o

Form 2555 – Foreign Earned Income Exclusion (SEQ 1220) cannot exceed Foreign Earned Income 

(SEQ 1050). Foreign Earned Income Repeated (SEQ 1070) must equal Foreign Earned Income 

(SEQ 1050). 

Form 2555EZ – Max. Of Foreign Earned Inc. Exclusion (SEQ 1260) cannot exceed $80,000 Total 

Foreign Earned Income (SEQ 1210). 

0456 o 

o

Form 1040 – When Housing/Foreign Earned Income Exclusion Literal (SEQ 0574) equals 

“FORM 2555”, Form 2555 must be present. 

When Housing/Foreign Earned Income Exclusion Literal (SEQ 0574) equals “FORM 2555-EZ”, 

Form 2555EZ must be present. 

0457 o Form 1040 – The absolute value of Housing/Foreign Earned Income Exclusion Amount (SEQ 0577) 

must equal the total of the following fields: Max. of Housing and Foreign Earned Inc. Exclusions 

(SEQ 1260) from Form 2555(s) plus Max. of Foreign Earned Inc. Exclusion (SEQ 1260) from 

Form(s) 2555EZ. 

0458 o Form 1040 – When Other Adjustments Literal (SEQ 0720) equals “FORM 2555”, Form 2555 must be 

present. 

0459 o Form 1040 – If Other Adjustments Literal (SEQ 0720) equals “FORM 2555”, then Other Adjustment 

Amount (SEQ 0730) must equal Total Housing Deduction (SEQ 1310) from Form(s) 2555. 

0460 o 

o

o

o

o

Form 2555/2555-EZ – Taxpayers must qualify for the Foreign Exclusion under the Bona Fide 

Residence or Physical Presence test. Both tests will be verified prior to the return being accepted. 

This Error Reject Code will be set in any case where the taxpayer did not qualify under either of the 

tests.

Form 2555 – When the taxpayer is qualifying under Bona Fide Residence: When Date Bona Fide 

Residence Ended (SEQ 0225) is equal to 1231 of the current tax year or is equal to “CONTINUE”, 

then Date Bona Fide Residence Began (SEQ 0220) must equal 0101 of the current tax year or must 

be prior to the current tax year or when Date Bona Fide Residence Ended (SEQ 0225) is prior to 

1231 of the current tax year (i.e., 20051031), then Date Bona Fide Residence Began (SEQ 0220) 

must equal 0101 of the previous tax year or earlier than the previous tax year (i.e., 20040101). 

Form 2555 – When the taxpayer is qualifying under Physical Presence: The difference, in number of 

days, between Physical Presence Test From (SEQ 0530) and Physical Presence Test Through 

(SEQ 0540) minus the total of Number of Days in US on Business – 1 through – 4 (SEQ 0610, 0670, 

0730, 0790) must be at least 330 days. 

Form 2555EZ – When the taxpayer is qualifying under Bona Fide Residence: When Date Bona Fide 

Residence Ended (SEQ 0040) is equal to 1231 of the current tax year or is equal to “CONTINUE”, 

then Date Bona Fide Residence Began (SEQ 0030) must equal 0101 of the current tax year or must 

be prior to the current tax year or When Date Bona Fide Residence Ended (SEQ 0040) is prior to 

1231 of the current tax year (i.e., 20051031), then Date Bona Fide Residence Began (SEQ 0030) 

must equal 0101 of the previous tax year or earlier than the previous tax year (i.e., 20040101). 

Form 2555EZ – When the taxpayer is qualifying under Physical Presence: The difference, in number 

of days, between Physical Presence Test From (SEQ 0070) and Physical Presence Test Through 

(SEQ 0080) minus the total of Number of Days in US on Business – 1 through – 9 (SEQ 0310, 0350, 

0390, 0430, 0470, 0510, 0550, 0590, 0630) must be at least 330 days. 

0461 o Form 2555 – Statement to Authorities – Yes (SEQ 0300) and Req’d to Pay Income Tax – No 

(SEQ 0330) cannot both be significant. 

0462 o Form 2555 – If No Travel Statement (SEQ 0560) is significant, then the following fields cannot be 

significant: Country Name (SEQ 0570), Arrival Date (SEQ 0580), Departure Date (SEQ 0590), Full 

Days in Country (SEQ 0600), Number of Days in US on Business (SEQ 0610), and Income Earned in 

the US on Business (SEQ 0620). 
0463 o 

o

Form 2555 – Taxpayer Foreign Street Address (SEQ 0011), Taxpayer Foreign City (SEQ 0012), and 

Taxpayer Foreign Country (SEQ 0015) must be significant. Country Code (SEQ 0018) must be 

significant and equal to a valid Country code. 

Form 2555EZ – Taxpayer Foreign Street Address (SEQ 0111), Taxpayer Foreign City (SEQ 0112), 

and Taxpayer Foreign Country (SEQ 0115) must be significant. Country Code (SEQ 0118) must be 

significant and equal to a valid Country code. 

0464 o Form 2555 – If Separate Foreign Residence – Yes (SEQ 0170) is significant, then Yes – City & 

Country of Foreign Residence (SEQ 0190) and Number of Days at That Address (SEQ 0200) must be 

significant. 

0465 o Form 2555 – Housing Exclusion (SEQ 1140) cannot be greater than Employer-Provided Amounts 

(SEQ 1120). 

0466 o Form 2555 – Total Housing and Foreign Earned Income Exclusions (SEQ 1230) must equal the total 

of Housing Exclusion (SEQ 1140) plus Foreign Earned Income Exclusion (SEQ 1220). 

0467 o Form 2555EZ – If Bona Fide Residence – Yes (SEQ 0010) is significant, then Date Bona Fide 

Residence Began (SEQ 0030) and Date Bona Fide Residence Ended (SEQ 0040) must be 

significant. 

0468 o Form 2555EZ – If Physically Present – Yes (SEQ 0050) is significant, then Physical Presence Test 

From (SEQ 0070) and Physical Presence Test Through (SEQ 0080) must be significant. 

0469 o Form 2555EZ – Tax Home Test – Yes (SEQ 0090) must be significant. 

0470 o 

o

Form 2555EZ – For each of the following, only one box can equal “X”: 

Bona Fide Residence – Yes (SEQ 0010) or Bona Fide 

Residence – No (SEQ 0020); 

Physically Present – Yes (SEQ 0050) or Physically Present – No (SEQ 0060); 

Revoked Exclusions – Yes (SEQ 0220) or Revoked Exclusions – No (SEQ 0230). 

If no Form 2555/2555EZ Box (SEQ 0210) is checked, then Revoked Exclusions -Yes (SEQ 0220) 

and Revoked Exclusions - No (SEQ 0230) should not be significant. 

0471 o Form 2555 – Part II or Part III must be present, but not both. 

0472 o Form 2555/2555EZ – Must be processed at the Philadelphia Submission Processing Center. 

0473-0474 RESERVED 

0475 o RESERVED 

0476 o Schedule EIC – The following fields cannot equal “X”: 

Disabled “No” Box – 1 (SEQ 0045) or Disabled “No” Box – 2 

(SEQ 0115). 

0477-0479 RESERVED 

0480 o Form 8839 – When Identifying Number Child (SEQ 0080, 0160) is significant, it must be within the 

valid ranges of SSN/ITIN/ATIN’s. 

0481 o 

o

o

Form 8839 – Eligible Child First Name – 1 (SEQ 0010), Eligible Child Last Name – 1 (SEQ 0020), 

Eligible Child Name Control – 1 (SEQ 0030), Year of Birth – 1 (SEQ 0040), and Identifying Number 

Child – 1 (SEQ 0080) must be significant. 

If any field of the following “eligible child group” is significant, then all fields in that group must be 

significant: Eligible Child First Name (SEQ 0010, 0090); Eligible Child Last Name (SEQ 0020, 0100); 

Eligible Child Name Control (SEQ 0030, 0110); Year of Birth (SEQ 0040, 0120); and Identifying 

Number Child (SEQ 0080, 0160). 

Eligible Child Name Control (SEQ 0030, 0110) must be in the correct format. 

0482 o Form 8839 – Year of Birth – 1 (SEQ 0040) and Year of Birth – 2 (SEQ 0120) cannot be greater than 

current tax year. 
0483 o Form 8839 – Identifying Number Child (SEQ 0080, 0160) cannot equal another Identifying Number 

Child (SEQ 0080, 0160) on any occurrence of Form 8839 on the return. Identifying Number Child 

(SEQ 0080, 0160) cannot equal Primary SSN (SEQ 0010) or Secondary SSN (SEQ 0030) of 

Form 1040/1040A. 

0484 o Form 8839 – If Year of Birth – 1 or – 2 (SEQ 0040, 0120) is prior to “1987”, then the corresponding 

Disabled Over 18 

Box – 1 or –2 (SEQ 0049, 0129) must equal “X”. 

0485 o 

o

o

Form 8839 – Modified AGI (SEQ 0240) must be less than $199,450 unless one of the following 

exceptions applies: 

Carryforward of Adoption Credit to Current Year (SEQ 0284) is significant and Adoption Literal (SEQ 

0368) on Form 1040/1040A does not equal “SNE” or “PYAB”. 

Adoption Literal (SEQ 0368) on Form 1040/1040A equals “AB” and Adoption Amount (SEQ 0369) is 

positive. 

0486 o 

o

Form 1040/1040A – When Adoption Credit (SEQ 0960) is significant, Form 8839 must be present. 

When Adoption Literal (SEQ 0368) equals “AB”, “SNE”, or “PYAB”, Adoption Amount (SEQ 0369) 

must be significant and page 2 of the first occurrence of Form 8839 must be present. 

0487 o Form 8839 – If Adoption Credit (SEQ 0297) is significant, then it must equal Adoption Credit (SEQ 

0960) on Form 1040/1040A. 

0488 o Form 8839 - When more than one Form 8839 is present, only the first occurrence of Form 8839 can 

contain entries in the following fields: SEQs 0230 through 0297, 0350, and 0380 through 0450. 

0489 o RESERVED 

0490 o Summary Record – If Year of the Electronic Postmark Date 

(SEQ 0260) is present, Year of Electronic Postmark Date must equal the current processing year. 

0491 o Summary Record – If one of the three fields is present, then all of the following fields must be 

present: Electronic Postmark Date (SEQ 0260), Electronic Postmark Time (SEQ 0270), Electronic 

Postmark Time Zone (SEQ 0280). 

0492 o RESERVED 

0493 o Summary Record – Software Identification Number (SEQ 0230) must be present. 

0494 o Form 1040 – If Form 8689 Amount (SEQ 1246) is significant, then Form 8689 must be present. 

0495 o 

o

Form 1040 – If Filing Status (SEQ 0130) is not equal to “2”, then only one Form 4563 can be present.

Form 1040 – If Filing Status (SEQ 0130) is equal to “2”, then two Forms 4563 can be present. 

0496 o 

o

Form 4563 – When only one Form 4563 is present, Taxpayer SSN (SEQ 0020) must equal Primary 

SSN (SEQ 0010) or Secondary SSN (SEQ 0030) of Form 1040. 

When two Forms 4563 are present, Taxpayer SSN (SEQ 0020) of the first Form 4563 must equal 

Primary SSN (SEQ 0010) of Form 1040 and Taxpayer SSN (SEQ 0020) of the second Form 4563 

must equal Secondary SSN (SEQ 0030) of Form 1040. 

0497-0498 RESERVED 

0499 o The Employer Identification Number (SEQ 0040) of Form W-2 and/or W-2GU, Payer Identification 

Number (SEQ 0026) of 

Form W-2G, and Payer Identification Number (SEQ 0050) of Form 1099-R is invalid for processing 

an Individual e-filed return. 
0500 o Primary SSN (SEQ 0010) and Primary Name Control (SEQ 0050) of the Tax Form must match data 

from the IRS Master File. 

0501 o Qualifying SSN (SEQ 0015, 0085) of Schedule EIC and the corresponding Qualifying Child Name 

Control (SEQ 0007, 0077) must match data from the IRS Master File. 

0502 o Employer Identification Number (SEQ 0040) of Form W-2 and/or W-2GU, Payer Identification 

Number (SEQ 0026) of Form W-2G, and Payer Identification Number (SEQ 0050) of Form 1099-R 

and Company or Trust Identification Number (SEQ 0120) of Form 2439 must match data from the 

IRS Master File.

Note: Form 1099-R is ONLY required when federal income tax is withheld. 

0503 o Secondary SSN (SEQ 0030) and Spouse’s Name Control (SEQ 0055) of the Tax Form must match 

data from the IRS Master File or If filing status (SEQ 0130) is equal to “4” and Exempt Spouse 

(SEQ 0163) is equal to “X”, then the Spouse SSN (SEQ 0030) and Exempt Spouse Name Control ( 

SEQ 0165) must match data from the IRS Master File. 

0504 o Dependent’s SSN (SEQ 0175, 0185, 0195, 0205) of Form 1040/1040A and corresponding 

Dependent Name Control (SEQ 0172, 0182, 0192, 0202) must match data from the IRS Master File. 

0505 o Employer Identification Number (SEQ 0040) of Form W-2 and/or W-2GU, or Payer Identification 

Number (SEQ 0026) of Form W-2G, or Payer Identification Number (SEQ 0050) of Form 1099-R or 

Company/Trust Identification Number (SEQ 0120) of Form 2439 was issued in the current 

processing year. 

0506 o Qualifying SSN (SEQ 0015, 0085) of Schedule EIC was previously used for the same purpose. 

0507 o Dependent’s SSN (SEQ 0175, 0185, 0195, 0205) of Form 1040/1040A was previously used for the 

same purpose. 

0508 o Primary SSN (SEQ 0010) has been used as a Secondary SSN (SEQ 0030) on another return with 

filing status 2 - Married filing joint status (SEQ 0130) or with filing status 4 – Head of Household and 

Exempt Spouse (SEQ 0163) equals to “X”; or Secondary SSN (SEQ 0030) has been used as a 

Primary SSN (SEQ 0010) on another return. 

0509 o Secondary SSN (SEQ 0030) was previously used as a Dependent’s SSN or as a Schedule EIC 

Qualifying SSN on a previous or current return; or Dependent’s SSN was used as a Secondary SSN 

on a previous or current return; or Schedule EIC Qualifying SSN was used as a Secondary SSN on a 

current or previous return. 

0510 o Primary SSN (SEQ 0010) and/or Secondary SSN (SEQ 0030) where the SSN was claimed as an 

exemption (SEQ 0160) on the return and was also used as a Dependent’s SSN (SEQ 0175, 0185, 

0195, 0205) on another return or the dependent's SSN has been used on another return as a 

Primary or Secondary SSN. 

0511 o Primary SSN (SEQ 0010) was used with the Filing Status (SEQ 0130) other than “3” or “4”, and was 

also used as a Secondary SSN (SEQ 0030) on another return with filing status value “3”. 

0512 o Form 8863 - Student’s Name Control (SEQ 0030, 0100, 0170, 0270, 0310, 0350) and corresponding 

Student’s SSN (SEQ 0035, 0105, 0175, 0275, 0315, 0355) must match data from the IRS Master 

File.

0513 o Secondary SSN (SEQ 0030) was used as a Secondary SSN more than once. 

0514 o Insured Name Control (SEQ 0295) and Insured SSN (SEQ 0310) of Form 8853 must match data 

from the IRS Master File. 

0515 o Primary SSN (SEQ 0010) was used as a Primary SSN more than once. 

0516 o Primary SSN (SEQ 0010) and the Primary Name Control (SEQ 0050) of the State-Only 1040 Return 

must match data from the IRS Master File. 
0517 o Secondary SSN (SEQ 0030) and the Secondary Name Control (SEQ 0055) of the State-Only 1040 

Return must match data from the IRS Master File or If filing status (SEQ 0130) is equal to “4” and 

Exempt Spouse (SEQ 0163) is equal to “X”, then the Spouse SSN (SEQ 0030) and Exempt Spouse 

Name Control (SEQ 0165) must match data from the IRS Master File. 

0518 o Form 1310 – The Name Control of Person Claiming Refund (SEQ 0050) and the SSN of Person 

Claiming Refund (SEQ 0070) must match data from the IRS Master File. 

0519 o Form 8697 - Employer Identification Number of Entity (SEQ 0150) and Employee Name Control 

(SEQ 0155) on Form 8697, must match data from the IRS Master File. 

0520 o Employer Name Control (SEQ 0015) and Employer Identification Number (SEQ 0030) of Schedule H 

must match data from the IRS Master File. 

0521 o Year of Birth for the following cannot equal the current processing year: Primary SSN (SEQ 0010) 

and Secondary SSN (SEQ 0030) of the Tax Form; Dependent's SSN (SEQ 0175, 0185, 0195, 0205) 

of Form 1040/1040A; Qualifying SSN - 1 (SEQ 0015) and Qualifying SSN - 2 (SEQ 0085) of 

Schedule EIC, and Child’s SSN (SEQ 0040, 0090, 0140, 0190) of Form 8901. 

0522 o 

o

o

Primary Date of Birth (SEQ 0010) in the Authentication Record of an Online Return does not match 

data from the IRS Master File. 

Exceptions:

Primary Date of Birth is not required when the Primary Date of Death (SEQ 0020) on Form 1040/A/EZ 

is significant AND the filing status is MFJ. 

When the Filing Status (SEQ 0130) equals "2" (Married Filing Jointly), and the Special Processing Literal 

(SEQ 0100) of the Tax Return equals "DESERTbSTORM, HAITI, FORMERbYUGOSLAVIA, 

UNbOPERATION, JOINTbGUARD, JOINTbFORGE, NORTHERNbWATCH, 

OPERATIONbALLIEDbFORCE, NORTHERNbFORGE, ENDURINGbFREEDOM, COMBATbZONE, or 

COMBATbZONEbYYYYMMDD", then the Primary Date of Birth (SEQ 0010) in the Authentication Record 

of an Online Return is not required.

0523 o 

o

o

Spouse Date of Birth (SEQ 0040) in the Authentication Record of an Online Return does not match 

data from the IRS Master File. 

Exceptions:

Spouse Date of Birth is not required when the Secondary Date of Death (SEQ 0040) on Form 

1040/A/EZ is significant. 

When the Filing Status (SEQ 0130) equals "2" (Married Filing Jointly), and the Special Processing Literal 

(SEQ 0100) of the Tax Return equals "DESERTbSTORM, HAITI, FORMERbYUGOSLAVIA, 

UNbOPERATION, JOINTbGUARD, JOINTbFORGE, NORTHERNbWATCH, 

OPERATIONbALLIEDbFORCE, NORTHERNbFORGE, ENDURINGbFREEDOM, COMBATbZONE, or 

COMBATbZONEbYYYYMMDD", then the Spouse Date of Birth (SEQ 0040) in the Authentication Record 

of an Online Return is not required. 

0524 o Qualifying Person Name Control - 1, - 2 (SEQ 0120, 0221) and Qualifying Person SSN - 1, - 2 

(SEQ 0214, 0223) of Form 2441/Schedule 2 do not match data from the IRS Master File. 

0525 o Eligible Child Name Control - 1, - 2 (SEQ 0030, 0110) and Identifying Number Child - 1, - 2 

(SEQ 0080, 0160) of Form 8839 do not match data from the IRS Master File. 

0526 o Qualifying Person SSN - 1, - 2 (SEQ 0214, 0223) of Form 2441/Schedule 2 was previously used for 

same purpose. 

0527 o Identifying Number Child - 1, - 2 (SEQ 0080, 0160) of Form 8839 was previously used for same 

purpose. 

0528 o Form 8863 - Student's SSN (SEQ 0035, 0105, 0175, 0275, 0315, 0355) was previously used to claim 

Education Credit on another tax return. 

0529 o Declaration Control Number (DCN) (SEQ 0008) of the Tax Return record Identification Page 1 cannot 

duplicate a DCN on a previously accepted electronic return for the current processing year. 

0530 o RESERVED 
0531 o Form 1040/1040A/1040EZ – A Date of Death is present on IRS records for the Primary SSN (SEQ 

0010). 

0532 o Form 1040/A/EZ – A Date of Death is present on IRS records for the Secondary SSN (SEQ 0030). 

0533 o Form 1040/1040A – A Date of Death is present on IRS records for one or more of the Dependents 

SSN (SEQ +0175, 0185, 0195, 0205 and/or statement records). 

0534 o Schedule EIC – A Date of Death is present on IRS records for the Qualifying Child (ren) SSN (SEQ 

0015, 0085). 

0535 o Schedule EIC - Qualifying SSN (SEQ 0015, 0085) of Schedule EIC and the corresponding Year of 

Birth (SEQ 0020, 0090) must match data received from the Social Security Administration. 

0536 o RESERVED 

0537 o Form 1040/1040A - Exempt Spouse Name Control (SEQ 0165) and Spouse SSN (SEQ 0030) match 

data from the IRS Master File. 

0538-0539 RESERVED 

0540 o Tax Form – Individuals who have filed returns in a U.S. Possession in the prior year are not eligible to 

claim Earned Income Tax Credit on electronically filed returns. 

0541-0559 RESERVED 

0560 o Form 8901 - Child’s SSN (SEQ 0040, 0090, 0140, 0190) and corresponding Child Name Control 

(SEQ 0030, 0080, 0130, 0180) must match data from the IRS Master File. 

0561-0562 RESERVED 

0563 o 

o

Form 1040/1040A - Dependent’s SSN (SEQ 0175, 0185, 0195, 0205) with Eligibility for Child Tax 

Credit (SEQ 0178, 0188, 0198, 0208) equal to “X” was previously used for child tax credit. 

Form 8901 - Child’s SSN (SEQ 0040, 0090, 0140, 0190) was previously used for child tax credit. 

0564-0565 RESERVED 

0566 o Form 8901 – A Date of Death is present on IRS records for one or more Child’s SSN (SEQ 0040, 

0090, 0140, 0190). 

0567-0599 RESERVED 

0600 o Tax Form – IRS Master File indicates that the taxpayer must file Form 8862 to Claim Earned Income 

Credit after disallowance. Form 8862 is missing from the tax return and it is required. 

Note: The IRS may request additional verification in addition to the completed Form 8862. 

0601 o RESERVED 

0602 o Form 8862- Year for Which You Are Filing This Form (SEQ 0010) must equal the current tax year. 

0603 o RESERVED 

0604 o RESERVED 

0605 o RESERVED 

0606 o Tax Form – IRS Master File indicates that the taxpayer is not allowed to claim the Earned Income 

Credit for this tax year. 

0607 o Form 8866 – If more than one Form 8866 is present, then only the first occurrence of Form 8866 can 

have significant data in Total Interest Due on Increase (SEQ 0430) or Total Interest to be Refunded on 

Decrease (SEQ 0440). 
0608-0609 RESERVED 

0610 o 

o

Tax Form - If Address Ind (SEQ 0097) is equal to "3" (indicating a foreign country), then the following 

fields must be present: Foreign Street Address (SEQ 0062), Foreign City, State or Province, Postal 

Code (SEQ 0064), and Foreign Country (SEQ 0066); and the following fields cannot be present: 

Name Line 2 (SEQ 0070), Street Address (SEQ 0080), City (SEQ 0083), State Abbreviation 

(SEQ 0087), and Zip Code (SEQ 0095). 

If Address Ind (SEQ 0097) is not equal to "3", then the following fields cannot be present: Foreign 

Street Address (SEQ 0062), Foreign City, State or Province, Postal Code (SEQ 0064), and Foreign 

Country (SEQ 0066). 

0611 o Tax Form - Foreign Street Address (SEQ 0062) is alphanumeric and cannot have leading or consecutive 

embedded spaces. The only special characters permitted are space, hyphen (-), and slash (/). 

0612 o Tax Form - Foreign City, State or Province, Postal Code (SEQ 0064) is alphanumeric and cannot have 

leading or consecutive embedded spaces. The left-most position must contain an alpha or numeric 

character. The only special characters permitted are space, hyphen (-), and slash (/). 

0613 o Tax Form - Foreign Country (SEQ 0066) must be left justified and must contain a minimum of three alpha 

characters. This field cannot contain consecutive embedded spaces and must contain only alpha 

characters and spaces. Do not abbreviate the country name. 

0614 o Tax Form - Earned Income Credit (SEQ 1180) cannot be significant when State Abbreviation (SEQ 0087) 

equals "AS", "GU", "MP", "PR", or "VI", or when Address Ind (SEQ 0097) equals "3". 

0615 o Tax Form - If State Abbreviation (SEQ 0087) equals "AS", "GU", "MP", "PR", or "VI"; or Address Ind 

(SEQ 0097) equals "3"; or any of the following forms are present: Form 4563, Form 5074, Form 8689, 

Form 8833, Form 8854, Form 8891 and/or Form W-2GU, then the return must be processed at 

Philadelphia Submission Processing Center. 

0616 o 

o

o

o

Form W-2 – When Employee Address Continuation (SEQ 0105) is significant, then a period (.) must 

be present in Employee State (SEQ 0113). 

Form W-2G – When Winner’s Address Continuation (SEQ 0143) is significant, then a period (.) must 

be present in Winners’ State (SEQ 0146). 

Form W-2GU – When Employee Address Continuation (SEQ 0105) is significant, then a period (.) 

must be present in Employee State (SEQ 0113). 

Form 1099R – When Recipient’s Address Continuation (SEQ 0080) is significant, then a period (.) 

must be present in Recipient’s State (SEQ 0092). 

0617 o RESERVED 

0618 o RESERVED 

0619 o Form 8379 – First Injured Spouse Box (SEQ 0030) and Second Injured Spouse Box (SEQ 0060) 

cannot both equal "X" and cannot both equal blank. 

0620 o Form 8379 – When Form 8379 is present, the following fields must be significant: either First Injured 

Spouse Box (SEQ 0030) or Second Injured Spouse Box (SEQ 0060), and either Community Property 

State–Yes Box (SEQ 0150) or Community Property State–No Box (SEQ 0160). 

0621 o Form 8379 – When Community Property State Yes Box (SEQ 0150) is equal to “X”, one or more of 

the following community state’s abbreviation must be significant: 

SEQ 0161 Community Property State Abbreviation for Arizona; 

SEQ 0162 Community Property State Abbreviation for California; 

SEQ 0163 Community Property State Abbreviation for Idaho; 

SEQ 0164 Community Property State Abbreviation for Louisiana; 

SEQ 0165 Community Property State Abbreviation for Nevada; 

SEQ 0166 Community Property State Abbreviation for New Mexico; 
SEQ 0167 Community Property State Abbreviation for Texas; 

SEQ 0168 Community Property State Abbreviation for Washington; and/or 

SEQ 0169 Community Property State Abbreviation for Wisconsin. 

0622 o Form 8379 – When Total Other Income-Joint Return (SEQ 0210) is significant, then the sum of Total 

Other Income-Injured Spouse (SEQ 0220) and Total Other Income-Other Spouse (SEQ 0230) must 

equal Total Other Income-Joint Return (SEQ 0210). 

0623 o RESERVED 

0624 o Form 8379 – When Standard or Itemized Deduction - Joint Return (SEQ 0540) is significant, then the 

sum of Standard or Itemized Deduction-Injured Spouse (SEQ 0550) and Standard or Itemized 

Deduction-Other Spouse (SEQ 0560) must equal Standard or Itemized Deduction-Joint Return 

(SEQ 0540).

0625 o Form 8379 – When Exemptions-Joint Return (SEQ 0570) is present, then either Exemptions-Injured 

Spouse (SEQ 0580) or Exemptions-Other Spouse (SEQ 0590) must be present and Exemptions-Joint 

Return (SEQ 0570) must equal Total Exemptions (SEQ 0355) of Form 1040/1040A. 

0626 o Form 8379 – When Credits-Joint Return (SEQ 0600) is present, then the sum of Credits-Injured 

Spouse (SEQ 0610) and Credits-Other Spouse (SEQ 0620) must equal Credits-Joint Return 

(SEQ 0600). 

0627 o Form 8379 – When Estimated Tax Payments-Joint Return (SEQ 0690) is significant, the sum of 

Estimated Tax Payments-Injured Spouse (SEQ 0700) and Estimated Tax Payments-Other Spouse 

(SEQ 0710) must equal Estimated Tax Payments-Joint Return (SEQ 0690). 

0628 o Form 8379 – When Form 8379 is present, Form 2555/2555EZ, 8833, 8854 and 8891 must not be 

present. 

0629 o Form 8379 – When Form 8379 is present, the following fields on Form 1040/A/EZ must not be 

present: Foreign Street Address (SEQ 0062), Foreign City, State or Province (SEQ 0064), or Foreign 

Country (SEQ 0066). 

0630 o 

o

Form 8379 – When Form 8379 is present, the State Abbreviation (SEQ 0087) of Form 1040/A/EZ 

cannot equal “AS”, “GU”,“MP”, “PR”, or “VI”. 

When Form 8379 is present, Forms W-2GU, 4563, 5074, and 8689 must not be present. 

0631 o Form 8379 – When 8379 is present, Filing Status (SEQ 0130) of Form 1040/1040A must equal “2” 

(Married Filing Joint) or Secondary SSN (SEQ 0030) of Form 1040EZ must be present. 

0632 o

o

o

o

o

o

o

Form 5471 – When Category of Filer-3 (SEQ 0135) is significant, Category 3 Attachment (SEQ 0136) 

must equal "STMbnn". 

When Other Income (Functional Currency) (SEQ 2110) or Other Income (U.S. Dollars) (SEQ 2130) is 

significant, Attach Schedule-Other Income (SEQ 2140) must equal "STMbnn". 

When Other Deductions (Functional Currency) (SEQ 2290) or Other Deductions (U.S. Dollars) 

(SEQ 2310) is significant, Attach Schedule-Other Deductions (SEQ 2320) must equal "STMbnn". 

When Other Current Assets – Beginning (SEQ 2770) or Other Current Assets - End (SEQ 2790) is 

significant, Other Current Assets (Attach Schedule) (SEQ 2800) must equal "STMbnn". 

When Investment In Subsidiaries – Beginning (SEQ 2830) or Investment In Subsidiaries – End 

(SEQ 2850) is significant, Investment In Subsidiaries (Attach Schedule)(SEQ 2860) must equal 

"STMbnn". 

When Other Investments – Beginning (SEQ 2870) or Other Investments – End (SEQ 2890) is 

significant, Other Investments (Attach Schedule) (SEQ 2900) must equal "STMbnn". 

When Other Assets – Beginning (SEQ 3090) or Other Assets – End (SEQ 3110) is significant, Other 

Assets (Attach Schedule) (SEQ 3120) must equal "STMbnn". 
o

o

o

o

o

o

o

When Other Current Liabilities – Beginning (SEQ 3170) or Other Current Liabilities – End (SEQ 3190) 

is significant, Other Current Liabilities (Attach Schedule) (SEQ 3200) must equal "STMbnn". 

When Other Liabilities – Beginning (SEQ 3230) or Other Liabilities – End (SEQ 3250) is significant, 

Other Liabilities (Attach Schedule) (SEQ 3260) must equal "STMbnn". 

When Paid-in or Capital Surplus – Beginning (SEQ 3305) or Paid-in or Capital Surplus – End (SEQ 

3315) is significant, Paid-in or Capital Surplus (Attach Reconciliation) (SEQ 3320) must equal 

"STMbnn". 

When Own 10% Interest in a Partnership – Yes (SEQ 3410) is significant, Own 10% Yes Attachment 

(SEQ 3425) must equal "STMbnn". 

When Own Foreign Entities – Yes (SEQ 3450) is significant, Own Foreign Entities Yes Attachment 

(SEQ 3465) must equal "STMbnn"or Paper Document Indicator 2 (Form 8858) of the Summary 

Record must contain 1 in the Summary Record. 

When Other Earnings (Net Additions) (SEQ 3620) or Other Earnings (Net Subtractions) (SEQ 3630) is 

significant, Other Earnings (Attach Schedule) (SEQ 3635) must equal "STMbnn". 

When Income of Foreign Corporation Blocked (Yes Box) (SEQ 3790) or Did Any Become Unblocked 

(Yes Box) (SEQ 3800) is significant, Statement (If Yes, Explain) (SEQ 3810) must equal "STMbnn". 

0633 o Form 5471 – The following fields must be positive: SEQs 2730, 2740, 2930, 2940, 2970, 2980, 3070, 

3080, 3350 and 3360. 

0634 o Schedule N (Form 5471) – If Deduction for Dividends Paid During Tax Year (SEQ 0750) is significant, 

then Deduction for Dividends Paid During Tax Year (SEQ 0750) must equal Deduction for Dividends 

Paid (SEQ 0640). 

0635 o RESERVED 

0636 o Form 8865 – For Each Form 8865 present, when Category 2 Filer (SEQ 0090) is significant, at least 

one Schedule K-1 (Form 8865) must be present. 

0637 o Form 8865 – Business Activity Code (SEQ 0690) must be within the valid range (111100 – 813000). 

0638 o Form 8865 – When Owns Constructive Interest (SEQ 1045) is significant, all of the following fields 

must be significant: Name Constructive Ownership (SEQ 1050), Address Constructive Ownership 

(SEQ 1060), City Constructive Ownership (SEQ 1070), State Constructive Ownership (SEQ 1080), 

Zip Code Constructive Ownership (SEQ 1090) and Identifying Number Constructive Ownership 

(SEQ 1100). 

0639 o Form 8865 – When Total (SEQ 2240) is significant, Gross Receipts or Sales (SEQ 2220) or Less 

Returns and Allowances (SEQ 2230) must be significant. 

0640 o Form 8865 – When Gross Profit (SEQ 2260) is significant, Total (SEQ 2240) or Cost of Goods Sold 

(SEQ 2250) must be significant. 

0641 o Form 8865 – When Net Farm Profit (Loss) (SEQ 2280) is significant, Schedule F (Form 1040) must 

be present. 

0642 o Form 8865 – When Total Income (Loss) (SEQ 2310) is significant, one of the following fields must be 

significant: Gross Profits (SEQ 2260), Ordinary Income (Loss) (SEQ 2270), Net Farm Profit (Loss) 

(SEQ 2280), Net Gain (Loss)(SEQ 2290) or Other Income (Loss) (SEQ 2300). 

0643 o Form 8865 – When Total Deductions (SEQ 2450) is significant, one of the following fields must be 

significant: Salaries & Wages (SEQ 2320), Guaranteed Payments to Partners (SEQ 2330), Repairs & 

Maintenance (SEQ 2340), Bad Debts (SEQ 2350), Rent(SEQ 2360), Taxes & Licenses (SEQ 2370), 

Interest (SEQ 2380), Depreciation (SEQ 2390), Less Depreciation Reported on Schedule A 

(SEQ 2400), Depletion (SEQ 2410), Retirement Plans (SEQ 2420), Employee Benefit Programs 

(SEQ 2430) or Other Deductions (SEQ 2440). 
0644 o Form 8865 – When Net S-T Capital Gain (Loss) (SEQ 2750) is significant, Net S-T Entire Year Capital 

Gain (Loss) (SEQ 3230) or Other Income (Loss) (SEQ 3280) must be significant. 

0645 o RESERVED 

0646 o Form 8865 – When Net Long-Term Capital Gain (Loss) (SEQ 3130) is significant, Net L-T Capital 

Gain (Loss) (SEQ 3240) or Other Income (Loss) (SEQ 3280) must be significant. 

0647 o Form 8865 – When Net Section 1231 Gain (Loss) (SEQ 3270) is significant, Form 4797 must be 

present. 

0648 o Form 8865 – When Rehabilitation Expenditures Rental Real Estate (SEQ 3410) is significant, Form 

3468 must be present. 

0649 o RESERVED 

0650 o RESERVED 

0651 o RESERVED 

0652 o RESERVED 

0653 o Form 8586 - If "Current Year Credit" (SEQ 0110) is significant, one or more Forms 8609-A must be 

present. 

0654 o Form 8586 - If "Number of Forms 8609-A Attached" (SEQ 0020) is significant, a matching number of 

Forms 8609-A must be present. 

0655 o Form 8865 – If File Form 1065 (SEQ 0800) is equal to "X", then the EIN Foreign Partnership (SEQ 

0650) must be numeric and the first two positions must be equal to a valid District Office Code. 

0656 o RESERVED 

0657 o Form 8586 – Flow-through Entity EIN (SEQ 0115) must be numeric and the first two digits must equal 

a valid District Office Code.

0658-0659 RESERVED 

0660 o Form 8586 – When Passive Activity or Total Current Year Credit (SEQ 0140) and Net Income Tax 

(SEQ 0300) both contain an entry greater than zero, Form 6251 must be present. 

0661 o

o

o

o

o

o

o

o

Form 8865 – When Number of Foreign Disregarded Entities (SEQ 0960) is significant, Attach List of 

Entities (SEQ 0965) must equal "STMbnn" or Paper Document Indicator 2 (Form 8858) of the 

Summary Record must contain 1 in Summary Record. 

When Ordinary Income (Loss) (SEQ 2270) is significant, Ordinary Income (Loss) (Attach Schedule) 

(SEQ 2275) must equal "STMbnn". 

When Other Income (Loss) (SEQ 2300) is significant, Other Income (Loss) (Attach Schedule) 

(SEQ 2305) must equal "STMbnn". 

When Other Deductions (SEQ 2440) is significant, Other Deductions (Attach Schedule) (SEQ 2445) 

must equal "STMbnn". 

When Expenses From Other Rental Activities (SEQ 3180) is significant, Expenses (Attach Schedule) 

(SEQ 3185) must equal "STMbnn". 

When Other Income (Loss) (SEQ 3280) is significant, Other Income (Loss) (Attach Schedule) (SEQ 

3285) must equal "STMbnn". 

When Contributions (SEQ 3300) is significant, Charitable Contributions (Attach Schedule) (SEQ 3305) 

must equal "STMbnn". 

When Other Deductions (SEQ 3350) is significant, Other Deductions (Attach Schedule) (SEQ 3355) 
o

o

o

o

o

o

o

o

o

must equal "STMbnn". 

When Other AMT (SEQ 3720) is significant, Other AMT Items (Attach Schedule) (SEQ 3725) must 

equal "STMbnn". 

When Other Current Assets BOY (SEQ 3940) or Other Current Assets EOY (SEQ 3950) is significant, 

Other Current Assets (Attach Schedule) (SEQ 3955) must equal "STMbnn". 

When Other Investments BOY (SEQ 3980) or Other Investments EOY (SEQ 3990) is significant, 

Other Investments (Attach Schedule) (SEQ 3995) must equal "STMbnn". 

When Other Assets BOY (SEQ 4200) or Other Assets EOY (SEQ 4210) is significant, Other Assets 

(Attach Schedule) (SEQ 4215) must equal "STMbnn". 

When Other Current Liabilities BOY (SEQ 4280) or Other Current Liabilities EOY (SEQ 4290) is 

significant, Other Current Liabilities (Attach Schedule) (SEQ 4295) must equal "STMbnn". 

When Other Liabilities BOY (SEQ 4340) or Other Liabilities EOY (SEQ 4350) is significant, Other 

Liabilities (Attach Schedule) (SEQ 4355) must equal "STMbnn". 

When Listed Categories BOY (SEQ 4460) or Listed Categories EOY (SEQ 4470) is significant, Listed 

Categories (Attach Schedule) (SEQ 4475) must equal "STMbnn". 

When Total Other Increases (SEQ 4690) is significant, Other Increases (Itemize) (SEQ 4685) must 

equal "STMbnn". 

When Total Other Decreases (SEQ 4730) is significant, Other Decreases (Itemize) (SEQ 4725) must 

equal "STMbnn". 

0662 o Form 8865 – The following fields must be positive: SEQs 2320, 2330, 2360, 2370, 2380 and 3100. 

0663 o RESERVED 

0664 o 

o

Authentication Record - When the Transmission Type Code (SEQ 0170) of the TRANA Record is 

equal to "O", then the PIN Type Code (SEQ 0008) must equal either "O" or Blank. 

Authentication Record - When the Transmission Type Code (SEQ 0170) of the TRANA Record is 

equal to Blank, then the PIN Type Code (SEQ 0008) must equal "P", or "S", or Blank. 

0665 o Form 8801 - Total Tax Credits (SEQ 0220) must be greater than zero. 

0666 o Form 1040 – If Form 8801 Block (SEQ 1005) is equal to “X”, then Form 8801 must be present. 

0667 o Form 4797 – If Form 4797 is present and Gain/Loss (Form 8824 Sec 1231) (SEQ 0456) or Form 8824 

Ordinary Gain/Loss for Entire Yr (SEQ 0974) is significant, then Form 8824 must be present. 

0668 o Self-Select PIN Program – The Primary Taxpayer is ineligible to participate in the Self-Select PIN 

program since the Primary Taxpayer is a duplicate on the IRS File. 

0669 o Self-Select PIN Program – The Secondary Taxpayer is ineligible to participate in the Self-Select PIN 

program since the Secondary Taxpayer is a duplicate on the IRS File. 

0670 o 

o

Authentication Record – When the PIN Type Code (SEQ 0008) is equal to "S", then the following 

fields must be present; Primary Date of Birth (SEQ 0010), Primary Prior Year Adjusted Gross Income 

(SEQ 0020), Primary Taxpayer Signature (SEQ 0035), Taxpayer Signature Date (SEQ 0070), 

Jurat/Disclosure Code (SEQ 0075), PIN Authorization Code (SEQ 0080) and ERO EFIN/PIN 

(SEQ 0090). 

Exceptions:

When the Filing Status (SEQ 0130) equals "2" (Married Filing Jointly), and the Primary Date of Death 

(SEQ 0020) is significant and the Secondary Date of Death (SEQ 0040) is "NOT" significant on the Tax 

Return, only the following fields (SEQ 0040, 0050, 0065, 0070, 0075, 0080, 0090) are required on the 

Authentication Record. 
o

o

When the Filing Status (SEQ 0130) equals "2" (Married Filing Jointly), and the Primary Date of Death 

(SEQ 0020) "AND" the Secondary Date of Death (SEQ 0040) are significant on the Tax Return, only 

the primary fields (SEQ 0010, 0020, 0035, 0070, 0075, 0080, 0090) are required on the Authentication 

Record. 

When the Filing Status (SEQ 0130) equals "2" (Married Filing Jointly), and the Special Processing Literal 

(SEQ 0100) of the Tax Return equals "DESERTbSTORM, HAITI, FORMERbYUGOSLAVIA, 

UNbOPERATION, JOINTbGUARD, JOINTbFORGE, NORTHERNbWATCH, 

OPERATIONbALLIEDbFORCE, NORTHERNbFORGE, ENDURINGbFREEDOM, COMBATbZONE, 

or COMBATbZONEbYYYYMMDD”, then either the primary fields (SEQ 0010, 0020, 0035, 0070, 0075, 

0080, 0090) or the Secondary fields (SEQ 0040, 0050, 0065, 0070, 0075, 0080, 0090) are required on the 

Authentication Record.

0671 o

o

o

Authentication Record – When the PIN Type Code (SEQ 0008) is equal to "S" and Filing Status 

(SEQ 0130) is "2" (Married Filing Jointly), then the following fields must be present; Spouse Date of 

Birth (SEQ 0040), Spouse Prior Year Adjusted Gross Income (SEQ 0050) and Spouse Signature 

(SEQ 0065), Taxpayer Signature Date (SEQ 0070), Jurat/Disclosure Code (SEQ 0075), PIN 

Authorization Code (SEQ 0080) and ERO EFIN/PIN (SEQ 0090).

Exceptions:

When the Filing Status (SEQ 0130) equals "2" (Married Filing Jointly), and the Secondary Date of 

Death (SEQ 0040) 

is significant and the Primary Date of Death (SEQ 0020) is 

"NOT" significant on the Tax Return, only the following fields (SEQ 0010, 0020, 0035, 0070, 0075, 

0080, 0090) are required on the Authentication Record. 

When the Filing Status (SEQ 0130) equals "2" (Married Filing Jointly), and the Special Processing 

Literal (SEQ 0100) of the Tax Return equals "DESERTbSTORM, HAITI, FORMERbYUGOSLAVIA, 

UNbOPERATION, JOINTbGUARD, JOINTbFORGE, NORTHERNbWATCH, 

OPERATIONbALLIEDbFORCE, NORTHERNbFORGE, ENDURINGbFREEDOM, COMBATbZONE, 

or COMBATbZONEbYYYYMMDD”, then either the primary fields (SEQ 0010, 0020, 0035, 0070, 0075, 

0080, 0090) or the secondary fields (SEQ 0040, 0050, 0065, 0070, 0075, 0080, 0090) are required on 

the Authentication Record. 

0672 o 

o

Authentication Record – When the PIN Type Code (SEQ 0008) is equal to “P” or “S”, then the ERO 

EFIN/PIN (SEQ 0090) must be present. 

When the PIN Type Code (SEQ 0008) is equal to “O”, then the ERO EFIN/PIN (SEQ 0090) cannot be 

present. 

0673 o RESERVED 

0674 o

o

o

o

Authentication Record – When the PIN Type Code (SEQ 0008) is equal to "P", "S" or "O", then 

Primary Taxpayer Signature (SEQ 1321) on the Tax Return must be five digits and cannot be all zeros

and the Primary Taxpayer Signature (SEQ 1321) on the Tax Return must match the Primary Taxpayer 

Signature (SEQ 0035) on the Authentication Record. 

Exceptions:

When the Filing Status (SEQ 0130) equals "2" (Married Filing Jointly), the Primary Date of Death 

(SEQ 0020) is significant and the Secondary Date of Death (SEQ 0040) is "NOT" significant on the Tax 

Return, the Spouse Signature (SEQ 1324) on the Tax Return must be five digits and cannot be all zeros; 

And the Spouse Signature (SEQ 1324) on the Tax Return must match the Spouse Signature (SEQ 0065) 

on the Authentication Record. 

When the Filing Status (SEQ 0130) equals "2" (Married Filing Jointly) and the Primary Date of Death 

(SEQ 0020) "AND" the Secondary Date of Death (SEQ 0040) are significant on the Tax Return, the 

Primary Taxpayer Signature (SEQ 1321) on the Tax Return must be five digits and cannot be all zeros; 

And the Primary Taxpayer Signature (SEQ 1321) on the Tax Return must match the Primary Taxpayer 

Signature (SEQ 0035) on the Authentication Record. 

When the PIN Type Code (SEQ 0008) is "Blank", then the Primary Taxpayer Signature (SEQ 0035) 

cannot be present. 
o When the Filing Status equals "2" (Married Filing Jointly) and the Special Processing Literal 

(SEQ 0100) on the Tax Return equals "DESERTbSTORM, HAITI, FORMERbYUGOSLAVIA, 

UNbOPERATION, JOINTbGUARD, JOINTbFORGE, NORTHERNbWATCH, 

OPERATIONbALLIEDbFORCE, NORTHERNbFORGE, ENDURINGbFREEDOM, COMBATbZONE, 

or COMBATbZONEbYYYYMMDD”, the Primary Taxpayer Signature (SEQ 1321) on the Tax Return 

must be five digits and cannot be all zeros and the Primary Taxpayer Signature (SEQ 1321) on the 

Tax Return must match the Primary Taxpayer Signature (SEQ 0035) on the Authentication Record 

or the Spouse Signature (SEQ 1324) on the Tax Return must be five digits and cannot be all zeros 

and the Spouse Signature (SEQ 1324) on the Tax Return must match the Spouse Signature 

(SEQ 0065) on the Authentication Record.

0675 o

o

o

o

Authentication Record – When the PIN Type Code (SEQ 0008) is equal to "P", "S" or "O" and the 

Filing Status (SEQ 0130) is “2” (Married Filing Jointly), then Spouse Signature (SEQ 1324) on the Tax 

Return must be five digits and cannot be all zeros; and the Spouse Signature (SEQ 1324) on the Tax 

Return must match the Spouse Signature (SEQ 0065) on the Authentication Record. 

Exceptions:

When the Filing Status (SEQ 0130) equals "2" (Married Filing Jointly) and the Secondary Date of 

Death (SEQ 0040) is significant but the Primary Date of Death (SEQ 0020) is "NOT" significant on the 

Tax Return , Primary Taxpayer Signature (SEQ 1321) on the Tax Return must be five digits and 

cannot be all zeros; and the Primary Taxpayer Signature (SEQ 1321) on the Tax Return Must match 

the Primary Taxpayer Signature (SEQ 0035) on the Authentication Record. 

When the PIN Type Code (SEQ 0008) is "Blank" and the Filing Status (SEQ 0130) equals "2" (Married 

Filing Jointly) on the return, the Spouse Signature (SEQ 0065) cannot be present on 

the Authentication Record. 

When the Filing Status equals "2" (Married Filing Jointly) and the Special Processing Literal 

(SEQ 0100) on the Tax Return equals "DESERTbSTORM, HAITI, FORMERbYUGOSLAVIA, 

UNbOPERATION, JOINTbGUARD, JOINTbFORGE, NORTHERNbWATCH, 

OPERATIONbALLIEDbFORCE, NORTHERNbFORGE, ENDURINGbFREEDOM, COMBATbZONE, 

or COMBATbZONEbYYYYMMDD”, the Primary Taxpayer Signature (SEQ 1321) on the Tax Return 

must be five digits and cannot be all zeros and the Primary Taxpayer Signature (SEQ 1321) on the 

Tax Return must match the Primary Taxpayer Signature (SEQ 0035) on the Authentication Record 

or the Spouse Signature (SEQ 1324) on the Tax Return must be five digits and cannot be all zeros 

and the Spouse Signature (SEQ 1324) on the Tax Return must match the Spouse Signature 

(SEQ 0065) on the Authentication Record. 

0676 o 

o

o

o

o

o

Authentication Record – When the PIN Type Code (SEQ 0008) is equal to “P”, “S”, or “O” and the 

Filing Status (SEQ 0130) is “2” (Married Filing Jointly), then the Primary Taxpayer Signature 

(SEQ 0035) and Spouse Signature (SEQ 0065) both must be present. 

Exceptions:

When the Filing Status (SEQ 0130) equals "2" (Married Filing Jointly), the Primary Date of Death 

(SEQ 0020) is significant and the Secondary Date of Death (SEQ 0040) is "NOT" significant on the Tax 

Return, only the Spouse Signature (SEQ 0065) must be present on the Authentication Record. 

When the Filing Status (SEQ 0130) equals "2" (Married Filing Jointly) and the Secondary Date of Death 

(SEQ 0040) is significant and the Primary Date of Death (SEQ 0020) is "NOT" significant on the Tax 

Return, only the Primary Taxpayer Signature (SEQ 0035) must be present on the Authentication Record. 

When the Filing Status (SEQ 0130) equals "2" (Married Filing Jointly) and the Primary Date of Death 

(SEQ 0020) "AND" the Secondary Date of Death (SEQ 0040) are significant on the Tax Return, only the 

Primary Taxpayer Signature (SEQ 0035) must be present on the Authentication Record. 

When the PIN Type Code (SEQ 0008) is equal to "P", "S" or "O" and the Filing Status is other than "2" 

(Married Filing Jointly), the Spouse Signature (SEQ 0065) cannot be present on the Authentication 

Record. 

When the Filing Status equals "2" (Married Filing Jointly) and the Special Processing Literal (SEQ 0100) 

of the Tax Return equals "DESERTbSTORM, HAITI, FORMERbYUGOSLAVIA, UNbOPERATION, 

JOINTbGUARD, JOINTbFORGE, NORTHERNbWATCH, OPERATIONbALLIEDbFORCE, 

NORTHERNbFORGE, ENDURINGbFREEDOM, COMBATbZONE, or OMBATbZONEbYYYYMMDD”, 

then either the Primary Taxpayer Signature (SEQ 0035) or Spouse Signature (SEQ 0065) must be 

present on the Authentication Record. 
0677 o Self-Select PIN Program – The Primary Taxpayer is ineligible to participate in the Self-Select PIN 

program, if they are under the age of sixteen and has never filed a tax return. 

0678 o Self-Select PIN Program – The Secondary Taxpayer is ineligible to participate in the Self-Select PIN 

program, if they are under the age of sixteen and did not file a tax return in the previous year. 

0679 o

o

o

o

Authentication Record – When the PIN TYPE Code (SEQ 0008) is equal to “S” or “O”, the Primary 

Prior Year Adjusted Gross Income (SEQ 0020) must match the Primary Prior Year Adjusted Gross 

Income on the IRS Master File.

Exceptions:

When the Filing Status (SEQ 0130) equals "2" (Married Filing Jointly) and the Primary Date of Death 

(SEQ 0020) is significant and the Secondary Date of Death (SEQ 0040) is "NOT" significant on the Tax 

Return, the Spouse Prior Year Adjusted Gross Income (SEQ 0050) on the Authentication Record must 

match the Spouse Prior Year Adjusted Gross Income on the IRS Master File. 

When the Filing Status (SEQ 0130) equals "2" (Married Filing Jointly) and the Primary Date of Death 

(SEQ 0020) "AND" the Secondary Date of Death (SEQ 0040) are significant on the Tax Return, the 

primary Prior Year Adjusted Gross Income on the Authentication Record must match the Primary Prior 

Year Adjusted Gross Income on the IRS Masterfile. 

When the Filing Status equals "2" (Married Filing Jointly) and the Special Processing Literal (SEQ 0100) 

of the Tax Return equals "DESERTbSTORM, HAITI, FORMERbYUGOSLAVIA, UNbOPERATION, 

JOINTbGUARD, JOINTbFORGE, NORTHERNbWATCH, OPERATIONbALLIEDbFORCE, 

NORTHERNbFORGE, ENDURINGbFREEDOM, COMBATbZONE, or 

COMBATbZONEbYYYYMMDD”, the Primary Prior Year Adjusted Gross Income (SEQ 0020) on the 

Authentication Record must match the Primary Prior Year Adjusted Gross Income on the IRS Master File 

or the Spouse Prior Year Adjusted Gross Income (SEQ 0050) on the Authentication Record must match 

the Spouse Prior Year Adjusted Gross Income on the IRS Master File.

0680 o 

o

o

Authentication Record – When the PIN TYPE Code (SEQ 0008) is equal to “S” or “O” and the Filing 

Status (SEQ 0130) is “2” (Married Filing Jointly), the Spouse Prior Year Adjusted Gross Income (SEQ 

0050) must match the Spouse Prior Year Adjusted Gross Income on the IRS Master File. 

Exceptions:

When the Filing Status (SEQ 0130) equals "2" (Married Filing Jointly), the Secondary Date of Death 

(SEQ 0040) is significant and the Primary Date of Death (SEQ 0020) is "NOT" significant on the Tax 

Return, the Primary Prior Year Adjusted Gross Income (SEQ 0020) on the Authentication Record must 

match the Primary Prior Year Adjusted Gross Income on the IRS Master File. 

When the Filing Status equals "2" (Married Filing Jointly) and the Special Processing Literal 

(SEQ 0100) of the Tax Return equals "DESERTbSTORM, HAITI, FORMERbYUGOSLAVIA, 

UNbOPERATION, JOINTbGUARD, JOINTbFORGE, NORTHERNbWATCH, 

OPERATIONbALLIEDbFORCE, NORTHERNbFORGE, ENDURINGbFREEDOM, COMBATbZONE, 

or COMBATbZONEbYYYYMMDD”, the Primary Prior Year Adjusted Gross Income (SEQ 0020) on 

the Authentication Record must match the Primary Prior Year Adjusted Gross Income on the IRS 

Master File or the Spouse Prior Year Adjusted Gross Income (SEQ 0050) on the Authentication 

Record must match the Spouse Prior Year Adjusted Gross Income on the IRS Master File.
0681 o 

o

o

o

Authentication Record – When the PIN Type Code (SEQ 0008) is equal to "O", then the following 

fields must be present; Primary Date of Birth (SEQ 0010), Primary Prior Year Adjusted Gross Income 

(SEQ 0020), Primary Taxpayer Signature (SEQ 0035), Taxpayer Signature Date (SEQ 0070), 

Jurat/Disclosure Code SEQ 0075) and PIN Authorization Code (SEQ 0080). 

Exceptions:

When the Filing Status (SEQ 0130) equals "2" (Married Filing Jointly), AND the Primary Date of Death 

(SEQ 0020) is significant and the Secondary Date of Death (SEQ 0040) is "NOT" significant on the Tax 

Return, the following fields (SEQ 0040, 0050, 0065, 0070, 0075, 0080) are required on the Authentication 

Record. 

When the Filing Status (SEQ 0130) equals "2" (Married Filing Jointly), and the Primary Date of Death 

(SEQ 0020) "AND" the Secondary Date of Death (SEQ 0040) are significant on the Tax Return, the 

primary fields (SEQ 0010, 0020, 0035, 0070, 0075, 0080) are required on the Authentication Record. 

When the Filing Status equals "2" (Married Filing Jointly) and the Special Processing Literal 

(SEQ 0100) of the Tax Return "DESERTbSTORM, HAITI, FORMERbYUGOSLAVIA, 

UNbOPERATION, JOINTbGUARD, JOINTbFORGE, NORTHERNbWATCH, 

OPERATIONbALLIEDbFORCE, NORTHERNbFORGE, ENDURINGbFREEDOM, COMBATbZONE, 

or COMBATbZONEbYYYYMMDD”, then either the Primary fields (SEQ 0010, 0020, 0035, 0070, 0075, 

0080) or the Secondary fields (SEQ 0040, 0050, 0065, 0070, 0075, 0080) are required on the 

Authentication Record.

0682 o

o

o

Authentication Record – When the PIN Type Code (SEQ 0008) is equal to "O" and Filing Status 

(SEQ 0130) is "2" (Married Filing Jointly), then the following fields must be present; Spouse Date of 

Birth (SEQ 0040), Spouse Prior Year Adjusted Gross Income (SEQ 0050) and Spouse Signature 

(SEQ 0065), Taxpayer Signature Date (SEQ 0070), Jurat/Disclosure Code (SEQ 0075) and PIN 

Authorization Code (SEQ 0080). 

Exceptions:

When the Filing Status (SEQ 0130) equals "2" (Married Filing Jointly), and the Secondary Date of Death 

(SEQ 0040) is significant and the Primary Date of Death (SEQ 0020) is "NOT" significant on the Tax 

Return, the following fields (SEQ 0010, 0020, 0035, 0070, 0075, 0080) are required on the Authentication 

Record. 

When the Filing Status equals "2" (Married Filing Jointly) and the Special Processing Literal 

(SEQ 0100) of the Tax Return equals "DESERTbSTORM, HAITI, FORMERbYUGOSLAVIA, 

UNbOPERATION, JOINTbGUARD, JOINTbFORGE, NORTHERNbWATCH, 

OPERATIONbALLIEDbFORCE, NORTHERNbFORGE, ENDURINGbFREEDOM, COMBATbZONE, 

or COMBATbZONEbYYYYMMDD”, then either the Primary fields (SEQ 0010, 0020, 0035, 0070, 

0075, 0080) or the Secondary fields (SEQ 0040, 0050, 0065, 0070, 0075, 0080) are required on the 

Authentication Record.

0683 o Authentication Record – When the PIN TYPE Code (SEQ 0008) is equal to “P” or “S”, the first six 

numeric of the ERO EFIN/PIN (SEQ 0090) must equal the Electronic Filer ID Number (EFIN) in the 

Declaration Control Number (DCN) (14 digits total). 

0684 o Authentication Record – When the PIN TYPE Code (SEQ 0008) is equal to “P”, “S” or “O”, then the 

Paper Document Indicator 1 (SEQ 0150) or Paper Document Indicator 2 (SEQ 0153) or Paper 

Document Indicator 3 (SEQ 0156) or Paper Document Indicator 4 (SEQ 0159) or Paper Documents 

Indicator 5 (SEQ 0162) or Paper Document Indicator 6 (SEQ 0168) or Paper Document Indicator 8 

(SEQ 0171) or Paper Document Indicator 9 (SEQ 0171) or Paper Document Indicator 10(SEQ 0171) 

of Summary Record cannot be present. 

0685 o Summary Record - Number of Preparer Note Records (SEQ 0110) must equal the number of 

preparer notes computed by the IRS. 

0686 o Summary Record - Number of Election Explanation Records (SEQ 0120) must equal the number of 

election explanations computed by the IRS. 

0687 o Summary Record - Number of Regulatory Explanation Records (SEQ 0130) must equal the number 

of regulatory explanations computed by the IRS. 
0688 o Summary Record - Count of Authentication Record (SEQ 0140) must equal the count of 

authentication record computed by the IRS. 

0689 o Authentication Record – The year of Taxpayer Signature Date (SEQ 0070) must equal current 

processing year. 

0690 o Form Payment (Balance Due) – If Refund (SEQ 1270) of the Tax Form is greater than zero, then a 

Tax Type Code of Form 1040, Form 1040A or Form 1040EZ cannot be present. 

0691 o Form Payment (Balance Due) – Amount of Tax Payment (SEQ 0060) cannot be greater than Amount 

Owed (SEQ 1290) of the Tax Form. 

0692 o Form Payment – Amount of Tax Payment (SEQ 0060) must be greater than zero. 

0693 o Form Payment – When there are two occurrences of Form Payments,one of the occurrences must 

have a Tax Type Code (SEQ 0070) of “1040S”. 

0694 o Authentication Record – When the PIN Type Code (SEQ 0008) is equal to "S", then the 

Jurat/Disclosure Code (SEQ 0075) must equal "C". 

0695 o Authentication Record – When the PIN Type Code (SEQ 0008) is equal to "P", then the 

Jurat/Disclosure Code (SEQ 0075) must equal "D". 

0696 o Authentication Record – When the PIN Type Code (SEQ 0008) is equal to "O", then the 

Jurat/Disclosure Code (SEQ 0075) must equal "A". 

0697 o 

o

o

o

Authentication Record – When the PIN Type Code (SEQ 0008) is equal to "P", then the following 

fields must be present; Primary Taxpayer Signature (SEQ 0035), Taxpayer Signature Date 

(SEQ 0070), Jurat/Disclosure Code (SEQ 0075), PIN Authorization Code (SEQ 0080) and ERO 

EFIN/PIN (SEQ 0090). 

Exceptions:

When the Filing Status (SEQ 0130) equals "2" (Married Filing Jointly), and the Primary Date of Death (Seq 

0020) is significant and the Secondary Date of Death (SEQ 0040) is "NOT" significant on the Tax Return , 

the following fields (SEQ 0065, 0070, 0075, 0080, 0090) are required on the Authentication Record. 

When the Filing Status (SEQ 0130) equals "2" (Married Filing Jointly), and the Primary Date of Death 

(SEQ 0020) "AND" the Secondary Date of Death (SEQ 0040) are significant on the Tax Return, the 

primary fields (SEQ 0035, 0070, 0075, 0080, 0090) are required on the Authentication Record. 

When the Filing Status equals "2" (Married Filing Jointly) and the Special Processing Literal (SEQ 0100) 

of the Tax Return equals "DESERTbSTORM, HAITI, FORMERbYUGOSLAVIA, UNbOPERATION, 

JOINTbGUARD, JOINTbFORGE, NORTHERNbWATCH, OPERATIONbALLIEDbFORCE, 

NORTHERNbFORGE, ENDURINGbFREEDOM, COMBATbZONE, or 

COMBATbZONEbYYYYMMDD”, either the Primary fields (SEQ 0035, 0070, 0075, 0080, 0090) or the 

Secondary fields (SEQ 0065, 0070, 0075, 0080, 0090) are required on the Authentication Record.

0698 o 

o

o

Authentication Record – When the PIN Type Code (SEQ 0008) is equal to "P" and Filing Status (SEQ 

0130) is "2" (Married Filing Jointly), then the following fields must be present; Spouse Signature (SEQ 

0065), Taxpayer Signature Date (SEQ 0070), Jurat/Disclosure Code (SEQ 0075), PIN Authorization Code 

(SEQ 0080) and ERO EFIN/PIN (SEQ 0090). 

Exceptions:

When the Filing Status (SEQ 0130) equals "2" (Married Filing Jointly) and the Secondary Date of 

Death (SEQ 0040) is significant and the Primary Date of Death (SEQ 0020) is "NOT" significant on the 

Tax Return, the following fields (SEQ 0035, 0070, 0075, 0080, 0090) are required on the 

Authentication Record. 

When the Filing Status equals "2" (Married Filing Jointly) and the Special Processing Literal 

(SEQ 0100) of the Tax Return equals "DESERTbSTORM, HAITI, FORMERbYUGOSLAVIA, 

UNbOPERATION, JOINTbGUARD, JOINTbFORGE, NORTHERNbWATCH, 

OPERATIONbALLIEDbFORCE, NORTHERNbFORGE, ENDURINGbFREEDOM, COMBATbZONE, 

or COMBATbZONEbYYYYMMDD”, either the Primary fields (SEQ 0035, 0070, 0075, 0080, 0090) or 

the secondary fields (SEQ 0065, 0070, 0075, 0080, 0090) are required on the Authentication Record.
0699 o Authentication Record – When the PIN Type Code (SEQ 0008) is equal to "P", then the following 

fields must NOT be present; Primary Prior Year Adjusted Gross Income (SEQ 0020) and Spouse Prior 

Year Adjusted Gross Income (SEQ 0050). 

0700 o Form 6781 – When Mixed Straddle Account Election Box (SEQ 0040) equals “X”, Statement Required 

by Regulations (SEQ 0050) must equal “STMbnn”. 

0701 o Form 6781 – When Form 1099-B Adjustments (SEQ 0200) is significant, Form 1099-B Adjustment 

Schedule (SEQ 0190) must contain “STMbnn”. 

0702 o Form 2120 - Person Supported First Name (SEQ 0020) and Person Support Last Name (SEQ 0030) 

must be significant. 

0703 o Form 2120 - Eligible First Name (SEQ 0040), Eligible Last Name (SEQ 0045), SSN (SEQ 0050), 

Street Address (SEQ 0060), City 

(SEQ 0070), State Abbr (SEQ 0080), and Zip Code (SEQ 0090) must be significant, else reject the 

return.

0704 o RESERVED 

0705 o RESERVED 

0706 o Form 2120 - The Calendar Year (SEQ 0010) must equal the Current Tax Year, else reject the return. 

0707 o

o

Form 2120 – The Person Supported First Name (SEQ 0020) must equal one of the following 

Dependent First (SEQs 0170, 0180, 0190, 0200). 

Last Name of Person Supported (SEQ 0030) must equal one of the following: Dependent Last Name 

(SEQs 0171, 0181, 0191, 0201) 

0708 o

o

o

Form 2120 - SSN of Eligible Person (SEQ 0050, 0110, and 0230) must be within the valid ranges of 

SSNs. It must be all numeric characters and cannot equal all zeroes or all nines. 

Form 2120 - SSN of T/P Not Claiming Dependent (SEQ 0170, 0050, 0110, and 0230) cannot equal 

Primary SSN (SEQ 0010) of Form 1040/1040A if the Filing Status (SEQ 0130) equals "1", "3", "4", 

 or "5". 

Form 2120 - SSN of T/P Not Claiming Dependent (SEQ 0170) cannot equal Primary SSN (SEQ 0010)

or Secondary SSN (SEQ 0030) of Form 1040/1040A if the Filing Status (SEQ 0130) equals "2". 

0709 o Tax Form - When both the Form 9465 (Installment Agreement Request) and a Form Payment (Balance 

Due Payment) are attached to the 1040, 1040A, or 1040EZ, the Payment With Tax Return (SEQ 0290) 

on the Form 9465 must equal to the Amount of Tax Payment (SEQ 0060) on the Form Payment. 

0710 o 

o

Form 9465 – When Direct Debit information is present, Routing Transit Number (RTN) (SEQ 0330) 

must contain nine numeric characters. The first two positions must be 01 through 12, or 21 through 

32; the RTN must be present on the Financial Organization Master File (FOMF); and the banking 

institution must process Electronic Funds Transfer (EFT). 

Bank Account Number (SEQ 0340) must be alphanumeric (i.e., only alpha characters, numeric 

characters, and hyphens), must be left-justified with trailing blanks if less than 17 positions, and 

cannot equal all zeros. 

0711 o Form 8082 - Only one of the Following fields can equal "X": Pass-Through Entity (Partnership) (SEQ 

0050) or Pass-Through Entity (Electing large Partnership) (SEQ 0055) or Pass-Through Entity 

(S Corporation) (SEQ 0060) or Pass-Through Entity (Estate) (SEQ 0065) or Pass-Through Entity 

(Trust) (SEQ 0070) or Pass-Through Entity (REMIC) (SEQ 0075). 

0712 o Form 8082 - Identifying Number of Pass-Through Entity (SEQ 0080) and Name of Pass-Through 

Entity (SEQ 0090) must be significant. 

0713 o Form 8082 - The Identifying Number (SEQ 0010) must be significant and equal to Primary SSN (SEQ 

0010) or Secondary SSN (SEQ 0030) of Form 1040. 
0714 o Form 8697 - Employer Identification Number of Entity (SEQ 0150) and Name of Entity (SEQ 0140) on 

Form 8697 must be present. 

0715 o Form 8697 – Only one of the following fields can be significant; REG-Net Amount of Interest You Owe 

(SEQ 0460) and SMI-Net Amount of Interest You Owe (SEQ 0830). 

0716 o Form 8697 - Identifying Number (SEQ 0080) must equal either Primary SSN (SEQ 0010) or 

Secondary SSN (SEQ 0030) of Form 1040. 

0717 o

o

o

o

o

Form 1040 – When F8697 Literal or F8866 Literal (SEQ 1129) is equal to “FORM 8697”, then Form 

8697 must be present and when F8697 Literal or F8866 Literal (SEQ 1129) is equal to“FORM 8866”, 

then Form 8866 must be present. 

Form 1040 – When F8697 or F8866 Amount (SEQ 1131) is significant and F8697 Literal or F8866 

Literal (SEQ 1129) is equal to “FORM 8697”, then REG-Net Amount of Interest You Owe (SEQ 0460) 

or SMI-Net Amount of Interest You Owe (SEQ 0830) of Form 8697 must be significant. 

Form 1040 – When F8697 or F8866 Amount (SEQ 1131) is significant and F8697 Literal or F8866 

Literal (SEQ 1129) is equal to “FORM 8866”, then Net Amount of Interest You Owe (SEQ 0460) of 

Form 8866 must be significant. 

When REG-Net Amount of Interest You Owe (SEQ 0460) or SMI-Net Amount of Interest You Owe 

(SEQ 0830) of Form 8697 is significant, then F8697 or F8866 Amount (SEQ 1131) of Form 1040 must 

be significant. 

When Net Amount of Interest You Owe (SEQ 0460) of Form 8866 is significant, then F8697 or F8866 

Amount (SEQ 1131) of Form 1040 must be significant. 

0718-0719 RESERVED 

0720 o Form 3800 – When any two or more of the following forms are present, Form 3800 must be present: 

Form 3468, Form 5884, Form 5884-A, Form 6765, Form 8586, Form 8820, Form 8826, Form 8830, 

Form 8835, Form 8845, Form 8846, Form 8847, Form 8861, Form 8864, Form 8874, Form 8881, Form 

8882 or Form 8896. 

0721 o

o

o

Form 1040 – When Specify Other Credit Literal (SEQ 1010) equals “8834”, Form 8834 must be 

present. 

When Specify Other Credit Literal (SEQ 1010) equals “8844”, Form 8844 must be present. 

If Form 1040, SEQ 1010 (Specify Other Credit Literal) contains “8860”, Form 8860 must be present. 

0722 o Form 1040 – When Other Credits (SEQ 1015) is significant, at least one of the following forms must be 

present: Form 3468, Form 3800, Form 5884, Form 5884-A, Form 6478, Form 6765,Form 8586, 

Form 8801, Form 8820, Form 8826, Form 8830, Form 8834, Form 8835, Form 8844, Form 8845, Form 

8846, Form 8847, Form 8860, Form 8861, Form 8864, Form 8874, Form 8881, Form 8882 or Form 

8896 unless Specify Other Credit Literal (SEQ 1010) contains or “TRANS ALASKA”. 

0723 o 

o

Form 3468 – If Certified Historic Structures (SEQ 0050) or Calculated Expenditures Certified Historic 

Struct. SEQ 0060) of Form 3468 is present, Qualified Rehabilitation NPS Number must be significant 

(SEQ 0071). 

Form 3468 – If Certified Historic Structures (SEQ 0050) or “Calculated Expenditures Certified Historic 

Struct. (SEQ 0060) of Form 3468 is present, Date of NPS Approval (SEQ 0071) must be significant. 

(Certified Historic Structures) 

0724 o Form 3468 – If Current Year Investment Credit (SEQ 0160) and Net Income Tax (SEQ 0320) both 

contain an entry greater than zero, then Form 6251 must be present. 

0725 o Form 3800 – If Current Year Investment Credit (SEQ 0020) is significant, then Form 3468 must be 

present. 

0726 o Form 3800 – If Current Year Work Opportunity Credit (SEQ 0030) is significant, then Form 5884 must 

be present. 
0727 o Form 3800 – If Current Year Welfare to Work Credit (SEQ 0040) is significant, then Form 8861 must 

be present. 

0728 o RESERVED 

0729 o Form 3800 – If Current Year Credit for Increasing Research (SEQ 0060) is significant, then Form 6765 

must be present. 

0730 o Form 3800 – If Current Year Low-Income Housing Credit (SEQ 0070) is significant, then Form 8586 

must be present. 

0731 o Form 3800 – If Current Year Enhanced Oil Recovery Credit (SEQ 0080) is significant, then Form 8830 

must be present. 

0732 o Form 3800 – If Current Year Disabled Access Credit (SEQ 0090) is significant, then Form 8826 must 

be present. 

0733 o Form 3800 – If Current Year Renewable Electricity Production (SEQ 0100) is significant, then Form 

8835 must be present. 

0734 o Form 3800 – If Current Year Indian Employment Credit (SEQ 0110) is significant, then Form 8845 

must be present. 

0735 o Form 3800 – If Current Year Credit for Employer Social Security (SEQ 0120) is significant, then Form 

8846 must be present. 

0736 o Form 3800 – If Current Year Orphan Drug Credit (SEQ 0130) is significant, then Form 8820 must be 

present. 

0737 o Form 3800 – If Current Year Credit for Contributions (SEQ 0660) is significant, then Form 8847 must 

be present. 

0738 o Form 3800 – If Current Year Trans-Alaska Pipeline Credit (SEQ 0680) is significant, then Current Yr 

Trans-Alaska Pipeline Attach Statement (SEQ 0675) must equal “STMbnn”. 

0739 o Form 3800 – If Passive Activity Credits (SEQ 0770) is significant, then Passive Activity Credits 

(SEQ 0740) must not be greater than Current Year General Business Credit (SEQ 0170). 

0740 o Form 3800 – If Subtract Line 3 from Line 2 (SEQ 0780) is significant, then Subtract Line 3 from Line 2 

(SEQ 0190) must not be less than zero. 

0741 o Form 3800 – If Passive Activity Credits Allowed (SEQ 0790) is significant, then Form 8582-CR must be 

present unless Passive Activity from Publicly Traded Partnership (SEQ 0800) contains “X”. 

0742 o Form 3800 – If Tentative General Business Credit (SEQ 0850) and Net Income Tax (SEQ 1110) both 

contain an entry greater than zero, then Form 6251 must be present. 

0743 o Form 3800 – The following fields must be positive: SEQs 0020, 0030, 0040, 0060, 0070, 0080, 0090, 

0100, 0110, 0120, 0130, 0540, 0550, 0560, 0570, 0580, 0590, 0660, 0680, 0690, 0705, 0770, 0790, 

and 0810. 

0744 o Form 5884 – If Total Current Year Work Opportunity Credit (SEQ 0110) and Net Income Tax 

(SEQ 0270) both contain an entry greater than zero, then Form 6251 must be present. 

0745 o Form 6478 – Qualified Ethanol Fuel Production (SEQ 0020) cannot be greater than 15000000 (fifteen 

million). 

0746 o Form 6478 - If Current Year Credit for Alcohol Used as Fuel (SEQ 0230) and Net Income Tax 

(SEQ 0390) both contain an entry greater than zero, then Form 6251 must be present. 

0747 o Form 6765 – Fixed-base Percentage (SEQ 0100) cannot be greater than 16% (016000). 

0748 o Form 6765 – If Subtract Line 3 from Line 2 – Sect. A (SEQ 0040), Subtract Line 12 from Line 9 

(SEQ 0130), Subtract line 20 from Line 19 (SEQ 0220), Subtract Line 29 from Line 27 (SEQ 0310), 

Subtract Line 31 from Line 27 (SEQ 0330) Subtract Line 32 from Line 30 (SEQ 0340), Subtract Line 34 

from Line 27 (SEQ 0360), and Subtract Line 35 from line 32 (SEQ 0370) cannot be less than zero. 
0749 o Form 6765 - If Total current year credit for Increasing Research (SEQ 0460) and Net Income Tax 

(SEQ 0690) both contain an entry greater than zero, then Form 6251 must be present. 

0750 o Form 8820 - If Current Year Orphan Drug Credit (SEQ 0050) and Net Income Tax (SEQ 0210) both 

contain an entry greater than zero, then Form 6251 must be present. 

0751 o Form 8826 – Subtract Line 2 from Line 1 (SEQ 0030) cannot be less than zero. 

0752 o Form 8826 – Current Year Disabled Access Credit (SEQ 0070) cannot be greater than 5000. 

0753 o Form 8826 - If Current Year Disabled Access Credit (SEQ 0070) and Net Income Tax (SEQ 0230) both 

contain an entry greater than zero, then Form 6251 must be present. 

0754 o Form 8830 - If Current Year Credit (SEQ 0050) and Net Income Tax (SEQ 0210) both contain an entry 

greater than zero, then Form 6251 must be present. 

0755 o Form 8834 - If Tentative Qualified Electric Vehicle Credit (SEQ 0230) and Net Regular Tax (SEQ 0360) 

both contain an entry greater than zero, then Form 6251 must be present. 

0756 o Form 8835 - If Current Year Credit (SEQ 0200) and Net Income Tax (SEQ 0360) both contain an entry 

greater than zero, then Form 6251 must be present. 

0757 o Form 8844 - If Current Year Credit (SEQ 0120) and Net Income Tax (SEQ 0280) both contain an entry 

greater than zero, then Form 6251 must be present. 

0758 o Form 8845 - If Current Year Credit (SEQ 0070) and Net Income Tax (SEQ 0230) both contain an entry 

greater than zero, then Form 6251 must be present. 

0759 o Form 8846 - If Current Year Credit (SEQ 0080) and Net Income Tax (SEQ 0240) both contain an entry 

greater than zero, then Form 6251 must be present. 

0760 o Form 8847 - If Current Year Credit (SEQ 0050) and Net Income Tax (SEQ 0210) both contain an entry 

greater than zero, then Form 6251 must be present. 

0761 o RESERVED 

0762 o Form 8861 - If Current Year Welfare-to-Work Credit (SEQ 0080) and Net Income Tax (SEQ 0240) both 

contain an entry greater than zero, then Form 6251 must be present. 

0763 o Form 8874 - When Current Year Credit (SEQ 0360) and Net Income Tax (SEQ 0560) both contain an 

entry greater than zero, Form 6251 must be present. 

0764 o Form 8881 - Current Year Credit (SEQ 0060) cannot be greater than $500. 

0765 o Form 8881 - When Current Year Credit (SEQ 0060)” and Net Income Tax (SEQ 0260) both contain an 

entry greater than zero, Form 6251 must be present. 

0766 o Form 8882 - When Current Year Credit (SEQ 0090)” and Net Income Tax (SEQ 0310) both contain an 

entry greater than zero, Form 6251 must be present. 

0767 o

o

Tax Form - When Third Party Designee "Yes" Box (SEQ 1303) equals to "X", Third Party Designee 

Name (SEQ 1307) and Third Party Designee PIN (SEQ 1313) must be present. 

If the literal “PREPARER” is in Third Party Designee Name (SEQ 1307), then Third Party Designee PIN 

(SEQ 1313) is not required. 

0768 o Form 8621 – If Deemed Dividend Election (SEQ 0250) equals “X”, then Attach Statement For Post 

1986 Earnings & Profits (SEQ 0255) must contain "STMbnn". 

0769 o RESERVED 

0770 o Tax Form – Third Party Designee “Yes” Box (SEQ 1303) and Third Party Designee “No” Box 

(SEQ 1305) cannot both equal “X”. 

0771 o Form 8621- Identifying Number (SEQ 0020) must be significant. 
0772 o Form 8621 – When Total Distributions From PFIC During Current Tax Year (SEQ 0500) or Total 

Distributions, Reduced (SEQ 0510) or Enter Gain (LOSS) of A Sec. 1291 Fund (SEQ 0550) is 

significant then Attach statement for each Distribution and Disposition (SEQ 0555) must contain 

“STMbnn”. 

0773 o 

o

Form 8621 – When Subtract Line 1b from Line 1a (SEQ 0310) of Form 8621 contains a significant 

entry, Total Ordinary Dividends (SEQ 0394) of Form 1040 must contain a significant entry. 

When Subtract Line 2b from Line 2a (SEQ 0340) of Form 8621 contains a significant entry, Schedule 

D must be present. 

0774 o RESERVED 

0775 o Form 8621 – When Elect to Treat POST 1986 Earnings & Profits as an Excess Distribution 

(SEQ 0250) equals “X”, then Subtract Line 10d from Line 10a (SEQ 0540) must be significant. 

0776 o Form 8621 – When Elect to Extend Time of PYMT (SEQ 0260) equal “X”, then Subtract Line 3d From 

Line 3a (SEQ 0390) must be significant. When Subtract Line 3d From Line 3a (SEQ 0390) is positive, 

Subtract Line 4b from Line 4a (SEQ 0420) must be significant.

0777 o Form 8621 – If Election To Recognize Gain On Deemed Sale Of Pfic (SEQ 0270) equals “X”, then e 

enter Gain (Loss) Of Stock Of A Sec. 1291 Fund (SEQ 0550) must be significant. 

0778 o Form 1040 – When F8611 Literal (SEQ 1114) equals “LIHCR” and F8611 Amount (SEQ 1116) is 

significant, then Form 8611 must be present. 

0779 o Form 1040 – If F8693 Approved Indicator (SEQ 1118) is significant, then F8693 Approved Date 

(SEQ 1119) must be significant. If F8693 Approved Date (SEQ 1119) is significant, then F8693 

Approved Indicator (SEQ 1118) must be significant 

0780 o RESERVED 

0781 o RESERVED 

0782 o Form 982 – When Discharge of Indebtedness in a Title 11 Case (SEQ 0020) equals blank, 

Discharge of Indebtedness to the Extent Insolvent (SEQ 0030) equals blank, Discharge of Qualified 

Real Prop Bus Indebtedness (SEQ 0050) equals blank and Discharge of Qualified Farm 

Indebtedness (SEQ 0040) is equal to “X”, then Amt Excluded From Inc: To Reduce Basis 

(SEQ 0150) must be blank. 

0783 o Form 982 – When Amt Excluded From Inc: Under Section 108(b)(5) (SEQ 0100) is significant, then 

Attach Description of Transactions (SEQ 0085) must equal “STMbnn”. 

0784 o Form 982 – When Discharge of Qualified Real Prop Bus Indebtedness (SEQ 0050) is significant, 

then Amt Excluded From Inc: Discharge of Qual Real Prop (SEQ 0090) must be significant. 

0785 o Form 2439 – All of these fields must be significant: Company or Trust Name Control (SEQ 0050), 

Company or Trust Name (SEQ 0060), and Company or Trust Identification Number (SEQ 0120). 

0786 o Form 2439 – Shareholder SSN (SEQ 0130) must equal Primary SSN (SEQ 0010) or Secondary SSN 

(SEQ 0030) of Form 1040. 

0787-0789 RESERVED 

0790 o Form 1040 – If Form 2439 Block (SEQ 1202) equal “X”, then Form 2439 must be present and vice 

versa.

0791 o Form 1040 – If Other Payments (SEQ 1210) is significant, then at least one of the following must 

equal “X”: Form 2439 Block (SEQ 1202), Form 4136 Block (SEQ 1205), Form 8885 Block 

(SEQ 1208). 

0792-0794 RESERVED 

0795 o RESERVED 
0796 o RESERVED 

0797-0804 RESERVED 

0805 o TRANS Record B (TRANB) must be present. 

0806 o RESERVED 

0807-0821 RESERVED 

0822 o TRANS Record A (TRANA) - Transmission Sequence for Julian Day (SEQ 0080) matches a 

previously accepted transmission (Duplicate Transmission). 

0823 o Unrecognizable Transmission - If there are any unrecognizable or inconsistent control data, the 

transmission will be rejected. 

0824 o TRANS Record A (TRANA) - Transmitter EFIN (SEQ 0110) must be present. 

0825 o 

o

Invalid Sequence of Records in Transmission - The data records of the transmission must be in the 

following sequence: TRANA, TRANB, Return Records (1-500 for dial-up or 1-10,000 for 

dedicated/leased line or high speed protocol), and RECAP. 

The format and content of the TRANA, TRANB, and RECAP Records must be exactly as defined in 

Part II Record Layouts. 

0826-0829 RESERVED 

0830 o RECAP Record - Total EFT (SEQ 0020) does not equal program-computed count. Total EFT Count 

is a count of Direct Deposit Requests and is incremented for each return that contains a non-blank 

character in any one of the Direct Deposit data fields (SEQ 1272, 1274, 1276, 1278) of the Tax Form. 

If an extraneous character is present within those fields, it will be counted as an EFT. 

0831 o RECAP Record - Total Return Count (SEQ 0030) does not equal program-computed count. Total 

Return Count is a count of returns transmitted and is incremented each time the Primary SSN within a 

Record ID changes. 

0832 o RECAP Record – Total State Only Return Count (SEQ 0130) does not equal program computed 

count. Total State only Return Count is a count of State Only Returns transmitted and is incremented 

each time the Primary SSN within a Record ID changes. 

0833-0839 RESERVED 

0840 o RECAP Record - The following fields must equal those in the Trans Record A (TRANA): 

IDENTIFICATION TRANA RECAP 

Electronic Trnsmtr Identification Number (ETIN) SEQ 0060 SEQ 0040 

Julian Day of Transmission SEQ 0070 SEQ 0050 

Transmission Sequence Number for Julian Day SEQ 0080 SEQ 0060 

0841-0899 RESERVED 

0900 o RESERVED 

0901 o RESERVED 

0902 o RESERVED 

0903 o RESERVED 

0904 o Primary SSN (SEQ 0010) of the Tax Form cannot duplicate a Primary SSN within the same “drain” of 

returns.

0905 o RESERVED 

0906 o Secondary SSN (SEQ 0030) of the Tax Return cannot duplicate a Secondary SSN within the same 

“drain” of returns. 
0907-0914 RESERVED 

0915 o Form 8609-A – If Have Form 8609-No (SEQ 0060) contains “X”, the rest of the fields on the form 

must be blank. 

0916 o Form 8609-A – If Building Qualified Low-Income – No (SEQ 0080) contains “X”, the rest of the fields 

on the form must be blank. 

0917-0920 RESERVED

0921 o Form 8864 – If Current Year Credit (SEQ 0120) and Net Income Tax (SEQ 0290) both contain an 

entry greater than zero, then Form 6251 must be present. 

0922-0924 RESERVED

0925 o Form 8896 – If Current Year Credit (SEQ 0090) and Net Income Tax (SEQ 0290) both contain an 

entry greater than zero, then Form 6251 must be present. 

0926-0929 RESERVED

0930 o Form 6251 - The following fields (when significant) may not be negative: SEQs 0085, 0098, 0100, 

0102, 0146, 0150, 0267, 0330. 

0931-0949 RESERVED

0950 o Form 8873 - When Election Under Section 942(a)(3) (SEQ 0020) equals “X”, Attachment Election 

Under Section 942(a)(3)(SEQ 0025) must equal “STMbnn”. 

0951 o Form 8873 - When Election Extraterritorial Income Exclusion FSC (SEQ 0030) equals “X”, 

Attachment Election Extraterritorial Exclusion FSC (SEQ 0035) must equal “STMbnn”. 

0952 o Form 8873 - When Aggregate on Tabular Schedule (SEQ 0085) equals “X”, Attachment to Tabular 

Schedule (SEQ 0090) must equal “STMbnn”. 

0953 o Form 8873 - When Tabular Schedule of Transactions (SEQ 0095)equals “X”, Attachment to Schedule 

of Transactions (SEQ 0100)must equal “STMbnn”. 

0954 o Form 8873 - When Group of Transactions (SEQ 0110) equals “X”, Attachment to Group of 

Transactions (SEQ 0115) must equal “STMbnn”. 

0955 o Form 8873 - When Additional Section 263A Costs Trade (SEQ 0310) or Additional Section 263A 

Costs Sale and Lease (SEQ 0320) is significant, Attachment to Section 263A Costs (SEQ 0325) must 

equal “STMbnn”. 

0956 o Form 8873 - When Other Costs Trade (SEQ 0330) or Other Costs Sale and Lease (SEQ 0340) is 

significant, Attachment Other Costs (SEQ 0345) must equal “STMbnn”. 

0957 o Form 8873 - When Other Expenses and Deductions Trade (SEQ 0430) or Other Expenses and 

Deductions Sale and Lease (SEQ 0440) is significant, Attachment for Other Expenses and Deductions

(SEQ 0445) must equal “STMbnn”. 

0958-0960 RESERVED 
0961 o 

o

o

o

o

o

Form 8901 - Qualifying child data must be complete and correctly formatted. 

Child First Name (SEQ 0010, 0060, 0110, 0160) and Child Last Name (SEQ 0020, 0070, 0120, 0170) 

must contain only alpha characters and spaces. A space cannot be in the first position of either Child 

First Name or Child Last Name. 

Child Name Control (SEQ 0030, 0080, 0130, 0180) must be in the correct format. 

Child's SSN (SEQ 0040, 0090, 0140, 0190) must be within the valid ranges of SSN/ITIN/ATINs. It 

must equal all numeric characters and cannot equal all zeros or all nines. 

If any field of the following "qualifying child group" is significant, then all fields in that group must be 

significant: Child First Name, Child Last Name, Child Name Control, Child's SSN, and Relationship. 

Qualifying children must be listed starting on the first line, with no blank lines allowed between 

children. 

0962 o 

o

o

o

Form 8901 - Form 8901 may not be e-filed when all of the following are true: 

Exempt Self (SEQ 0160) equals “X”, 

If married filing jointly, Exempt Spouse (SEQ 0163) also equals “X”, and 

Any child on Form 8901 (SEQ 0010, 0060, 0110, 0160) was under age 16 at the end of the tax year. 

(Note: A paper return may be filed to include on Form 8901 a married qualifying child, under age 16, 

who files a joint return for the tax year.) 

0963 o RESERVED 

0964 o Form 8901 - Child's SSN (SEQ 0040, 0090, 0140, 0190) cannot equal another Child's SSN from Form 

8901. It cannot equal Primary SSN (SEQ 0010), Secondary SSN (SEQ 0030), or a Dependent’s SSN 

(SEQ 0175, 0185, 0195, 0205) from Form 1040 or 1040A. 

0965-0969 RESERVED 

0970 o Form 1116 - When Financial Services Income (SEQ 0040) equals “X”, Financial Services Income 

Statement (SEQ 0045) must equal “STMbnn”. 

Exception: When Financial Services Income (SEQ 0040) equals "X" on two Forms 1116 and the Alt. Min. 

Tax Literal (SEQ 0010) is significant on one of the two Forms 1116, Financial Services Income Statement 

(SEQ 0045) must equal "STMbnn" only for the Form 1116 on which the Alt. Min. Tax Literal (SEQ 0010) 

is not significant. 

0971 o Form 1116 - When Allocable Expenses A (SEQ 0200) is significant, Allocable Expense Statement A 

(SEQ 0205) must equal “STMbnn”, or When Allocable Expenses B (SEQ 0320) is significant, 

Allocable Expense Statement B (SEQ 0325) must equal “STMbnn”,or When Allocable Expenses C 

(SEQ 0440) is significant, Allocable Expense Statement C (SEQ 0445) must equal “STMbnn”. 
0972 o Form 1116 - When Other Deductions A (SEQ 0220) is significant, Other Deductions Statement A 

(SEQ 0225) must equal “STMbnn”, or When Other Deductions B (SEQ 0340) is significant, Other 

Deductions Statement B (SEQ 0345) must equal “STMbnn”,or When Other Deductions C (SEQ 0460) 

is significant, Other Deductions Statement C (SEQ 0465) must equal “STMbnn”. 

0973 o Form 1116 - When Taxes Wthld on Dividends Foreign Curr. A (SEQ 0610), or Taxes Wthld Rent/Roy. 

Foreign Curr. A (SEQ 0620), or Taxes Wthld on Interest Foreign Curr. A (SEQ 0630), or 

Other Taxes Paid/Accrued Foreign Curr. A (SEQ 0640) is significant, Taxes Wthld/Paid/Accrued Curr. 

A Statement (SEQ 0645) must equal “STMbnn”, or 

When Taxes Wthld on Dividends Foreign Curr. B (SEQ 0710), or Taxes Wthld Rent/Roy. Foreign 

Curr. B (SEQ 0720), or

Taxes Wthld on Interest Foreign Curr. B (SEQ 0730), or Other Taxes Paid/Accrued Foreign Curr. B 

(SEQ 0740) is significant, 

Taxes Wthld/Paid/Accrued Curr. B Statement (SEQ 0745) must equal “STMbnn”, or 

When Taxes Wthld on Dividends Foreign Curr. C (SEQ 0810), or Taxes Wthld Rent/Roy. Foreign 

Curr. C (SEQ 0820), or

Taxes Wthld on Interest Foreign Curr. C (SEQ 0830), or Other Taxes Paid/Accrued Foreign Curr. C 

(SEQ 0840) is significant, 

Taxes Wthld/Paid/Accrued Curr. C Statement (SEQ 0845) must equal “STMbnn”. 

09749 o Form 1116 - When Carryback/Carryover Amount (SEQ 0950) is significant, Carryback/Carryover 

Explanation (SEQ 0940) must equal “STMbnn”. 

0975 o Form 1116 - When Foreign Tax Reduction Amount (SEQ 0980) is significant, Foreign Tax Reduction 

Explanation (SEQ 0970) must equal “STMbnn”. 

0976 o Form 1116 - When Adjustments to Taxable Income (SEQ 1020) is significant, Adjustments 

Explanation (SEQ 1010) must equal “STMbnn”. 

0977-0981 RESERVED 

0982 o Form 1040 - When Domestic Production Activities Ded (SEQ 0710) is significant it must equal 

Domestic Production Activities Deduction (SEQ 0530) of Form 8903, and vice versa. 

0983 o Form 8903 - When Wage-Limited DPA Deduction (SEQ 0390) is significant and Adjusted Gross 

Income (SEQ 0750) of Form 1040 is positive, Income Limitation (SEQ 0210) must equal the sum of 

Domestic Production Activities Ded (SEQ 0710) of Form 1040 and Adjusted Gross Income 

(SEQ 0750) of Form 1040. 

0984-0985 RESERVED 

0986 o Form T - When Other Consideration Amount (SEQ 0130) is significant, Other Consideration Amount 

Statement (SEQ 0135) must equal “STMbnn”. 

0987 o Form T - When Section 631(a) Timber Cutting Election – Yes Box SEQ 1310) equals “X”, 

Section 631(a) Adjusted Basis Statement (SEQ 1315) must equal “STMbnn”, and 

Section 631(a) Cut Timber Detail Statement (SEQ 1325) must equal “STMbnn”, 

and Section 631(a) Timber Valuation Statement (SEQ 1335) must equal “STMbnn”, and 

Section 631(a) Valuation Comparison Statement (SEQ 1345) must equal “STMbnn”, and 

Section 631(a) Operations Statement (SEQ 1355) must equal “STMbnn”, and Section 631(a) Activity 

Status Statement (SEQ 1365) must equal “STMbnn”. 

0988 o Form T - When Other Consideration Amount-S (SEQ 1440) is significant, Other Consideration 

Amount-S Statement (SEQ 1445)

must equal “STMbnn”. 

0989-0998 RESERVED 

0999 o A maximum of 96 Error Reject Codes can be provided in the acknowledgment file. If more than 96 

reject conditions are identified, the 96th Error Reject Code will be replaced with "0999". 

1000 o Form 1310 – When the Filing Status Code (SEQ 0130) of the Tax Form is NOT equal to "Married 

Filing Joint" and the Refund (SEQ 1270) of the Tax Form is significant, then Form 1310 must be 

present and the Decedent's SSN (SEQ 0040) must equal the Primary SSN (SEQ 0010) of the Tax 

Form.
1001 o Form 1310 – When the Filing Status Code (SEQ 0130) of the Tax Form is equal to "Married Filing 

Joint", the Decedent's SSN (SEQ 0040) must equal either the Primary SSN (SEQ 0010) or the 

Secondary SSN (SEQ 0030) of the Tax Form. 

1002 o Form 1310 – The Tax Year Decedent Due Refund (SEQ 0010) must equal the current tax year. 

1003 o Form 1310 – The year of the Date of Death (SEQ 0030) must equal the current tax year or 

processing year. 

1004 o Form 1310 – The Date of Death (SEQ 0030) must be significant and match either the Primary Date of 

Death (SEQ 0020) or the Secondary Date of Death (SEQ 0040) on the Tax Form. 

1005 o Form 1310 – When Person Other Than A or B Claiming Decedent Refund (SEQ 0190) equals "X", 

then all of the following fields must also equal "X": Did Decedent Leave a Will "YES" Box (SEQ 0210) 

or Did Decedent Leave a Will "NO" Box (SEQ 0220), Court Appointed Personal Rep "NO" Box (SEQ 

0240), Personal Rep will be Appointed "NO" Box (SEQ 0260) and Refund Paid out According to State 

Laws "YES" Box (SEQ 0270). 

1006 o Form 1310 - When Person Other Than A or B Claiming Decedent Refund (SEQ 0190) and Refund 

Paid Out According to State Laws "YES" Box (SEQ 0270) are equal to "X", then at least one of the 

following fields on the Tax Form must be significant: Primary Date of Death (SEQ 0020) or Secondary 

Date of Death (SEQ 0040). 

1007 o Form 1310 – Person Claiming Refund Signature (SEQ 0290) and Signature Date (SEQ 0300) must 

be significant. 

1008 o Form 1310 – Valid Proof of Death is in my Possession (SEQ 0200) must equal "X". 

1009 o 

o

Form 1310 – Street Address (SEQ 0110) is alphanumeric and cannot have leading or consecutive 

embedded spaces. The left-most position must contain an alpha or numeric character. The only 

special characters permitted are space, hyphen (-), and slash (/). 

Street Address (SEQ 0110) is a required field. 

1010 o Form 1310 – Zip Code (SEQ 0150) must be within the valid ranges of zip codes listed for the 

corresponding State Abbreviation (SEQ 0140). The zip code cannot end in "00", with the exception of 

20500 (the White House zip code). 

1011 o 

o

Form 1310 – State Abbreviation (SEQ 0140) must be significant and consistent with the standard 

state abbreviations issued by the Postal Service. 

State Abbreviation (SEQ 0140) is a required field. 

1012 o 

o

Form 1310 – City (SEQ 0130) must be left-justified and must contain a minimum of three alpha 

characters. This field cannot contain consecutive embedded spaces and must contain only alphabetic 

characters and spaces. Do not abbreviate the city name. 

City (SEQ 0130) is a required field. 

1013 o Form 1310 – If Address Ind (SEQ 0160) equals "1" (APO/FPO Address), then City (SEQ 0130) must 

equal "APO" or "FPO", and State Abbreviation (SEQ 0140) must equal "AA", "AE", or "AP" with the 

appropriate Zip Code (SEQ 0150). If State Abbreviation (SEQ 0140) equals "AA", "AE", or "AP", then 

Address Ind (SEQ 0160) must equal "1". 

1014 o Tax Form – When Filing Status Code (SEQ 0130) is equal to "2" and the Primary Date of Death 

(SEQ 0020) and the Secondary Date of Death (SEQ 0040) and Refund (SEQ 1270) are significant, 

then Form a 1310 must be present for both taxpayers and Name of Person Claiming Refund 

(SEQ 0060) on the first Form 1310 must be equal to Name of Person Claiming Refund (SEQ 0060) of 

the second Form 1310. 

1015 o Tax Form - When Filing Status (SEQ 0130) is equal to "2" and either the Primary Date of Death 

(SEQ 0020) or the Secondary Date of Death (SEQ 0040) is significant, then Surviving Spouse Yes 

(SEQ 1325) must also be significant. 
1016 o Tax Form - When Filing Status Code (SEQ 0130) is NOT equal to "2" and the Primary Date of Death 

(SEQ 0020) and the Refund (SEQ 1270) are significant, then Form 1310 must be present and Person 

other than A or B Claiming Decedent Refund (SEQ 0190) must be significant. 

1017 o 

o

o

Form 1310 – The SSN of Person Claiming Refund must be significant and cannot equal Primary SSN 

(SEQ 0010) or Secondary SSN (SEQ 0030) of Form 1040. 

When two Form 1310 are present, the SSN of Person Claiming Refund (SEQ 0070) of the first Form 

1310 must equal the SSN of Person Claiming Refund (SEQ 0070) of the second Form 1310. 

Exception: When the Filing Status is MFS, the SSN of Person Claiming Refund must be significant and 

MUST equal Secondary SSN (SEQ 0030) of Form 1040/A/EZ. 

1018 o

o

Form 1310 – When only one Form 1310 is present, Decedent's SSN (SEQ 0040) must equal Primary 

SSN (SEQ 0010) or Secondary SSN (SEQ 0030) of Form 1040. 

When two Forms 1310 are present, Decedent's SSN (SEQ 0040) of the first Form 1310 must equal 

Primary SSN (SEQ 0010) of Form 1040 and Decedent's SSN (SEQ 0040) of the second Form 1310 

must equal Secondary SSN (SEQ 0030) of Form 1040. 

1019 o 

o

Tax Form - When Filing Status (SEQ 0130) is "Other Than 2" and the Primary Date of Death (SEQ 0020) 

is significant, then Personal Representative (SEQ 1326) must also be significant. 

Tax Form - When Filing Status (SEQ 0130) is equal to "2" and 

the Primary Date of Death (SEQ 0020) and the Secondary Date of Death (SEQ 0040) are significant, then 

Personal Representative (SEQ 1326) must also be significant. 

1020 o RESERVED 

1021 o RESERVED 

1022 o RESERVED 

1023 o RESERVED 

1024 o RESERVED 

1025 o RESERVED 

1026 o RESERVED 

1027 o RESERVED 

1028 o RESERVED 

1029 o RESERVED 

1030 o RESERVED 

1031 o RESERVED 

1032 o

o

Tax Form - When Primary Date of Death (SEQ 0020) on the Tax Return is significant, the year of 

Primary Date of Death must equal the current tax year or processing year and must match data from 

the IRS Master File. 

When Secondary Date of Death (SEQ 0040) on the Tax Return is significant, the year of Secondary 

Date of Death must equal the current tax year or processing year and must match data from the IRS 

Master File. 
1033 o

o

Tax Form - When Primary Date of Death (SEQ 0020) on the Tax Return is significant, then the 

following fields cannot be present: Foreign Street Address (SEQ 0062), Foreign City, State or 

Province, Postal Code (SEQ 0064), and Foreign Country (SEQ 0066). 

When Secondary Date of Death (SEQ 0040) on the Tax Return is significant, then the following fields 

cannot be present: Foreign Street Address (SEQ 0062), Foreign City, State or Province, Postal Code 

(SEQ 0064), and Foreign Country (SEQ 0066). 

1034 o 

o

Tax Form - When Primary Date of Death (SEQ 0020) on the Tax Return is significant, then Name Line 

2 (SEQ 0070) must also be significant. 

When Secondary Date of Death (SEQ 0040) on the Tax Return is significant, then Name Line 2 

(SEQ 0070) must also be significant. 

1035 o Tax Form - When the Filing Status (SEQ 0130) is Other Than “2” and the Primary Date of Death 

(SEQ 0020) is significant, then Name Line 1 (SEQ 0060) must contain “space DECD or less than sign 

DECD”, else reject. 

1036 o 

o

Form 1310 - Name of Person Claiming Refund (SEQ 0060) must equal Name Line 2 (SEQ 0070) of Tax 

Form. 

Name Line 2 (SEQ 0070) of Tax Form must equal Name of Person Claiming Refund (SEQ 0060) on 

Form 1310 if present. 

1037 o Tax Form - When the Filing Status (SEQ 0130) is “2”, and the Primary Date of Death (SEQ 0020) is 

significant, then Name Line 1 (SEQ 0060) must contain “DECD space ampersand sign”, else reject. 

1038 o Tax Form - When the Filing Status (SEQ 0130) is “2”, and the Secondary Date of Death (SEQ 0040) is 

significant, then Name Line 1 (SEQ 0060) must contain “space DECD”, else reject. 

1039 o RESERVED 

1040 o RESERVED 

1041 o Form W-2GU – When Advance EIC Payment (SEQ 0200) is significant, taxpayers cannot file Form 

1040EZ. 

1042 o Form W-2GU – Employer City (SEQ 0070) must contain at least three characters. 

1043 o Form W-2GU – Employer Identification Number (SEQ 0040) must be numeric, then first two digits of 

Employer Identification Number (SEQ 0040) must equal a valid District Office Code, Employer Name 

Control (SEQ 0045) must be significant, and W-2GU Indicator (SEQ 0300) must equal "N" or "S". 

Note: The value "N" (Non-Standard) indicates that the Form W-2GU was altered, handwritten, or 

typed, or that a cumulative earnings statement or a substitute Form W-2GU was used. The value "S" 

(Standard) identifies a Form W-2GU that is a computer-produced print, an IRS form, or an IRSapproved facsimile. 

1044 o 

o

o

Form W-2GU - The following fields must be significant: Employer Name (SEQ 0050), Employer 

Address (SEQ 0060), Employee Name (SEQ 0090), Employee Address (SEQ 0100), Employee City 

(SEQ 0110), Employee State (SEQ 0113), Employee Zip Code (SEQ 0115), and Wages (SEQ 0120). 

Exception: The check for Wages (SEQ 0120) is bypassed when Combat Pay has been excluded from 

Wages. 

Exception: When a period (.) is present in the Employee State (SEQ 0113), the checks for Employee 

City (SEQ 0110) and Employee Zip Code (SEQ 0115) are bypassed. 

1045 o Form W-2GU – Employee SSN (SEQ 0080) must equal either the Primary SSN (SEQ 0010) or 

Secondary SSN (SEQ 0030) of the Tax Form. 

1046 o Summary Record – Number of Forms W-2GU Records (SEQ 0063) must equal the number of Forms 

W-2GU computed by the IRS. 
1047 o Form W-2GU – If the total of Wages (SEQ 0120) from Form(s) W-2GU is greater than $4,999 and the 

Adjusted Gross Income (SEQ 0750) of Tax Form is greater than $49,999, then Form 1040 must be 

used, Form 5074 must be attached and the return must be processed at the Philadelphia Submission 

Processing Center. 

1048 o Tax Form – If the State Abbreviation (SEQ 0087) is equal to "GU" and Wages, Salaries, and Tips 

(SEQ 0375) equals the total amount(s) of Wages (SEQ 0120) from Form(s) W-2GU and 

Wages, Salaries, and Tips (SEQ 0375) equals Total Income (SEQ 0600) from Form 1040/A or 

Adjusted Gross Income (SEQ 0750) from Form 1040EZ and Total Payments (SEQ 1250) equals the 

total amount(s) of Guam Withholding (SEQ 0130) from Form(s) W-2GU, then this return must be filed 

with the Department of Revenue and Taxation, Government of Guam. 

1049 o Tax Form - Tax returns from the U.S. Possessions of American Samoa, Guam, and the Commonwealth of 

the Northern Mariana Islands may not be electronically filed. 

1050 o Form 8594 – When SEQ 0300 is present, then SEQ 0315 must equal "STMbnn". 

10515 o Tax Form - Earned Income Credit may not be claimed by residents of the U.S. Possessions or foreign 

countries. 

1052-1054 RESERVED

1055 o RESERVED

1056 o RESERVED

1057 o RESERVED

1058-1059 RESERVED

1060 o

o

STCGL/LTCGL – Schedule D Page 1 or Form 8865 Page 1 must be the next record after the Capital 

Gain/Loss Records.

The Subpart Type (SEQ 0001) and Subpart Occurrence Number (SEQ 0005) must match the Record 

ID (SEQ 0000) and Schedule/Form Occurrence Number (SEQ 0005) from the parent (Schedule D or 

Form 8865) that immediately follows the Capital Gain Records. 

1061 o STCGL/LTCGL – The Transaction Occurrence Number (SEQ 0010) must be significant and in 

ascending, consecutive numerical sequence beginning with "0000001". 
1062 o

o

o

o

STCGL/LTCGL – Any STCGL Reference number "STCGL" occurring within a tax return must have a 

corresponding STCGL Record. 

Any LTCGL Reference number "LTCGL" occurring within a tax return must have a corresponding 

LTCGL Record. 

If ST Property Desc 1 of Schedule D (SEQ 0020) is equal to "STCGL" then SEQ 0030 – 0290 must be 

blank. If LT Property Desc 1 of Schedule D (SEQ 0880) is equal to "LTCGL" then SEQ 0890 – 1155 

must be blank. 

If S-T Description of Property of Form 8865 (SEQ 2480) is equal to "STCGL" then SEQ 2490 – 2710 

must be blank. If L-T Description of Property of Form 8865 (SEQ 2760) is equal to "LTCGL" then 

SEQ 2770 – 3030 must be blank. 

1063 o Summary Record – Number of STCGL Records (SEQ 0133) must equal the number of STCGL 

Records computed by the IRS. 

1064 o Summary Record – Number of LTCGL Records (SEQ 0135) must equal the number of LTCGL 

Records computed by the IRS. 

1065-1067 RESERVED

1068 o 

o

Tax Form – If Nontaxable Combat Pay Election (SEQ 1185) is significant, it must equal total 

nontaxable combat pay on Forms W-2. On Form W-2, nontaxable combat pay is the amount in 

Employer’s Use Amount (SEQ 0246, 0256, 0259, 0262, statement) when the corresponding 

Employer’s Use Code (SEQ 0242, 0252, 0257, 0260, statement) is “Q”. 

Exception – When PYEI Literal (SEQ 1175) equals “PYEI” and Nontaxabe Combat Pay Election 

(SEQ 1185) is significant, the prior year nontaxable combat pay amount must be used. 

1069 o Form 1040/1040A - When Earned Income Credit (SEQ 1180) and Additional Child Tax Credit (Form 

8812) (SEQ 1192) are both significant, and the Hurricane Katrina election to use prior year earned 

income is made for one credit, the election must be made for both credits. The election is made when 

PYEI Literal (SEQ 1175) of Form 1040/1040A equals “PYEI” and 2004 Earned Income Indicator 

(SEQ 0019) of Form 8812 equals “X”. 

10704 o

o

o

Form 8885 - When only one Form 8885 is present, SSN of Recipient (SEQ 0020) must equal the 

Primary SSN (SEQ 0010) or Secondary SSN (SEQ 0030) of Form 1040. 

When two Forms 8885 are present, SSN of Recipient (SEQ 0020) of the first Form 8885 must equal 

the Primary SSN (SEQ 0010) of Form 1040 and SSN of Recipient (SEQ 0020) of the second Form 

8885 must equal the secondary SSN (SEQ 0030) of Form 1040. 

When two Forms 8885 are present, SSN of Recipient (SEQ 0020) of the first Form 8885 cannot equal 

SSN of Recipient (SEQ 0020) of the Form 8885 of the second Form 8885. 

1071 o Form 1040 - If Form 8885 Block (SEQ 1208) is significant, then Form 8885 must be attached and vice 

versa.

1072 o Form 8885 – On each Form 8885 at least one of the following fields must equal “X”: SEQ 0035, 0045, 

0055, 0065, 0075, 0085, 0095, 0105, 0115, 0125, 0135 or 0145. 

1073 o Form 8885 – Amount Paid for Health Insurance (SEQ 0190) must contain a significant entry. 

1074 o Form 8885 – If “Advance Payments” (SEQ 0240) does not contain a significant amount, “Multiply Line 

4 by 65%” (SEQ 0230) must equal “Health Coverage Tax Credit” (SEQ 0250). 

1075 o Form 8885 – Information provided to the IRS indicates that filer is not eligible to claim the Health 

Coverage Tax Credit. Eligibility is determined through either filer’s state workforce agency 

(Department of Labor) or the Pension Benefit Guaranty Corporation (PBGC). Only these organizations 

can determine filer’s potential eligibility. To determine eligibility, trade adjustment assistance (TAA) 

and alternative trade adjustment recipients (ATAA) may call the DOL at 1-877-US-2JOBS (TTY 1-877-

889-5627). PBGC recipients should call 1-800-400-7242. 
1076 o Form 8885 – When any of the Month boxes (SEQ 0035, 0045, 0055, 0065, 0075, 0085, 0095, 0105, 

0115, 0125, 0135, 0145)or Amount Paid for Health Insurance (SEQ 0190) contain a significant entry, 

then the PIN TYPE Code (SEQ 0008) of the Authentication Record must be blank. (Note: This error 

will be set on the PIN TYPE Code).

1077-1079 RESERVED 

10801 o Form 1040 – If Form 8859 Block (SEQ 0990) equals “X”, then Form 8859 must be attached. 

1081-1084 RESERVED 

1085 o Form 8889 - SSN of HSA account beneficiary (SEQ 0010) of Form 8889 must equal Primary SSN (SEQ 

0010) or Secondary SSN (SEQ 0030) of Form 1040. 

1086 o RESERVED 

1087-1089 RESERVED 

1090 o RESERVED 

1091-1093 RESERVED 

1094 o Form 1040 - When Filing A Community Property State Return (SEQ 1317) is significant, the 

Allocation Record must be present and the Filing Status equals "3", the State Abbreviation (SEQ 

0087) must equal one of the following states: AZ (Arizona), CA (California), ID (Idaho), LA 

(Louisiana), NM (New Mexico), NV (Nevada), TX (Texas), WA (Washington) and WI (Wisconsin) and 

vice versa. 

1095 o 

o

Allocation Record - When the Allocation Record is present, Total Income (SEQ 0250) must be 

significant and cannot be zero filled or blank. 

Exception: This check is bypassed when Combat Pay has been excluded from Income. 

1096 o Summary Record - Count of Allocation Record (SEQ 0105) must equal the count of Allocation Record 

computed by the IRS. 

1097-1099 RESERVED 

1100-1119 RESERVED 

1120 o Form 4684 – If more than one Form 4684 is present, only the first occurrence of Form 4684 can 

contain entries in the following fields: SEQ 0400, 0410, 0420, 0430, 0445, 0447, 0451, and 0453. 

1121-1149 RESERVED 

1150 o Authentication Record – An Authentication Record must be present when the Practitioner PIN, SelfSelect PIN by Practitioner, Online Self-Select PIN or Regular Online (Form 8453-OL) is used. 

1151-1154 RESERVED 

1155 o Authentication Record – When the Primary Taxpayer Signature (SEQ 1321) or Spouse Signature 

(SEQ 1324) on the Tax Return is significant, the PIN TYPE Code (SEQ 0008) on the Authentication 

Record must be present and must be P, S, or O. 

1156-1169 RESERVED 

1170 o Form 3800 – If Current Year New Markets Credit (SEQ 0540) is significant, then Form 8874 must be 

present. 

1171 o Form 3800 – If Credit for Small Employer Pension Plan Startup Cost (SEQ 0550) is significant, then 

Form 8881 must be present. 
1172 o Form 3800 – If Credit for Employer-Provided Child Care Facilities (SEQ 0580) is significant, then 

Form 8882 must be present. 

1173 o Form 3800 – If Current Year Biodiesel Fuels Credit (SEQ 0580) is significant, then Form 8864 must 

be present. 

1174 o Form 3800 – If Current Year Low Sulfur Diesel Fuel Credit (SEQ 0590) is significant, then Form 8896 

must be present. 

1175 o Form 3800 – If Katrina Employee Retention Credit (SEQ 0705) is significant, then Form 5884-A must 

be present. 

1176-1199 RESERVED 

1200 o Form 8891 - Registered Retirement Savings Plan Box (SEQ 0110) and Registered Retirement 

Income Fund Box (SEQ 0120) cannot both equal “X”, and cannot both equal blank. 

1201 o Form 8891 - Beneficiary Plan Status Box (SEQ 0130) and Annuitant Plan Status Box (SEQ 0140) 

cannot both equal “X”, 

and cannot both equal blank. 

1202 o Form 8891 - If Annuitant Plan Status Box (SEQ 0140) equals “X”, 

Previous U.S. Tax Deferral Elect “Yes” Box (SEQ 0150), and Previous U.S. Tax Deferral Elect “No” 

Box (SEQ 0160), and 

U.S. Tax Deferral New Elect Box (SEQ 0180) cannot equal “X”, 

and First Year U.S. Tax Deferral Elect (SEQ 0170) cannot be significant. 

1203 o Form 8891 - If Annuitant Plan Status Box (SEQ 0140) equals blank, Previous U.S. Tax Deferral Elect 

“Yes” Box (SEQ 0150) 

and Previous U.S. Tax Deferral Elect “No” Box (SEQ 0160) cannot both equal “X”, and 

cannot both equal blank. 

1204 o Form 8891 - If Annuitant Plan Status Box (SEQ 0140) equals blank, and if Previous U.S. Tax Deferral 

Elect “Yes” Box 

(SEQ 0150) equals “X”, First Year U.S. Tax Deferral Elect 

(SEQ 0170) must be significant, and U.S. Tax Deferral New Elect Box (SEQ 0180) cannot equal “X”. 

1205 o Form 8891 - If Annuitant Plan Status Box (SEQ 0140), or Previous U.S. Tax Deferral Elect “Yes” Box 

(SEQ 0150), or U.S. Tax Deferral New Elect Box (SEQ 0180) equals “X”, Current Year Plan 

Contributions (SEQ 0220), and Current Year Undistributed Interest (SEQ 0230), and Current Year 

Undistributed Ordinary Dividends (SEQ 0240), and Current Year Undistributed Qualified Dividends 

(SEQ 0250), and Current Year Undistributed Capital Gains (SEQ 0260), and Current Year Undistrib 

Other Income Total Amount (SEQ 0280) cannot be significant, and Current Year Undistrib Other 

Income List Statement (SEQ 0270) cannot be significant, and cannot equal “STMbnn”. 

1206-1214 RESERVED 

1215 o 

o

Form 1040/1040A - When Exemption Amount (SEQ 0810) exceeds an amount equal to $3,200 

multiplied by Total Exemptions (SEQ 0355), Form 8914 must be present to substantiate the higher 

exemption amount. 

Form 8914 - When Form 8914 is present, Net Total Exemption Amount (SEQ 0940) must equal 

Exemption Amount (SEQ 0810) of Form 1040/1040A 

1216 o 

o

o

Form 8914 - Entries for displaced individuals must begin on the first line. No lines may be skipped 

between individuals. 

If any field of a displaced individual’s entry significant then all fields of the entry must be significant. 

Each entry consists of Individual First Name, Individual Last Name, Individual Name Control, 

Individual SSN, Former Street Address, Former City, Former State, Former Zip Code, and Days Lived 

With You. 

Individuals’ SSNs must be within the valid ranges of SSN/ITIN/ATIN's. Refer to Attachment 9 for valid 

ranges of Social Security/Taxpayer Identification Numbers 
1217-1220 RESERVED 

1221 o Form 8915 - SSN of Qualified Taxpayer (SEQ 0020) on the first Form 8915 must be significant and 

equal to Primary SSN (SEQ 0010) or Secondary SSN (SEQ 0030) of Form 1040/1040A 

1222 o Form 8915 - SSN of Qualified Taxpayer (SEQ 0020) on the second Form 8915 must be significant 

and equal to Secondary SSN (SEQ 0030) of Form 1040/1040A and must not be equal to SSN of 

Qualified Taxpayer (SEQ 0020) on the first Form 8915. When both spouses are filing Form 8915, 

Form 8915 for the primary taxpayer must precede Form 8915 for the secondary taxpayer.

1223-1299 RESERVED 

1300 o RESERVED 

1301 o RESERVED 

1302 o RESERVED 

1303 o Form 8862 – If Number of Days Child 1/Child 2 Lived in U.S. (SEQ 0062/0072) is less than 184, then 

Child 1/Child 2 Date of Birth (SEQ 0082/0092) or Child 1/Child 2 Date of Death (SEQ 0084/0094) must be 

present. 

1304 o RESERVED 

1305 o Form 8862 - If Person Lived w/Child –Yes (SEQ 0290) equal “X”, then one of the following must be 

present; 

Other Person Name -1 Child 1 (SEQ 0310) and Other Person Relationship -1 Child 1 (SEQ 0320). 

If Child 2 is present, then the following must be present;Other Person Name -1 Child 2 (SEQ 0380) 

and Other Person Relationship -1 Child 2 (SEQ 0390). 

1306-9999 RESERVED 
ERROR REJECT CODE (ERC) Explanations

for Electronically Transmitted Documents 

 (Forms 56, 2350, 4868, 9465, and Form Payment) 

See Appendix for assistance in identifying SEQ numbers. 

_____________________________________________________________________________ 

0003 o The Tax Period must be "200512". 

004 o 

o

o

o

o

o

o

o

The Primary SSN must be numeric, cannot be all blanks nor all zeros nor all nines AND 

must be within the valid range of SSNs/ITINs. 

The Primary Social Security Number (P-SSN) (Field 0003 of the Record Id) must be 

numeric. 

The Primary SSN (P-SSN) (Field 0003 of the Record ID) must match the Primary SSN of 

the Form. 

The Form 4868 Primary SSN (SEQ 0090) is a required field. 

The Form 9465 Primary SSN (SEQ 0020) is a required field. 

The Form 2350 Primary SSN (SEQ 0030) is a required field. 

 | 

The Form payment Primary SSN (SEQ 0010) is a required field. 

The SSN of the Summary record (Field 0002) must be numeric. 

0006 o 

o

o

o

o

The Primary Name Control and the Spouse Name Ctrl must not contain leading or 

embedded spaces. The two leftmost positions must be alpha. Only an alpha, hyphen 

and space are allowed. 

The Form 4868 Primary Name Control (SEQ 0010) is a required field. 

The Form 9465 Primary Name Control (SEQ 0015) is a required field. 

The Form 2350 Taxpayer's Name Control (SEQ 0020) is a required field. 

 

The Form 9465 Spouse Name Control (SEQ 0035) is a required field when the Form 9465 

Spouse Name (SEQ 0030) is present. It must meet the same criteria for validation as the 

Primary Name Control. 
0007 o 

o

o

o

o

Street Address (Form 9465 SEQ 0050, Form 2350 SEQ 0070, and Form 4868 SEQ 0040) 

is alphanumeric and can have no leading | or consecutive embedded spaces. The only 

special characters allowed are space, hyphen (-) and slash (/). 

Foreign Street Address (Form 2350 SEQ 0110, and Form 4868 SEQ 0032) is 

alphanumeric and can have no leading or consecutive embedded spaces. The only 

special characters allowed are space, hyphen (-) and slash (/). 

Foreign City State or Province (Form 2350 SEQ 0120, and Form 4868 SEQ 0034) is 

alphanumeric and can have no leading or consecutive embedded spaces. The only 

special characters allowed are space, hyphen (-) and slash (/). 

The first position or character entered in the Street Address must be alphabetic or 

numeric. 

Street Address (Form 9465 SEQ 0050) is a required field. 

0010 o 

o

o

o

All alphanumeric fields must contain the type of data specified under the columnar 

heading "Field Description" in Record Layouts. All alphanumeric fields must be leftjustified and blank-filled unless otherwise specified. 

Significant money fields must be right-justified and zero-filled. Money fields must be whole 

dollars (no cents). 

Significant date fields with a length of eight positions must contain eight numeric 

characters in YYYYMMDD format. Significant date fields with a length of six positions 

must contain six numeric characters in YYYYMM format when transmitted in variable or 

fixed format. 

The PIN must be numeric and greater than zeros. 

0014 o This reject code is set for fields which are defined in Part 3, Section 7 Record Layouts as 

"NO ENTRY". 

0016 o 

o

Zip Code (Form 9465 SEQ 0090, Form 2350 SEQ 0100, and Form 4868 SEQ 0070) must 

be within the valid range of zip codes listed for that state and must not end in "00", with 

the exception of 20500 (the White House Zip Code). 

Zip Code (Form 9465 SEQ 0090) is a required field. 
0020 o 

o

o

o

Name Line 1 (Form 4868 SEQ 0030) or Taxpayer's Name (Forms 56, 2350, and 9465 

SEQ 0010) cannot have leading or consecutive embedded spaces. The only characters 

allowed are alpha, space, ampersand (&), hyphen (-) and less-than sign (<). The leftmost 

position must be alpha. The less-than sign replaces the intervening space to identify the 

Primary Taxpayer's last name. It cannot be preceded or followed by a space. Do not 

enter a space before or after any less-than sign; the less-than sign takes the place of a 

space. 

Note: The Taxpayer's Name for forms 56, 2350, and 9465 cannot have ampersand (&). 

If Spouse Name for Form 9465 (SEQ 0030), and Form 2350 (SEQ 0040) is present, it 

must meet the same criteria for validation as Taxpayer's Name. 

 The Name Line 1 (Form 4868 SEQ 0030) is a required field. 

Taxpayer's Name for Forms 56 and 9465 (SEQ 0010), and Form 2350 (SEQ 0010) is a 

required field. 

0022 o 

o

State Abbreviation (Form 9465 SEQ 0080, Form 2350 SEQ 0090, and Form 4868 

SEQ 0060) must be alpha and consistent with the standard state abbreviations issued by 

the Postal Service. 

State Abbreviation (Form 9465 SEQ 0080) is a required field. 

0023 o 

o

o

o

The City (Form 9465 SEQ 0070, Form 2350 SEQ 0080, and Form 4868 SEQ 0050) must 

be present, left-justified and contain a minimum of three alpha characters, blank filled 

when transmitted in fixed format. 

The Foreign Country (Form 2350 SEQ 0120, and Form 4868 SEQ 0036) must be present, 

left-justified and contain a minimum of three alpha characters, blank filled when 

transmitted in fixed format. 

City may not contain consecutive, embedded spaces. Only alphabetic characters and 

spaces are valid. DO NOT abbreviate cities. 

The City (Form 9465 SEQ 0070) is a required field. 

0027 o 

o

The Electronic Document Originator Name (Field 0010) must be present in the Summary 

Record. 

The EFIN of the Originator (Field 0020) must be present in the Summary Record AND be 

equal to the EFIN in the DCN of the ETD Document. 
0028 o The Two Digit Electronic Filing Identification Number (EFIN) Prefix Codes in the EFIN of 

the Originator in the Document Record must be valid. 

An “out of service center” Two Digit Electronic Filing Identification Number (EFIN) Prefix 

Codes is permitted when Processing Site equals “G” (Philadelphia) and at one of the 

following is present: Forms 56, 2350, 4868, 9465, and address indicator of the Form equal 

to “3” or State Abbreviation is a U.S. Possession. 

0030 o 

o

A Form Payment must be accompanied by Forms 4868 or 2350, if 

there is a payment. 

An Authentication record must be present with Form 56, 2350, 9465 and Form 4868 with 

a payment. 

0031 o The Document Sequence Number must be numeric. 

0032 o The Declaration Control Number must be numeric. 

0033 o Fields on a record must NOT be longer than specified in Section 7 Record Layouts. 

0034 o For each record, significant data must be present following the Record ID. 

0035 o Sequence Numbers of fields for each record must be in ascending order and valid for that 

tax document. 

0044 o The incoming record has an invalid RECORD ID. The Form is invalid for Electronic 

Transmitted Documents, or the page number is incorrect or duplicated. 

0045 o 

o

The number of occurrences for tax documents cannot exceed the allowed number. 

The format and content of the record identification information Record Id) which begins 

each type of record must be exactly as presented in the input specifications. 

0060 o The Document Sequence Number (DSN) must be in ascending numerical sequence 

within a transmission. However, the DSN does not have to be consecutive. 

0061 o The Declaration Control Number must be in ascending numerical sequence within the 

transmission. However, the DCN does not have to be consecutive. 

0062 o The first two digits of the Declaration Control Number must be zeros. 

0064 o The Year Digit of the DCN must be “6”. 

0071 o If present, the Spouse SSN must be all numeric, cannot be all zeros, nor all nines; must 

be within the valid range of SSNs/ITINs and must not equal the Primary SSN. 

0167 o Form 9465 Monthly Payment Date (SEQ 0310) must be present and within the range of 

01 to 28. 

0168 o Form 9465 Monthly Payment (SEQ 0300) must be $25.00 or more. 

0172 o Form 9465 Amount Owed (SEQ 0280) CANNOT be greater than $25,000. 
0304 o 

o

o

If Form Payment is for an extension payment the primary PIN (SEQ 0035) must be 

present and numeric. 

If Spouse’s SSN is present and Form Payment is present, the spouse’s PIN must be 

present. 

The Primary PIN number must be present for Form 2350(SEQ 0330), and Form 9465 

(SEQ 380), unless Other Than Taxpayer (SEQ 0300) is present. 

 o If preparer name is present, preparer signature date (SEQs 0305, or 0355) must be 

present. 

0305 o Agent’s name (if applicable) cannot be used as return label without taxpayer's name for 

Form 2350. 

0306 o 

o

For return label for Form 2350, agent Name (SEQ 0380) cannot be present without 

taxpayer's name (SEQ 0370). 

For the extensions filed from foreign country (excluding U.S. possessions), address 

indicator (Form 56 SEQ 0220, Form 2350 SEQ 0150, Form 4868 SEQ 0080, and Form 

9465 SEQ 0095) must be set to 3 and the domestic address fields must be blank and 

Foreign Address fields must be filled. 

0310 o Forms 4868 and 2350 must be received no later than April 17, 2006 or April 22, 2006 in 

the case of corrected forms. 

0311 o Foreign Forms 4868 and 2350 must be received no later than June 15, 2006 in the case 

of retransmitted for June 20, 2006. 

0312 o 

o

o

o

If the Spouse SSN (SEQ 0100) on Form 4868 is present, the Name Line 1 (SEQ 0030) 

must contain an ampersand. 

If the Name Line 1 (SEQ 0030) contains an ampersand, the Spouse SSN (SEQ 0100) 

must be present. 

If the Spouse SSN (SEQ 0060) on Form 2350 is present, Spouse’s name (SEQ 0040) 

must be present. 

If the Spouse SSN (SEQ 0060) on Form 2350 is not present, Spouse’s name (SEQ 0040) 

must not be present. 

0313 o 

o

o

The Tax Type Code of Form Payment (SEQ 0070) must be “4868E” for extension 

payment attached to the Form 4868 and 2350E for 

Extension payment attached to the Form 2350. 

The Tax Type Code of Form Payment (SEQ 0070) is a required Field. 

Only one Tax Type Code of Form Payment (SEQ 0070) can be present on each Form 

4868.

0315 o The Primary SSN and the Name Control for the tax document must match the 

corresponding data in the IRS Master File. 
0316 o The Spouse SSN and the Name Control for the tax document must match the 

corresponding data in the IRS Master File. 

0318 o 

o

o

The Form 56 either the Fiduciary’s USA Phone No. (SEQ 0225) or Fiduciary’s Foreign 

Phone No. (SEQ 230) must be present and numeric. It cannot be all zeroes. 

The Form 9465 either the Taxpayer’s Home Phone (SEQ 0110) or Taxpayer’s Work 

Number (SEQ 0130) or (SEQ 0155) must be present, 10/20 characters long and numeric. 

Form Payment – The taxpayer’s Day Time Phone Number (SEQ 0090) must be 10 

characters long and numeric. It cannot be all zeroes. 

0320 o 

o

The Amount of Tax Payment on the Form PMT (SEQ 0060) must be greater than zeroes. 

If Part 2 is present on Form 4868, the Amount of Tax Payment on the Form PMT 

(SEQ 0060) (Tax Type Code 4868E) must be equal to the amount on Form 4868, 

Line 7 (SEQ 0210). 

 o For Form 2350, the Amount of Tax Payment on the Form Payment 

(SEQ 0060) and (Tax Type Code 2350E), must be equal to the amount on Form 2350, 

Line 5. 

0321 o For Form 2350, Line 4 (SEQ 0220 through SEQ 0260) must be filled and valid. 

0322 o The Extension Date for Form 2350 (SEQ 0160) is a required field. 

0323 o When Date of Death (SEQ 0250) of Form 56 is present, then Year cannot be equal or 

later than processing year. 

0324 o The Tax Form Number (SEQs 0320 and 0353) of Form 56 must contain “1040”. 

0325 o The Tax Year One (SEQ 0330 & 0354), Year Two (SEQ 0332 & 0355), Year Three 

(SEQ 0334 & 0356), Period One (SEQ 0340 & 0357), Period Two (0342 & 0358) or 

Period Three (SEQ 0344 & 0359) cannot be all blanks. 

0326 o The Jurat/Disclosure Code of the Authentication Record (SEQ 0075) must be “E” for Form 

4868 with Electronic Funds Withdrawal), “F” for Form 9465, “G” for Form 2350, “H” for 

Form 56, and “I” for Form 4868 when with Electronic Funds Withdrawal when the 

Practitioner PIN method is used. 

0327 o The Preparer Name (SEQ 0350 for Form 2350 must match with Signature of Preparer 

Other Than Taxpayer SEQ 0100)of Authentication Record. 

0328 o The Fiduciary Name (SEQ 0610) for Form 56 must match with Fiduciary Name 

(SEQ 0120) of Authentication Record. 

0329 o No Form 4868 on file at the IRS or the tax return (Form 1040/A/EZ) has already been 

filed.
0395 o 

o

o

o

The Primary SSN of Form PMT (SEQ 0010) must be same as the Primary SSN of Form 

4868 (SEQ 0090) and Form 2350 (SEQ 0030). 

If the Secondary SSN of Form PMT is present, it must be same as the Spouse SSN of 

Form 4868 (SEQ 0100) and Form 2350 (SEQ 0060). 

The Taxpayer’s SSN of Form PMT (SEQ 0010) must be same as the Primary SSN of 

Form 2350 (SEQ 0030). 

If the Secondary SSN of Form PMT is present, it must be same as the Spouse SSN of 

Form 2350 (SEQ 0060). 

0396 o 

o

o

o

The Form 9465 Routing Transit Number (RTN)(SEQ 0330), or the Form 4868 Form 

Payment Routing Transit Number (SEQ 0030) must contain nine numeric characters. 

The first two positions must be 01 through 12, or 21 through 32; The RTN must be 

present on the Financial Organization Master File (FOMF); and the banking institution 

must Process Electronic Funds Transfer (EFT). 

The Bank Account Number for Form 9465 (SEQ 0340) or Form Payment (SEQ 0040) 

must be alphanumeric (i.e., only alpha characters, numeric characters, and hyphens), 

must be left-justified with trailing blanks if less than 17 positions, and cannot equal all 

zeros. 

Form 9465 if the Routing Transit Number (SEQ 0330) or Bank Account Number 

(SEQ 0340) is significant the Electronic Funds Withdrawal must be from the Checking 

Account. 

The Type of Account for Forms 4868 and 2350 Form Payment, Payment (SEQ 0050) 

must contain “1” or “2”. 

0397 o 

o

o

The Requested Payment Date for Form Payment (SEQ 0080) must be present and 

cannot be later than April 17, 2006, when a domestic payment is present. 

The Requested Payment Date for Form Payment (SEQ 0080) must be present and 

cannot be later than June 15, 2006, when a foreign payment is present. 

The Requested Payment Date for Form Payment (SEQ 0080) must be a valid date format 

(YYYYMMDD).

0490 o When Electronic Postmark is present, Year of Electronic Post-mark Date (SEQ 0260) 

must equal the current processing year. 

0491 o When Electronic Postmark is present, the following three fields must be present: 

Electronic Postmark Date (SEQ 0260), Electronic Postmark Time (SEQ 0270), Electronic 

Postmark Time Zone (SEQ 0280). (For Authorized Electronic Postmark Transmitters 

only).

0668 o Self-Select PIN Program – Taxpayer is ineligible to participate in the Self-select PIN 

Program since the Primary Taxpayer is a duplicate on the IRS File. 

0669 o Self-Select PIN Program – The Secondary Taxpayer is ineligible to participate in Selfselect PIN Program since the Secondary Taxpayer is a duplicate on the IRS File. 
0670 o 

o

When the PIN Type Code (SEQ 0008) of Authentication Record is “S”, and there is no 

Electronic Funds Withdrawal, the Primary Date of Birth (SEQ 0010), Primary Taxpayer 

Signature (SEQ 0035), Signature Date (SEQ 0070) and Jurat/Disclosure Code (SEQ 

0075) must be present. 

When the PIN Type Code (SEQ 0008) of the Authentication Record is "S" and an 

Electronic Funds Withdrawal is present the Primary Date of Birth (SEQ 0010), Primary 

Prior Year Adjusted Gross Income (SEQ 0020), Primary Taxpayer Signature (SEQ 0035), 

Signature Date (SEQ 0070), Jurat/Disclosure Code (SEQ 0075) and PIN Authorization 

Code (SEQ 0080) must be present on the Authentication Record. 

0671 o 

o

When the PIN Type Code (SEQ 0008) of Authentication Record is “S” and Spouse PIN 

Number is present (SEQ 0340 for Form 2350, SEQ 0290 for SEQ 0400 for Form 9465), 

then Spouse’s Date of Birth (SEQ 0040), Spouse’s Prior Year AGI (SEQ 0050), and 

Spouse’s Signature (SEQ 0065) must be present. 

When the PIN Type Code (SEQ 0008) of the Authentication Record is "S" and the 

Spouse’s SSN is present on the Form and an Electronic Funds Withdrawal is present, the 

Spouse Date of Birth (SEQ 0040), Spouse Prior Year Adjusted Gross Income 

(SEQ 0050), Spouse Signature (SEQ 0065), Signature Date (SEQ 0070), Jurat/Disclosure 

Code (SEQ 0075) and PIN Authorization Code (SEQ 0080) must be present on the 

Authentication Record. 

0674 o When the PIN Type Code (SEQ 0008) of Authentication Record is “P”, “S” or “O”, then, 

Taxpayer PIN Number (SEQ 0330 for Form 2350, and SEQ 0380 for Form 9465) must be 

(numeric and greater than zeroes) and must equal to Primary Taxpayer Signature 

(SEQ 0035) of Authentication Record. 

0675 o When the PIN Type Code (SEQ 0008) of Authentication Record is “P”,“S” or “O”, and 

Spouse PIN Number is present (SEQ 0340 for Form 2350, and SEQ 0400 for Form 9465) 

it must match and the Spouse PIN Number must be (numeric and greater than zeroes) 

and must equal to Spouse Signature (SEQ 0065) of Authentication Record. 

0677 o The Primary Taxpayer is ineligible to participate in the Self-Select PIN program if under 

the age of sixteen and have not filed previously. 

0678 o The Secondary Taxpayer is ineligible to participate in the Self-Select PIN program if under 

the age of sixteen and has not filed in the prior year. 

0679 o When the PIN Type Code (SEQ 0008) of Authentication Record is “S” or “O”, then, 

Primary Prior Year AGI (SEQ 0020) of Authentication record must match with IRS Master 

File.

0680 o When the PIN Type Code (SEQ 0008) of Authentication Record is “S” or “O”, then, 

Spouse Prior Year AGI (SEQ 0050) of Authentication record must match with IRS Master 

File.
0681 o 

o

When the PIN Type Code (SEQ 0008) of Authentication Record is “O”, then, Primary Date 

of Birth (SEQ 0010), Primary Prior Year AGI (SEQ 0020), Primary Taxpayer Signature 

(SEQ 0035), Signature Date (SEQ 0070) and Jurat/Disclosure Code (SEQ 0075) must be 

present. 

When the PIN Type Code (SEQ 0008) of the Authentication Record is "O" and an 

Electronic Funds Withdrawal is present, the Primary Date of Birth (SEQ 0010), Primary 

Prior Year Adjusted Gross Income (SEQ 0020), Primary Taxpayer Signature (SEQ 0035), 

Signature Date (SEQ 0070), Jurat/Disclosure Code (SEQ 0075), and PIN Authorization Code 

(SEQ 0080) must be present on the Authentication Record. 

0682 o 

o

When the PIN Type Code (SEQ 0008) of Authentication Record is “O” and Spouse PIN 

Number is present (SEQ 0340 for Form 2350, and SEQ 0400 for Form 9465), then, 

Spouse Date of Birth (SEQ 0040), Spouse Prior Year AGI (SEQ 0050), and Spouse 

Signature (SEQ 0065) must be present. 

When the PIN Type Code of the Authentication Record is "O" and a Spouse SSN is present 

on the Form, and an Electronic Funds Withdrawal is present, the Spouse Date of Birth 

(SEQ 0040), Spouse Prior Year Adjusted Gross Income (SEQ 0050), Spouse Signature 

(SEQ 0065), Signature Date (SEQ 0070), Jurat/Disclosure Code (SEQ 0075), and PIN 

Authorization Code (SEQ 0080) must be present on the Authentication Record. 

0697 o 

o

When the PIN Type Code (SEQ 0008) of Authentication Record is “P”, then, Primary 

Taxpayer Signature (SEQ 0035), Signature Date (SEQ 0070) and Jurat/Disclosure Code 

(SEQ 0075) must be present. 

For Form 4868 - When the PIN Type Code (SEQ 0008) of the Authentication Record is "P" 

and an Electronic Funds 

Withdrawal is present, the Primary Taxpayer Signature (SEQ 0035), Signature Date 

(SEQ 0070), Jurat/Disclosure Code (SEQ 0075), PIN Authorization Code (SEQ 0080) and 

ERO EFIN/PIN (SEQ 0090) must be present on the Authentication Record. 

0698 o 

o

o

When the PIN Type Code (SEQ 0008) of Authentication Record is “P” and Spouse PIN 

Number (SEQ 0340 for Form 2350, and SEQ 0400 for Form 9465) is present, then, 

Spouse Signature (SEQ 0065)must be present. 

For Form 4868 - When the PIN Type Code (SEQ 0008) of Authentication Record is “P”, 

then, Primary Taxpayer Signature (SEQ 0035), Signature Date (SEQ 0070) and 

Jurat/Disclosure Code (SEQ 0075) must be present. 

For Form 4868 - When the PIN Type Code (SEQ 0008) of the Authentication Record is "P" 

and an Electronic Funds Withdrawal is present, the Primary Taxpayer Signature (SEQ 0035), 

Signature Date (SEQ 0070), Jurat/Disclosure Code (SEQ 0075), PIN Authorization Code 

(SEQ 0080) and ERO EFIN/PIN (SEQ 0090) must be present on the Authentication Record. 

 o For Form 4868 - When the PIN Type Code (SEQ 0008) of the Authentication Record is 

"P" and Spouse SSN (SEQ 0010) is present on the Form, and an Electronic Funds 

Withdrawal is present, then Spouse Signature (SEQ 0065), Signature Date (SEQ 0070), 

Jurat/Disclosure Code (SEQ 0075), PIN Authorization Code (SEQ 0080) and ERO 

EFIN/PIN (SEQ 0090) must be present on the Authentication Record. 

0699 o When the PIN TYPE CODE (SEQ 0008) of the Authentication Record is "P", then the 

Primary Prior Year Adjusted Gross Income (SEQ 0020), and Spouse Prior Year Adjusted 

Gross Income (SEQ 0050) must be blank on the Authentication Record. 
0806 o Processing Site must equal a valid Electronic Filing Site (SEQ 0040): Andover = “C”, 

Austin = “E”, Kansas = “F”, Philadelphia = “G”, Fresno = “H”. 

0822 o The Transmission Sequence Number of the TRANA cannot match a previously accepted 

transmission. 

0823 o If there is any unrecognizable or inconsistent control data, the transmission will be 

rejected. 

NOTE: DO NOT INCLUDE FORM PAYMENT IN YOUR COUNT.

0824 o TRANA Record A(TRANA) – Transmitter EFIN must be (SEQ 0110) Present. 

0825 o TRANA Record A (TRANA) – Transmission Type (SEQ 0170) must Equal “D” (ETD), or 

“N” (On-line). 

0840 o The ETIN and Transmitter's Use Code (Field 0040), Julian day (Field 0050), and 

Transmission Sequence Number (Field 0060) of the RECAP Record must agree with the 

corresponding fields of the TRANA record (Fields 0060-0080). 

0900 o The Primary SSN must not duplicate the Primary SSN of any previously accepted 

electronic transmitted Form 4868 for the current tax year. 

0999 o If more than 96 reject conditions are identified, the last Reject Code will be "0999". 
Appendix
Form Field Exhibit Index TY 2005 

Form or 

Schedule Page Number 

Form or 

Schedule Page Number 

Form 1040 B-1 Form 3800 B-60 

 Schedule A&B B-3 Form 3903 B-62 

 Schedule C B-5 Form 4136 B-63 

 Schedule C-EZ B-7 Form 4137 B-65 

 Schedule D B-8 Form 4255 B-66 

 Schedule E B-10 Form 4562 B-67 

 Schedule EIC B-12 Form 4563 B-69 

 Schedule F B-13 Form 4684 B-70 

 Schedule H B-15 Form 4797 B-72 

 Schedule J B-17 Form 4835 B-74 

 Schedule R B-18 Form 4952 B-75 

 Schedule SE B-20 Form 4970 B-76 

Form 1040A B-22 Form 4972 B-77 

 Schedule 1 B-24 Form 5074 B-78 

 Schedule 2 B-25 Form 5329 B-79 

 Schedule 3 B-27 Form 5471 B-81 

Form 1040EZ B-29 Schedule J B-85 

Form 1099-R B-30 Schedule M B-86 

Form W-2 B-31 Schedule O B-87 

Form W-2G B-32 Form 5713 B-89 

Form W-2GU B-33 Schedule A B-93 

FEC Template B-34 Schedule B B-94 

Form 970 B-35 Schedule C B-95 

Form 982 B-37 Form 5884 B-97 

Form 1116 B-38 Form 5884-A B-98 

Form 1310 B-40 Form 6198 B-99 

Form 2106 B-41 Form 6251 B-100 

Form 2106-EZ B-43 Form 6252 B-102 

Form 2120 B-44 Form 6478 B-103 

Form 2210 B-45 Form 6765 B-104 

Form 2210F B-49 Form 6781 B-106 

Form 2439 B-50 Form 8082 B-107 

Form 2441 B-51 Form 8271 B-109 

Form 2555 B-53 Form 8275 B-110 

Form 2555EZ B-56 Form 8275-R B-112 

Form 3468 B-58 Form 8283 B-114 

A-1
Form Field Exhibit Index TY 2005 (Cont.) 

Form or 

Schedule Page Number 

Form or 

Schedule Page Number 

Form 8379 B-116 Form 8862 B-167

Form 8396 B-117 Form 8863 B-168

Form 8582 B-118 Form 8864 B-169

Form 8582-CR B-121 Form 8865 B-170

Form 8586 B-123 Schedule K-1 B-177

Form 8594 B-124 Schedule O B-178

Form 8606 B-126 Schedule P B-179

Form 8609-A B-128 Form 8866 B-180

Form 8611 B-129 Form 8873 B-181

Form 8615 B-130 Form 8874 B-183

Form 8621 B-131 Form 8880 B-184

Form 8689 B-133 Form 8881 B-185

Form 8697 B-134 Form 8882 B-186

Form 8801 B-136 Form 8885 B-187

Form 8812 B-138 Form 8886 B-188

Form 8814 B-139 Form 8889 B-190

Form 8815 B-140 Form 8891 B-191

Form 8820 B-141 Form 8896 B-192 

Form 8824 B-142 Form 8901 B-193 

Form 8826 B-144 Form 8903 B-194 

Form 8828 B-145 Form 8914 B-195

Form 8829 B-146 Form 8915 B-196

Form 8830 B-147 Form T B-198

Form 8833 B-148

Form 8834 B-149

Form 8835 B-150

Authentication 

Record B-202

Form 8839 B-152

Form 8844 B-154

Allocation 

Record B-203

Form 8845 B-155

Form 8846 B-156

Form Payment 

Record B-205

Form 8847 B-157 Form 9465 B-206 

Form 8853 B-158

Form 8854 B-160 Form 56 B-207

Form 8859 B-164 Form 2350 B-209

Form 8860 B-165 Form 4868 B-210

Form 8861 B-166

A-2
Department of the Treasury—Internal Revenue Service 1040 U.S. Individual Income Tax Return

For the year Jan. 1–Dec. 31, 2005, or other tax year beginning , 2005, ending , 20 OMB No. 1545-0074

Your first name and initial Last name Your social security number

(See

instructions

on page 16.)

L

A

B

E

L

H

E

R

E

If a joint return, spouse’s first name and initial Last name Spouse’s social security number

Use the IRS

label.

Otherwise,

please print

or type.

Home address (number and street). If you have a P.O. box, see page 16. Apt. no.

City, town or post office, state, and ZIP code. If you have a foreign address, see page 16.

Presidential

Election Campaign 

1 Single

Filing Status 2 Married filing jointly (even if only one had income)

Check only

one box.

3

Qualifying widow(er) with dependent child (see page 17)

6a Yourself. If someone can claim you as a dependent, do not check box 6a

Exemptions b Spouse

(4) if qualifying

child for child tax

credit (see page 19)

c Dependents: (2) Dependent’s

social security number

(3) Dependent’s

relationship to (1) First name Last name you

If more than four

dependents, see

page 19.

d Total number of exemptions claimed

7 Wages, salaries, tips, etc. Attach Form(s) W-2 7

Income 8a Taxable interest. Attach Schedule B if required 8a

b Tax-exempt interest. Do not include on line 8a 8b Attach Form(s)

W-2 here. Also

attach Forms

W-2G and

1099-R if tax

was withheld.

9a Ordinary dividends. Attach Schedule B if required 9a

10 Taxable refunds, credits, or offsets of state and local income taxes (see page 23) 10

11 Alimony received 11

12 Business income or (loss). Attach Schedule C or C-EZ 12

Enclose, but do

not attach, any

payment. Also,

please use

Form 1040-V.

13 Capital gain or (loss). Attach Schedule D if required. If not required, check here  13

14 Other gains or (losses). Attach Form 4797 14

15a IRA distributions 15a 15b b Taxable amount (see page 25)

16a Pensions and annuities 16a b Taxable amount (see page 25) 16b

17 Rental real estate, royalties, partnerships, S corporations, trusts, etc. Attach Schedule E 17

18 Farm income or (loss). Attach Schedule F 18

19 Unemployment compensation 19

20a Social security benefits 20a b Taxable amount (see page 27) 20b

21 21

22 Add the amounts in the far right column for lines 7 through 21. This is your total income  22

25

IRA deduction (see page 31)

23

27

33

One-half of self-employment tax. Attach Schedule SE

Self-employed health insurance deduction (see page 30) 29

34

30

26

Self-employed SEP, SIMPLE, and qualified plans

31a

27

Penalty on early withdrawal of savings

32

29

Alimony paid b Recipient’s SSN 

Add lines 23 through 31a and 32 through 35 36

28

Subtract line 36 from line 22. This is your adjusted gross income 

30

Adjusted

Gross

Income

37

If you did not

get a W-2,

see page 22. Form

Married filing separately. Enter spouse’s SSN above

and full name here. 

Cat. No. 11320B



Label

Form 1040 (2005)

IRS Use Only—Do not write or staple in this space.

Head of household (with qualifying person). (See page 17.) If

the qualifying person is a child but not your dependent, enter

this child’s name here. 

Other income. List type and amount (see page 29)

Moving expenses. Attach Form 3903

32

26

For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see page 78.

Boxes checked

on 6a and 6b

No. of children

on 6c who:

Dependents on 6c

not entered above

Add numbers on

lines above 

● lived with you

● did not live with

you due to divorce

or separation

(see page 20)

31a

34

Student loan interest deduction (see page 33) 33

36

Checking a box below will not

change your tax or refund.

Check here if you, or your spouse if filing jointly, want $3 to go to this fund (see page 16)  You Spouse

(99)

Tuition and fees deduction (see page 34)

37

4

5

Educator expenses (see page 29) 23

b Qualified dividends (see page 23) 9b

24 Certain business expenses of reservists, performing artists, and

fee-basis government officials. Attach Form 2106 or 2106-EZ 24

25 Health savings account deduction. Attach Form 8889

28

2005

35 Domestic production activities deduction. Attach Form 8903 35

You must enter

your SSN(s) above.

010 020

030 040

060

070

062 080

055

064 066 083 087 095 097

100

110 120

130

@135 "STMbnn"

150 153

640

380

385 390 "F8814"

420

430

440

447 450

460 "F4684" 470

475 477 "ROLLOVER" 480

485 487 "ROLLOVER" 495

510

520

545 "REPAID" 551 552

555 "D", "LSE" 553 557

*560 +570 / *574 +577 590

600

635

637

670

680

705

700

*693 "STM nn"

702

*720 +730 732 733 735 740

750

B-1

624

160

163

167

240

247

350

355

*170 +171 +172 +175 +177 +178

180 181 182 185 187 188

190 191 192 195 197 198

200 201 202 205 207 208

@479 "STM nn"

050

623

650

+695 697

164 165

392 "F8814"

710

098

357 358 362 364 366 367 368 369 370 371 372 373 @374 "STM nn" 375 378 379

391 394

396

140
Married filing

jointly or

Qualifying

widow(er),

$10,000

Head of

household,

$7,300

Itemized deductions (from Schedule A) or your standard deduction (see left margin)

Add lines 64, 65, 66a, and 67 through 70. These are your total payments 

Form 1040 (2005) Page 2

38 Amount from line 37 (adjusted gross income) 38

Check

if:

39a

Tax and

Credits

39a

Single or

Married filing

separately,

$5,000

b If your spouse itemizes on a separate return or you were a dual-status alien, see page 35 and check here 39b

40 40

41 Subtract line 40 from line 38 41

42

If line 38 is over $109,475, or you provided housing to a person displaced by Hurricane Katrina,

see page 37. Otherwise, multiply $3,200 by the total number of exemptions claimed on line 6d

42

43 Taxable income. Subtract line 42 from line 41. If line 42 is more than line 41, enter -0- 43

44 44

49

53

Education credits. Attach Form 8863

48

Other credits. Check applicable box(es):

47

56

57

Add lines 47 through 55. These are your total credits

Subtract line 56 from line 46. If line 56 is more than line 46, enter -0- 

56

Self-employment tax. Attach Schedule SE

57

Other

Taxes

58

72

Social security and Medicare tax on tip income not reported to employer. Attach Form 4137

Additional tax on IRAs, other qualified retirement plans, etc. Attach Form 5329 if required 60

59

61

Add lines 57 through 62. This is your total tax 

62 62

64 Federal income tax withheld from Forms W-2 and 1099 64

65 2005 estimated tax payments and amount applied from 2004 return 65 Payments

66a

Amount paid with request for extension to file (see page 59) 69

68

Excess social security and tier 1 RRTA tax withheld (see page 59) 67

69

71

70 Payments from:

73a 73a

74 74

If line 71 is more than line 63, subtract line 63 from line 71. This is the amount you overpaid

75 75

Amount of line 72 you want refunded to you 

Refund

76

Amount of line 72 you want applied to your 2006 estimated tax 

Estimated tax penalty (see page 60)

Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to the best of my knowledge and

belief, they are true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.

76

You were born before January 2, 1941, Blind.

Spouse was born before January 2, 1941, Blind.

a Form 3800

b Form 8801 c Form

a Form 2439 b Form 4136

60

Household employment taxes. Attach Schedule H

61

70

Amount

You Owe

Sign

Here Your signature Date

Keep a copy

for your

records.

Spouse’s signature. If a joint return, both must sign. Date

Date Preparer’s SSN or PTIN Preparer’s

signature Check if

self-employed

Paid

Preparer’s

Use Only Firm’s name (or

yours if self-employed),

address, and ZIP code

EIN

Phone no.







Your occupation

Tax (see page 37). Check if any tax is from:

Amount you owe. Subtract line 71 from line 63. For details on how to pay, see page 60 

b

Direct deposit?

See page 59

and fill in 73b,

73c, and 73d.

Routing number

Account number

c Checking Savings

a Form(s) 8814 Form 4972

b

d





71

54

Retirement savings contributions credit. Attach Form 8880

58

59

Advance earned income credit payments from Form(s) W-2

72



Child tax credit (see page 41). Attach Form 8901 if required

Credits from:

52

Additional child tax credit. Attach Form 8812

67

68

Standard

Deduction

for—

Joint return?

See page 17.

Daytime phone number

( )

Earned income credit (EIC)

Credit for the elderly or the disabled. Attach Schedule R

45

46

Alternative minimum tax (see page 39). Attach Form 6251

Add lines 44 and 45 

Credit for child and dependent care expenses. Attach Form 2441

50

If you have a

qualifying

child, attach

Schedule EIC.

45

46

66a

Spouse’s occupation

( )

Form 1040 (2005)

● People who

checked any

box on line

39a or 39b or

who can be

claimed as a

dependent,

see page 36.

● All others:

Designee’s

name 

Do you want to allow another person to discuss this return with the IRS (see page 61)? Third Party

Designee Phone

no.  ( )

Yes. Complete the following. No

Personal identification

number (PIN) 

55

Foreign tax credit. Attach Form 1116 if required

55

a Form 8396 b Form 8859

51

Adoption credit. Attach Form 8839

63 63

Type:

c Form 8885

Total boxes  checked 

51

49

53

48

47

54

52

50

b Nontaxable combat pay election  66b

770

772 774

776 778 783

786

787 "SECT 933" 789

800

810

820

853 857 880 890 "ECR" 900 

918

920

922

925

930

935

937

960

990

1005 1006 1010 1015

1020

1030

1040

1070 "RRTA"

1095 "NO" 1100

1105

1107 *1110 +1112 1114

1124 1126 1128 1129

1161 1162 "DIV" 1170 @1173 "STM nn"

1178 1183 "CLERGY" or "NO"

1188

1192

1197

1131 1132 1134 1136

1202 1208 1210

1250

1260

1270

1272

1274 1276

1278

1280 1290

1309

1321 1323

1324 1325 1326 1327

1328 1329

1338 "IRS-PREPARED" 

"IRS-REVIEWED" 1340

1350

1360

1370 1380

1390 1400 1410 1420

B-2

1245 "FORM 8689" 1246

1303 1305

1307 1313

940

1000

1205

@1016 "STMbnn"

1150 "Formb1099"

985 995

1035

1080

1118 1119 1121 1122 1123

1136 1137 1139 1141 1145 1150

1160

1180

1185

1276
SCHEDULES A&B OMB No. 1545-0074 Schedule A—Itemized Deductions

(Form 1040) (Schedule B is on back)

Department of the Treasury

Internal Revenue Service  Attach to Form 1040.

Attachment

Sequence No. 07

Name(s) shown on Form 1040 Your social security number

Medical Caution. Do not include expenses reimbursed or paid by others.

and

Dental

Expenses

1 Medical and dental expenses (see page A-2) 1

2 2

3 Multiply line 2 by 7.5% (.075) 3

4 Subtract line 3 from line 1. If line 3 is more than line 1, enter -0- 4

5

Taxes You 5 State and local (check only one box):

Paid

6 Real estate taxes (see page A-5) 6

8 Other taxes. List type and amount 

(See

page A-2.)

8

9 Add lines 5 through 8 9

Interest 10 Home mortgage interest and points reported to you on Form 1098

You Paid

10

Home mortgage interest not reported to you on Form 1098. If paid

to the person from whom you bought the home, see page A-6

and show that person’s name, identifying no., and address 

11

(See

page A-5.)

11

12

Points not reported to you on Form 1098. See page A-6

for special rules

12

13 Investment interest. Attach Form 4952 if required. (See

page A-6.) 13

14 Add lines 10 through 13 14

Gifts to 

Charity 15a

15a Total gifts by cash or check. If you made any gift of $250

or more, see page A-7

16

Other than by cash or check. If any gift of $250 or more,

see page A-7. You must attach Form 8283 if over $500

16

17 Carryover from prior year 17

18 Add lines 15a, 16, and 17 18

19 Casualty or theft loss(es). Attach Form 4684. (See page A-8.)

Casualty and 

Theft Losses 19

Unreimbursed employee expenses—job travel, union

dues, job education, etc. Attach Form 2106 or 2106-EZ

if required. (See page A-8.) 

Job Expenses 20

and Certain

Miscellaneous

Deductions

22 Other expenses—investment, safe deposit box, etc. List

type and amount 

(See

page A-8.)

23 Add lines 20 through 22

24 Enter amount from Form 1040, line 38

25 Multiply line 24 by 2% (.02)

26 Subtract line 25 from line 23. If line 25 is more than line 23, enter -0- 26

Other 27 Other—from list on page A-9. List type and amount  

Miscellaneous

Deductions 27

Total 28

Itemized

Deductions 28

For Paperwork Reduction Act Notice, see Form 1040 instructions. Schedule A (Form 1040) 2005

24

20

22

23

If you made a

gift and got a

benefit for it,

see page A-7.

25

Enter amount from Form 1040, line 38

No. Your deduction is not limited. Add the amounts in the far right column

for lines 4 through 27. Also, enter this amount on Form 1040, line 40.

Yes. Your deduction may be limited. See page A-9 for the amount to enter.

Cat. No. 11330X



Note.

Personal

interest is

not

deductible.



7 Personal property taxes 7

21 Tax preparation fees 21

Is Form 1040, line 38, over $145,950 (over $72,975 if married filing separately)?

(99)  See Instructions for Schedules A&B (Form 1040).

a Income taxes, or

b General sales taxes (see page A-3) 

2005

29 If you elect to itemize deductions even though they are less than your standard deduction, check here 

b Gifts by cash or check after August

27, 2005, that you elect to treat as

qualified contributions (see page A-7) 15b

015

065

070

080

090

100

110

*130 "STM nn" +135 140

150

@159 "STM nn" 160

@165 "STM nn"

*170 "STM nn"

+180 +190

195

203

207

290

350

360

370

380

390

*400 "STM nn" +405

410

415

*420 "STM nn" +430

432 434 435

445

450

455

465

*475 "STM nn" +485

495

520

B-3

092

094

355

530
Schedules A&B (Form 1040) 2005 OMB No. 1545-0074 Page 2

Name(s) shown on Form 1040. Do not enter name and social security number if shown on other side. Your social security number

Attachment Schedule B—Interest and Ordinary Dividends Sequence No. 08

Part I

Interest

(See page B-1

and the

instructions for

Form 1040,

line 8a.)

Amount List name of payer. If any interest is from a seller-financed mortgage and the

buyer used the property as a personal residence, see page B-1 and list this

interest first. Also, show that buyer’s social security number and address 

1

Note. If you

received a Form

1099-INT, Form

1099-OID, or

substitute

statement from

a brokerage firm,

list the firm’s

name as the

payer and enter

the total interest

shown on that

form.

1

2 Add the amounts on line 1 2

3

Excludable interest on series EE and I U.S. savings bonds issued after 1989.

Attach Form 8815

3

4 Subtract line 3 from line 2. Enter the result here and on Form 1040, line 8a  4

Part II

Ordinary

Dividends

Amount

(See page B-1

and the

instructions for

Form 1040,

line 9a.)

5 List name of payer 

Note. If you

received a Form

1099-DIV or

substitute

statement from

a brokerage firm,

list the firm’s

name as the

payer and enter

the ordinary

dividends shown

on that form.

5

6 Add the amounts on line 5. Enter the total here and on Form 1040, line 9a  6

For Paperwork Reduction Act Notice, see Form 1040 instructions. Schedule B (Form 1040) 2005

Note. If line 4 is over $1,500, you must complete Part III.

Note. If line 6 is over $1,500, you must complete Part III.

You must complete this part if you (a) had over $1,500 of taxable interest or ordinary dividends; or (b) had

Part III a foreign account; or (c) received a distribution from, or were a grantor of, or a transferor to, a foreign trust.

Foreign

Accounts

and Trusts

Yes No

At any time during 2005, did you have an interest in or a signature or other authority over a financial

account in a foreign country, such as a bank account, securities account, or other financial account?

See page B-2 for exceptions and filing requirements for Form TD F 90-22.1

7a

b If “Yes,” enter the name of the foreign country  

(See

page B-2.) During 2005, did you receive a distribution from, or were you the grantor of, or transferor to, a

foreign trust? If “Yes,” you may have to file Form 3520. See page B-2

8

*010 "STM nn" +011 +012 +015 025

*030 "STM nn" +040

050 060

070 080

090 100

110 120

130 140

160 "INTEREST SUBTOTAL" 220

230 "NOMINEE DISTIBUTION" 240

250 "ACCRUED INTEREST" 260

270 "TAX-EXEMPT INTEREST" 280

281 "OID ADJUSTMENT" 282

283 "ABP ADJUSTMENT" 284

288

289

290

*300 "STM nn" +310

320 330

340 350

360 370

380 390

400 410

420 430

440 450

460 470

480 490

495 "DIVIDEND SUBTOTAL" 499

510 "NOMINEE DISTRIBUTION" 520

525

587 "FORM 8814"

590 595

600

608 "FORM 8814" 610 615

B-4
SCHEDULE C OMB No. 1545-0074

(Form 1040)

Profit or Loss From Business

(Sole Proprietorship)

 Partnerships, joint ventures, etc., must file Form 1065 or 1065-B.

Department of the Treasury

Internal Revenue Service

Attachment

 Attach to Form 1040 or 1041.  See Instructions for Schedule C (Form 1040). Sequence No. 09

Name of proprietor Social security number (SSN)

A Principal business or profession, including product or service (see page C-2 of the instructions) B Enter code from pages C-8, 9, & 10



C Business name. If no separate business name, leave blank. D Employer ID number (EIN), if any

Accounting method:

E

F

G Yes No

H

Did you “materially participate” in the operation of this business during 2005? If “No,” see page C-3 for limit on losses

If you started or acquired this business during 2005, check here 

Income

Gross receipts or sales. Caution. If this income was reported to you on Form W-2 and the “Statutory

employee” box on that form was checked, see page C-3 and check here 

1

1

2 Returns and allowances 2

3 Subtract line 2 from line 1 3

4 Cost of goods sold (from line 42 on page 2) 4

5 Gross profit. Subtract line 4 from line 3 5

6 Other income, including Federal and state gasoline or fuel tax credit or refund (see page C-3) 6

7 Gross income. Add lines 5 and 6  7

Expenses. Enter expenses for business use of your home only on line 30.

8

21 Repairs and maintenance 21

8 Advertising

22 Supplies (not included in Part III) 22

23

9

23 Taxes and licenses

10

24 Travel, meals, and entertainment:

Car and truck expenses (see

page C-3)

9

24a

11

a Travel

10 Commissions and fees

12 Depletion 12

Deductible meals and

entertainment (see page C-5)

b

Depreciation and section 179

expense deduction (not

included in Part III) (see

page C-4)

13

13

14 Employee benefit programs

(other than on line 19) 14

15 Insurance (other than health) 15 25 Utilities 25

16 Interest: 26 Wages (less employment credits) 26

a Mortgage (paid to banks, etc.) 16a Other expenses (from line 48 on

page 2)

27

b Other 16b

17

Legal and professional

services

18 Office expense 18

19 Pension and profit-sharing plans 19

20 Rent or lease (see page C-5):

a Vehicles, machinery, and equipment 20a

b Other business property 20b

28 Total expenses before expenses for business use of home. Add lines 8 through 27 in columns  28

31

31

32a All investment is at risk.

32

Some investment is not

at risk.

32b

For Paperwork Reduction Act Notice, see page C-7 of the instructions. Schedule C (Form 1040) 2005

(1) Cash (2) Accrual (3) Other (specify) 

Business address (including suite or room no.) 

City, town or post office, state, and ZIP code

Cat. No. 11334P

29

30

Tentative profit (loss). Subtract line 28 from line 7

Expenses for business use of your home. Attach Form 8829

29

30



Part I

Part II

27

Net profit or (loss). Subtract line 30 from line 29.

● If a profit, enter on Form 1040, line 12, and also on Schedule SE, line 2 (statutory employees,

see page C-6). Estates and trusts, enter on Form 1041, line 3.

● If a loss, you must go to line 32.

If you have a loss, check the box that describes your investment in this activity (see page C-6).

● If you checked 32a, enter the loss on Form 1040, line 12, and also on Schedule SE, line 2

(statutory employees, see page C-6). Estates and trusts, enter on Form 1041, line 3.

● If you checked 32b, you must attach Form 6198. Your loss may be limited.



(99)

11 Contract labor (see page C-4)

2005

24b

17

010 015

020 030

040 060

061

062

063 064 066 *068 "STM nn"

177 183

195

198

200

210

220

230

240

260

270

280

293

297

303

307

317

327

@333 "STM nn"

337

@340 "STM nn" 343

353

357

363

365

367

373

377

383

387

393

407

450

605

700

702

703

705 "PAL"

710

720

730

B-5

300
Schedule C (Form 1040) 2005 Page 2

Cost of Goods Sold (see page C-6)

Inventory at beginning of year. If different from last year’s closing inventory, attach explanation 35

33

Purchases less cost of items withdrawn for personal use 36

34

Cost of labor. Do not include any amounts paid to yourself 37

35

Materials and supplies 38

36

Other costs 39

37

Add lines 35 through 39 40

38

Inventory at end of year 41

39

Cost of goods sold. Subtract line 41 from line 40. Enter the result here and on page 1, line 4

40

42

Part IV

Part III

Information on Your Vehicle. Complete this part only if you are claiming car or truck expenses on

line 9 and are not required to file Form 4562 for this business. See the instructions for line 13 on page

C-4 to find out if you must file Form 4562.

41

When did you place your vehicle in service for business purposes? (month, day, year)  .

42

Of the total number of miles you drove your vehicle during 2005, enter the number of miles you used your vehicle for:

a Business b Commuting (see instructions) c Other

45 Do you (or your spouse) have another vehicle available for personal use?

46 Was your vehicle available for personal use during off-duty hours?

47a Do you have evidence to support your deduction?

b If “Yes,” is the evidence written?

Yes No

Other Expenses. List below business expenses not included on lines 8–26 or line 30.

48 Total other expenses. Enter here and on page 1, line 27

/ /

Yes No

Yes No

Yes No

48

Part V

Printed on recycled paper

Method(s) used to

value closing inventory: Cost b Other (attach explanation)

Was there any change in determining quantities, costs, or valuations between opening and closing inventory? If

“Yes,” attach explanation

a Lower of cost or market c

Yes No

43

44

Schedule C (Form 1040) 2005

741 742 744 @746 "STM nn"

748

@751 "STM nn"

753

755

758

760

770

780

790

800

810

*820 YYYYMMDD or "STM nn"

+830 +840 +850

+860 +870

+880 +890

+900 +910

+920 +930

*940 "STM nn" +950

960 970

980 990

1000 1010

1020 1030

1040 1050

1060 1070

1080 1090

1100 1110

1140

B-6
SCHEDULE C-EZ OMB No. 1545-0074

(Form 1040)

Net Profit From Business

(Sole Proprietorship)

 Partnerships, joint ventures, etc., must file Form 1065 or 1065-B.

Department of the Treasury

Internal Revenue Service

Attachment

 Attach to Form 1040 or 1041.  See instructions on back. Sequence No. 09A

Business name. If no separate business name, leave blank. D Employer ID number (EIN), if any

Business address (including suite or room no.). Address not required if same as on Form 1040, page 1.

C

E

Gross receipts. Caution. If this income was reported to you on Form W-2 and the “Statutory

employee” box on that form was checked, see Statutory Employees in the instructions for

Schedule C, line 1, on page C-3 and check here  1

2 Total expenses (see instructions). If more than $5,000, you must use Schedule C 2

3

3 Net profit. Subtract line 2 from line 1. If less than zero, you must use Schedule C. Enter on

Form 1040, line 12, and also on Schedule SE, line 2. (Statutory employees do not report this

amount on Schedule SE, line 2. Estates and trusts, enter on Form 1041, line 3.)

For Paperwork Reduction Act Notice, see page 2. Cat. No. 14374D Schedule C-EZ (Form 1040) 2005

City, town or post office, state, and ZIP code

You May Use

Schedule C-EZ

Instead of

Schedule C

Only If You:

And You:

● Use the cash method of accounting.

● Had only one business as either a

sole proprietor or statutory

employee.

● Had business expenses of $5,000 or

less. ● Are not required to file Form 4562,

Depreciation and Amortization, for

this business. See the instructions

for Schedule C, line 13, on page

C-4 to find out if you must file.

● Do not deduct expenses for

business use of your home.

● Do not have prior year unallowed

passive activity losses from this

business.

 

Name of proprietor Social security number (SSN)

General Information

A Principal business or profession, including product or service B Enter code from pages C-8, 9, & 10



Figure Your Net Profit

Part I

Part II

● Did not have a net loss from your

business.

● Had no employees during the year.

1

● Did not have an inventory at any

time during the year.

6 Do you (or your spouse) have another vehicle available for personal use? Yes No

8a Do you have evidence to support your deduction? Yes No

If “Yes,” is the evidence written? Yes No

7 Was your vehicle available for personal use during off-duty hours? Yes No

5 Of the total number of miles you drove your vehicle during 2005, enter the number of miles you used your vehicle for:

4

Part III Information on Your Vehicle. Complete this part only if you are claiming car or truck expenses on line 2.

b

When did you place your vehicle in service for business purposes? (month, day, year)  . / /

2005

a Business b Commuting (see instructions) c Other

010 015

020 030

040 060

061

062

198

200

700

710

*820 MMDDYYYY or "STM nn"

+830 +840 +850

+860 +870

+880 +890

+900 +910

+920 +930

B-7
OMB No. 1545-0074 SCHEDULE D Capital Gains and Losses (Form 1040)  Attach to Form 1040.  See Instructions for Schedule D (Form 1040).

Department of the Treasury

Internal Revenue Service

Attachment

 Use Schedule D-1 to list additional transactions for lines 1 and 8. Sequence No. 12

Name(s) shown on Form 1040 Your social security number

Short-Term Capital Gains and Losses—Assets Held One Year or Less

(f) Gain or (loss)

Subtract (e) from (d)

(e) Cost or other basis

(see page D-6 of

the instructions)

(a) Description of property

(Example: 100 sh. XYZ Co.)

(d) Sales price

(see page D-6 of

the instructions)

(c) Date sold

(Mo., day, yr.)

1

Enter your short-term totals, if any, from Schedule D-1,

line 2

2

Total short-term sales price amounts. Add lines 1 and 2 in

column (d)

3

3

5

Short-term gain from Form 6252 and short-term gain or (loss) from Forms 4684, 6781, and 8824

5

6

6

Net short-term gain or (loss) from partnerships, S corporations, estates, and trusts from

Schedule(s) K-1

7

Short-term capital loss carryover. Enter the amount, if any, from line 8 of your Capital Loss

Carryover Worksheet on page D-6 of the instructions

Net short-term capital gain or (loss). Combine lines 1 through 6 in column (f)

Long-Term Capital Gains and Losses—Assets Held More Than One Year

8

Enter your long-term totals, if any, from Schedule D-1,

line 9

9

10 Total long-term sales price amounts. Add lines 8 and 9 in

column (d) 10

11

Gain from Form 4797, Part I; long-term gain from Forms 2439 and 6252; and long-term gain or

(loss) from Forms 4684, 6781, and 8824

11

12

12

13

Net long-term gain or (loss) from partnerships, S corporations, estates, and trusts from

Schedule(s) K-1

14

Capital gain distributions. See page D-1 of the instructions

14

15

Long-term capital loss carryover. Enter the amount, if any, from line 13 of your Capital Loss

Carryover Worksheet on page D-6 of the instructions ( )

Net long-term capital gain or (loss). Combine lines 8 through 14 in column (f). Then go to

Part III on the back 15

For Paperwork Reduction Act Notice, see Form 1040 instructions. Schedule D (Form 1040) 2005 Cat. No. 11338H

( )

4 4

Part I

Part II

13

(b) Date

acquired

(Mo., day, yr.)

2

9

(99)

(a) Description of property

(Example: 100 sh. XYZ Co.)

(c) Date sold

(Mo., day, yr.)

(b) Date

acquired

(Mo., day, yr.)

(e) Cost or other basis

(see page D-6 of

the instructions)

(d) Sales price

(see page D-6 of

the instructions)

7

(f) Gain or (loss)

Subtract (e) from (d)

2005

*020 "STCGL" +030

"VARIOUS

+040

"BANKRUP

+050

"EXPIRED"

+060

"EXPIRED"

+075

090 100 110 120 130 145

160 170 180 190 200 215

230 240 250 260 270 285

639 649

710

715

725

860

877

*880 "STM nn"

+890

"INHERIT"

"VARIOUS"

+900

"BANKRUP

+910

"EXPIRED"

+920

"EXPIRED" +935

950 960 970 980 990 1005

1020 1030 1040 1050 1060 1075

1090 1100 1110 1120 1130 1145

1701 1703

1715

1720

1731

1760 "FORM 8814"

1770 1775

1820

1835

B-8

300 310 320 330 340 350

1300 1320 1340 1360 1380 1400
Schedule D (Form 1040) 2005

Summary

Combine lines 7 and 15 and enter the result. If line 16 is a loss, skip lines 17 through 20, and

go to line 21. If a gain, enter the gain on Form 1040, line 13, and then go to line 17 below

16

16

18

Part III

Page 2

18 Enter the amount, if any, from line 7 of the 28% Rate Gain Worksheet on page D-7 of the

instructions 

Are lines 18 and 19 both zero or blank?

19

Schedule D (Form 1040) 2005

21

Enter the amount, if any, from line 18 of the Unrecaptured Section 1250 Gain Worksheet on

page D-8 of the instructions 

20

21 If line 16 is a loss, enter here and on Form 1040, line 13, the smaller of:

19

● The loss on line 16 or

● ($3,000), or if married filing separately, ($1,500) 

Yes. Complete Form 1040 through line 43, and then complete the Qualified Dividends and

Capital Gain Tax Worksheet on page 38 of the Instructions for Form 1040. Do not complete

lines 21 and 22 below.

No. Complete Form 1040 through line 43, and then complete the Schedule D Tax Worksheet

on page D-9 of the instructions. Do not complete lines 21 and 22 below.

22 Do you have qualified dividends on Form 1040, line 9b?

Yes. Complete Form 1040 through line 43, and then complete the Qualified Dividends and

Capital Gain Tax Worksheet on page 38 of the Instructions for Form 1040.

No. Complete the rest of Form 1040.

( )

17 Are lines 15 and 16 both gains?

Yes. Go to line 18.

No. Skip lines 18 through 21, and go to line 22.

Note. When figuring which amount is smaller, treat both amounts as positive numbers.

2420

2440

2460

2500

2520

2540

2560

2580

B-9

2400

2480
SCHEDULE E OMB No. 1545-0074 Supplemental Income and Loss

(Form 1040) (From rental real estate, royalties, partnerships,

S corporations, estates, trusts, REMICs, etc.)

 Attach to Form 1040 or Form 1041.  See Instructions for Schedule E (Form 1040). Department of the Treasury

Internal Revenue Service

Attachment

Sequence No. 13

Name(s) shown on return Your social security number

Income or Loss From Rental Real Estate and Royalties Note. If you are in the business of renting personal property, use

Schedule C or C-EZ (see page E-3). Report farm rental income or loss from Form 4835 on page 2, line 40.

1 List the type and location of each rental real estate property:

A

B

C

2 Yes No

A

B

C

Properties Totals

(Add columns A, B, and C.) Income: A B C

3 Rents received 3 3

4 Royalties received 4 4

Expenses:

5 Advertising 5

6 Auto and travel (see page E-4) 6

7 Cleaning and maintenance 7

8 Commissions 8

9 Insurance 9

10 Legal and other professional fees 10

11

Mortgage interest paid to banks,

etc. (see page E-4) 12

11

12

Other interest

12

13

Repairs

13

14

Supplies

14

15

Taxes

15

16

Utilities

16

17 17

18 Other (list) 

18

19 Add lines 5 through 18 19 19

Depreciation expense or depletion

(see page E-4)

20

20 20

21 Total expenses. Add lines 19 and 20 21

Income or (loss) from rental real

estate or royalty properties.

Subtract line 21 from line 3 (rents)

or line 4 (royalties). If the result is

a (loss), see page E-5 to find out

if you must file Form 6198

22

22

Deductible rental real estate loss.

Caution. Your rental real estate

loss on line 22 may be limited. See

page E-5 to find out if you must

file Form 8582. Real estate

professionals must complete line

43 on page 2

23

23 ( ) ( ) ) (

24 Income. Add positive amounts shown on line 22. Do not include any losses 24

25 ( ) 25 Losses. Add royalty losses from line 22 and rental real estate losses from line 23. Enter total losses here

26 Total rental real estate and royalty income or (loss). Combine lines 24 and 25. Enter the result here.

If Parts II, III, IV, and line 40 on page 2 do not apply to you, also enter this amount on Form 1040, 

line 17. Otherwise, include this amount in the total on line 41 on page 2 26

For Paperwork Reduction Act Notice, see page E-7 of the instructions. Cat. No. 11344L Schedule E (Form 1040) 2005

Part I

Management fees

(99)

For each rental real estate property

listed on line 1, did you or your family

use it during the tax year for personal

purposes for more than the greater of:

● 14 days or

● 10% of the total days rented at

fair rental value?

(See page E-3.)

2005

010

020

025

030

035

040

045 050

055 060

065 070

100 110 120 125

130 140 150 155

170 180 190

200 210 220

230 240 250

260 270 280

290 300 310

320 330 340

342 343 344

@345 "STM nn"

350 360 370 380

390 400 410

420 430 440

450 460 470

480 490 500

510 520 530

*570 "STM nn" +580 +590 +600

610 620 630 640

650 660 670 680

690 700 710 720

730 740 750 760

970 980 990 1000

1010 1020 1030 1040

1050 1060 1070

1080 1090 1100

1103 1105 1107

1110

1120

1130 "NPA"

1140

1150

B-10

@385 "STM nn"
Schedule E (Form 1040) 2005 Attachment Sequence No. 13 Page 2

Name(s) shown on return. Do not enter name and social security number if shown on other side. Your social security number

Income or Loss From Partnerships and S Corporations Note. If you report a loss from an at-risk activity for

which any amount is not at risk, you must check the box in column (e) on line 28 and attach Form 6198. See page E-1.

(b) Enter P for

partnership; S

for S corporation

(c) Check if

foreign

partnership

(d) Employer

identification

number

28 (a) Name

(e) Check if

any amount is

not at risk

A

B

C

D

Passive Income and Loss Nonpassive Income and Loss

(h) Nonpassive loss

from Schedule K–1

(g) Passive income 

from Schedule K–1

(j) Nonpassive income 

from Schedule K–1

(f) Passive loss allowed

(attach Form 8582 if required)

(i) Section 179 expense

deduction from Form 4562

A

B

C

D

29a Totals

b Totals

30 Add columns (g) and (j) of line 29a 30

31 ( ) 31 Add columns (f), (h), and (i) of line 29b

Total partnership and S corporation income or (loss). Combine lines 30 and 31. Enter the

result here and include in the total on line 41 below

32

32

Income or Loss From Estates and Trusts

(b) Employer

identification number 33 (a) Name

A

B

Passive Income and Loss Nonpassive Income and Loss

(e) Deduction or loss

from Schedule K–1

(d) Passive income

from Schedule K–1

(f) Other income from

Schedule K–1

(c) Passive deduction or loss allowed

(attach Form 8582 if required)

A

B

34a Totals

b Totals

35 Add columns (d) and (f) of line 34a 35

36 ( ) 36 Add columns (c) and (e) of line 34b

37 Total estate and trust income or (loss). Combine lines 35 and 36. Enter the result here and

include in the total on line 41 below 37

Income or Loss From Real Estate Mortgage Investment Conduits (REMICs)—Residual Holder

(c) Excess inclusion from

Schedules Q, line 2c

(see page E-6)

(e) Income from 

Schedules Q, line 3b

(d) Taxable income (net loss)

from Schedules Q, line 1b

(b) Employer

identification number 38 (a) Name

39 Combine columns (d) and (e) only. Enter the result here and include in the total on line 41 below 39

Summary

40 Net farm rental income or (loss) from Form 4835. Also, complete line 42 below 40

41 Total income or (loss). Combine lines 26, 32, 37, 39, and 40. Enter the result here and on Form 1040, line 17  41

Reconciliation of farming and fishing income. Enter your gross farming

and fishing income reported on Form 4835, line 7; Schedule K-1 (Form

1065), box 14, code B; Schedule K-1 (Form 1120S), box 17, code N; and

Schedule K-1 (Form 1041), line 14, code F (see page E-7)

42

42

Part III

Part V

Part IV

Part II

Reconciliation for real estate professionals. If you were a real estate

professional (see page E-1), enter the net income or (loss) you reported

anywhere on Form 1040 from all rental real estate activities in which

you materially participated under the passive activity loss rules

43

43

Schedule E (Form 1040) 2005

27 Are you reporting any loss not allowed in a prior year due to the at-risk or basis limitations, a prior year unallowed

loss from a passive activity (if that loss was not reported on Form 8582), or unreimbursed partnership expenses? Yes No

If you answered “Yes,” see page E-6 before completing this section.

Caution. The IRS compares amounts reported on your tax return with amounts shown on Schedule(s) K-1.

*1170 "STM nn" +1172 +1174 +1176 +1180

*+1186 "STM nn" +1188 +1192 +1194 +1196

1200 1210 1220 1230 1238

1243 1247 1253 1255 1257

1260 1270 1280 1290 1298

1303 1307 1313 1315 1317

1320 1330 1340 1350 1358

1363 1367 1373 1375 1377

1445 1455

1475 1485 1495

1750

1755

1765

*1790 "STM nn" +1800

*+1807 "STM nn" +1813 +1817 +1825

1830 1840

1847 1853 1857 1865

1913 1917

1923 1927

1933

1937

1939 "ES PAYMENT CLAIMED" 1943 1945

*1953 "STM nn" +1957 +1963 +1967 +1973

1977

1991

2010

2020

2030

B-11

1166 1167
 OMB No. 1545-0074 SCHEDULE EIC Earned Income Credit (Form 1040A or 1040)

Department of the Treasury

Internal Revenue Service

Attachment

Sequence No. 43

Qualifying Child Information

For Paperwork Reduction Act Notice, see Form 1040A

or 1040 instructions.

Cat. No. 13339M Schedule EIC (Form 1040A or 1040) 2005

Before you begin: See the instructions for Form 1040A, lines 41a and 41b, or Form 1040, lines 66a and

66b, to make sure that (a) you can take the EIC and (b) you have a qualifying child.

Qualifying Child Information

● 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.

4

2

5

6

1 Child’s name

Child’s SSN

Child’s relationship to you

Number of months child lived with

you in the United States during 2005

months

Yes.

months

If the child was born before 1987—

Was the child permanently and totally

disabled during any part of 2005?

b

Yes.

First name Last name First name Last name

Name(s) shown on return Your social security number

(99)

EIC

1040A

1040

Complete and attach to Form 1040A or 1040

only if 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 or disallow your

EIC. If the name or SSN on the child’s social security card is not correct, call the Social Security

Administration at 1-800-772-1213.

Child 1 Child 2

If you have more than two qualifying children, you

only have to list two to get the maximum credit.

The child must have an SSN as defined on page 44

of the Form 1040A instructions or page 48 of the

Form 1040 instructions unless the child was born and

died in 2005. If your child was born and died in 2005

and did not have an SSN, enter “Died” on this line

and attach a copy of the child’s birth certificate.

No. No.

Go to line 5. Go to line 5. Continue Continue

Yes. Yes. No. No.

Continue Continue The child is not a

qualifying child.

The child is not a

qualifying child.

● If the child lived with you for more than half of

2005 but less than 7 months, enter “7.”

● If the child was born or died in 2005 and your

home was the child’s home for the entire time he

or she was alive during 2005, enter “12.”

Do not enter more than 12 months. Do not enter more than 12 months.

You may also be able to take the additional child tax credit if your child (a) was under age 17 at the end of 2005, and

(b) is a U.S. citizen or resident alien. For more details, see the instructions for line 42 of Form 1040A or line 68 of

Form 1040.

. . . . . . . . . .

● 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 back of schedule for details.

(for example, son, daughter, grandchild,

niece, nephew, foster child, etc.)

Was the child under age 24 at the end

of 2005 and a student?

a

Child’s year of birth

If born after 1986, skip lines 4a

and 4b; go to line 5.

Year

If born after 1986, skip lines 4a

and 4b; go to line 5.

Year 3

CAUTION

TIP

2005

007

010 011

015

030 035

040 045

060 "CHILD", "SON", 

"DAUGHTER",

"GRANDCHILD",

"FOSTERCHILD"

070

077

080 081

085

100 105

110 115

130 "CHILD", "SON", 

"DAUGHTER",

"GRANDCHILD",

"FOSTERCHILD"

140

B-12

020 090
SCHEDULE F OMB No. 1545-0074 Profit or Loss From Farming

(Form 1040)  Attach to Form 1040, Form 1041, Form 1065, or Form 1065-B.

Department of the Treasury

Internal Revenue Service

Attachment

Sequence No. 14

Name of proprietor Social security number (SSN)

A Principal product. Describe in one or two words your principal crop or activity for the current tax year. B Enter code from Part IV

C Accounting method: Accrual Cash D Employer ID number (EIN), if any

E Did you “materially participate” in the operation of this business during 2005? If “No,” see page F-2 for limit on passive losses. Yes No

Farm Income—Cash Method. Complete Parts I and II (Accrual method. Complete Parts II and III, and Part I, line 11.)

Do not include sales of livestock held for draft, breeding, sport, or dairy purposes; report these sales on Form 4797.

(1)

1 Sales of livestock and other items you bought for resale

(2)

2 Cost or other basis of livestock and other items reported on line 1

3 Subtract line 2 from line 1 3

4 Sales of livestock, produce, grains, and other products you raised 4

5a Cooperative distributions (Form(s) 1099-PATR) 5a 5b 5b Taxable amount

6a Agricultural program payments (see page F-2) 6a 6b 6b Taxable amount

7 Commodity Credit Corporation (CCC) loans (see page F-3):

a CCC loans reported under election 7a

b CCC loans forfeited 7b 7c Taxable amount 7c

8 Crop insurance proceeds and Federal crop disaster payments (see page F-3):

a Amount received in 2005 8a 8b 8b Taxable amount

c If election to defer to 2006 is attached, check here  8d Amount deferred from 2004 8d

9 Custom hire (machine work) income 9

10 Other income, including Federal and state gasoline or fuel tax credit or refund (see page F-3) 10

Gross income. Add amounts in the right column for lines 3 through 10. If you use the accrual method, enter

the amount from Part III, line 51 

11

11

Farm Expenses—Cash and Accrual Method.

Do not include personal or living expenses such as taxes, insurance, repairs, etc., on your home.

Labor hired (less employment credits)

12

24 24

Pension and profit-sharing

plans

Chemicals

12 25

Rent or lease (see page F-5):

Conservation expenses (see 

page F-4)

13

26a

13

Vehicles, machinery, and

equipment

a

26b

14

14

Custom hire (machine work) b Other (land, animals, etc.)

26

Repairs and maintenance

15

Depreciation and section 179

expense deduction not claimed

elsewhere (see page F-4)

27 27

Seeds and plants 28

15

28

29 Storage and warehousing 29

Supplies

16

Employee benefit programs other

than on line 25

30

16

30

17 Taxes 31

17

31

18 Utilities 32

Fertilizers and lime

18 32

19 Veterinary, breeding, and medicine

Freight and trucking

19 33

Other expenses (specify):

34a

20

Gasoline, fuel, and oil

20

a

34b

21 21

Insurance (other than health) b

23 Interest: c 34c

a Mortgage (paid to banks, etc.) 23a d 34d

b Other 23b e 34e

35 Total expenses. Add lines 12 through 34f  35

36 Net farm profit or (loss). Subtract line 35 from line 11.

● If a profit, enter on Form 1040, line 18, and also on Schedule SE, line 1.

● If a loss, you must go to line 37. Estates, trusts, and partnerships, see page F-6.

36

37a All investment is at risk. 37 If you have a loss, you must check the box that describes your investment in this activity (see page F-6).

37b Some investment is not at risk. ● If you checked 37a, enter the loss on Form 1040, line 18, and also on Schedule SE, line 1.

● If you checked 37b, you must attach Form 6198. Your loss may be limited.

For Paperwork Reduction Act Notice, see page F-6 of the instructions. Schedule F (Form 1040) 2005

 See Instructions for Schedule F (Form 1040).

Car and truck expenses (see

page F-4—also attach Form 4562)

Cat. No. 11346H

Feed

22 22

f 34f

25

33

34

1

2



Part I

Part II



(99)

2005



010 020

030 040

050 060 070

100 110

140

150

160

170

180 195

205 210

@215 "STM nn" 230

235 240

245 250

@251 "STM nn" 252 255

260

270

280

295

300

310

315

320

330

340

350

360

370

380

@385 "STM nn"

390

@395 "STM nn" 400

410

450

460

465

470

480

490

510

520

530

540

*550 "STM nn" +560

570 580

590 600

610 620

630 640

642 644

650

675 "PAL"

680

690

700

B-13
Schedule F (Form 1040) 2005 Page 2

Farm Income—Accrual Method (see page F-6).

Do not include sales of livestock held for draft, breeding, sport, or dairy purposes; report these sales on Form

4797 and do not include this livestock on line 46 below.

38 Sales of livestock, produce, grains, and other products 38

39a Cooperative distributions (Form(s) 1099-PATR) 39a 39b Taxable amount 39b

40a Agricultural program payments 40a 40b 40b Taxable amount

Commodity Credit Corporation (CCC) loans:

a CCC loans reported under election 41a

b CCC loans forfeited 41b 41c Taxable amount 41c

Crop insurance proceeds

41

42

Custom hire (machine work) income

42

43

Other income, including Federal and state gasoline or fuel tax credit or refund

43

44

Add amounts in the right column for lines 38 through 44

44

Inventory of livestock, produce, grains, and other products at beginning of

the year

45

Cost of livestock, produce, grains, and other products purchased during

the year

46

46

47

Add lines 46 and 47

47

48

Inventory of livestock, produce, grains, and other products at end of year

48

Cost of livestock, produce, grains, and other products sold. Subtract line 49 from line 48* 50

49

51 Gross income. Subtract line 50 from line 45. Enter the result here and on Part I, line 11  51

*If you use the unit-livestock-price method or the farm-price method of valuing inventory and the amount on line 49 is larger than the amount on

line 48, subtract line 48 from line 49. Enter the result on line 50. Add lines 45 and 50. Enter the total on line 51 and on Part I, line 11.

Principal Agricultural Activity Codes

Select the code that best identifies your primary farming

activity and enter it on page 1, line B.

50

45

49

Part IV

Part III

File Schedule C (Form 1040) or Schedule C-EZ

(Form 1040) instead of Schedule F if (a) your

principal source of income is from providing

agricultural services such as soil preparation, veterinary,

farm labor, horticultural, or management for a fee or on a

contract basis, or (b) you are engaged in the business of

breeding, raising, and caring for dogs, cats, or other pet

animals.

Crop Production

111100 Oilseed and grain farming

111210 Vegetable and melon farming

111300 Fruit and tree nut farming

111400 Greenhouse, nursery, and floriculture production

111900 Other crop farming

Animal Production

112111 Beef cattle ranching and farming

112112 Cattle feedlots

112120 Dairy cattle and milk production

112210 Hog and pig farming

112300 Poultry and egg production

112400 Sheep and goat farming

112510 Animal aquaculture

112900 Other animal production

Forestry and Logging

113000 Forestry and logging (including forest nurseries

and timber tracts)

These codes for the Principal Agricultural Activity classify

farms by the type of activity they are engaged in to facilitate the

administration of the Internal Revenue Code. These six-digit

codes are based on the North American Industry Classification

System (NAICS).

Schedule F (Form 1040) 2005

CAUTION

720

730 735

760 770

@775 "STM nn" 780

790 800

810

820

830

840

850

860

870

880

890

900

B-14
Household Employment Taxes

Department of the Treasury

Internal Revenue Service

(For Social Security, Medicare, Withheld Income, and Federal Unemployment (FUTA) Taxes)

1 Total cash wages subject to social security taxes (see page H-4) 1

2 Social security taxes. Multiply line 1 by 12.4% (.124) 2

3 Total cash wages subject to Medicare taxes (see page H-4) 3

4 Medicare taxes. Multiply line 3 by 2.9% (.029) 4

OMB No. 1545-1971

Part I Social Security, Medicare, and Income Taxes

Cat. No. 12187K

 Attach to Form 1040, 1040NR, 1040-SS, or 1041.

5 Federal income tax withheld, if any 5

Total social security, Medicare, and income taxes (add lines 2, 4, and 5)

Advance earned income credit (EIC) payments, if any

Net taxes (subtract line 7 from line 6)

6

7

8

6

7

8

Did you pay total cash wages of $1,000 or more in any calendar quarter of 2004 or 2005 to household employees?

(Do not count cash wages paid in 2004 or 2005 to your spouse, your child under age 21, or your parent.)

Name of employer Social security number

Yes.

No.

Go to line 10 on the back.

SCHEDULE H

(Form 1040)

Attachment

Sequence No. 44

Schedule H (Form 1040) 2005

A

Employer identification number

For Privacy Act and Paperwork Reduction Act Notice, see page 7 of the separate instructions.

Stop. Enter the amount from line 8 above on Form 1040, line 62. If you are not required to file Form 1040, see the

line 9 instructions on page H-4.

9

Did you pay any one household employee cash wages of $1,400 or more in 2005? (If any household employee was your

spouse, your child under age 21, your parent, or anyone under age 18, see the line A instructions on page H-3 before you

answer this question.)

Yes. Skip lines B and C and go to line 1.

No. Go to line B.

Did you withhold federal income tax during 2005 for any household employee?

Yes. Skip line C and go to line 5.

No. Go to line C.

Did you pay total cash wages of $1,000 or more in any calendar quarter of 2004 or 2005 to all household employees?

(Do not count cash wages paid in 2004 or 2005 to your spouse, your child under age 21, or your parent.)

No. Stop. Do not file this schedule.

Yes. Skip lines 1-9 and go to line 10 on the back. (Calendar year taxpayers having no household employees in 2005 do

not have to complete this form for 2005.)

B

C

(99)  See separate instructions.

2005

010

015

020

030

040

045

050

055

060

065

070

080

090

100

110

120

130

140

150

155

B-15

125
Are you required to file Form 1040?

Part III Total Household Employment Taxes

26

27

Enter the amount from line 8

Add line 17 (or line 25) and line 26

26

Page 2

22 Multiply line 21 by 6.2% (.062) 22

23 Multiply line 21 by 5.4% (.054) 23

18

Enter the smaller of line 20 or line 23

FUTA tax. Subtract line 24 from line 22. Enter the result here and go to line 26

24

25 25

(a)

Name

of

state

(i)

Contributions

paid to state

unemployment

fund

(h)

Subtract col. (g)

from col. (f). If

zero or less,

enter -0-.

(g)

Multiply col. (c)

by col. (e)

(f)

Multiply col. (c)

by .054

(e)

State

experience

rate

(b)

State reporting number

as shown on state

unemployment tax

return

(c)

Taxable wages (as

defined in state act)

(d)

State experience rate

period

From To

Totals 

Add columns (h) and (i) of line 19

Complete all columns below that apply (if you need more space, see page H-5):

19

20

24

27

Schedule H (Form 1040) 2005

20

19

Did you pay unemployment contributions to only one state? (If you paid contributions to New York State,

check "No.")

Did you pay all state unemployment contributions for 2005 by April 17, 2006? Fiscal year filers, see page H-4

Were all wages that are taxable for FUTA tax also taxable for your state’s unemployment tax?

Part II Federal Unemployment (FUTA) Tax

FUTA tax. Multiply line 16 by .008. Enter the result here, skip Section B, and go to line 26

13

14

15

Name of the state where you paid unemployment contributions  

State reporting number as shown on state unemployment tax return  

Contributions paid to your state unemployment fund (see page H-4) 15

17 17

10

11

12

Section A

Section B

16 Total cash wages subject to FUTA tax (see page H-4) 16

21 Total cash wages subject to FUTA tax (see the line 16 instructions on page H-4)

Part IV Address and Signature—Complete this part only if required. See the line 28 instructions on page H-5.

Address (number and street) or P.O. box if mail is not delivered to street address Apt., room, or suite no.

City, town or post office, state, and ZIP code

Under penalties of perjury, I declare that I have examined this schedule, including accompanying statements, and to the best of my knowledge and belief, it is true,

correct, and complete. No part of any payment made to a state unemployment fund claimed as a credit was, or is to be, deducted from the payments to employees.

 Employer’s signature  Date

21

Yes No

Next: If you checked the “Yes” box on all the lines above, complete Section A.

If you checked the “No” box on any of the lines above, skip Section A and complete Section B.

28

Yes.

No.

Stop. Enter the amount from line 27 above on Form 1040, line 62. Do not complete

Part IV below.

You may have to complete Part IV. See page H-5 for details.

10

11

12

Schedule H (Form 1040) 2005

(New York State employers must use the worksheet in the separate instructions and check here)

170 175

180 185

190 195

200

210

220 "0% RATE"

230

240

250 260 270 280 285 290 300 310 320 330

340 350 360 370 375 380 390 400 410 420

440 450

460

470

480

490

500

510

520

530

540

550

B-16

503
SCHEDULE J OMB No. 1545-0074 Income Averaging for

(Form 1040) Farmers and Fishermen

 Attach to Form 1040. Department of the Treasury

Internal Revenue Service

Attachment

Sequence No. 20

Name(s) shown on Form 1040 Social security number (SSN)

1

2

3 3

4 4

5

5

6 6

7 7

8 8

9

9

10 10

11

 See Instructions for Schedule J (Form 1040).

1

2

Enter the taxable income from your 2005 Form 1040, line 43

Enter your elected farm income (see page J-1). Do not enter more than the amount on line 1

Subtract line 2 from line 1

Figure the tax on the amount on line 3 using the 2005 tax rates (see page J-1)

If you used Schedule J to figure your tax for:

● 2004, enter the amount from your 2004 Schedule J, line 11.

● 2003 but not 2004, enter the amount from your 2003 Schedule J,

line 15.

● 2002 but not 2003 nor 2004, enter the amount from your 2002

Schedule J, line 3.

Otherwise, enter the taxable income from your 2002 Form 1040, 

line 41; Form 1040A, line 27; or Form 1040EZ, line 6. If zero or less,

see page J-2.

Divide the amount on line 2 by 3.0

Combine lines 5 and 6. If zero or less, enter -0-

Figure the tax on the amount on line 7 using the 2002 tax rates (see page J-3)

If you used Schedule J to figure your tax for:

● 2004, enter the amount from your 2004 Schedule J, line 15.

● 2003 but not 2004, enter the amount from your 2003

Schedule J, line 3. 

Otherwise, enter the taxable income from your 2003 Form 1040,

line 40; Form 1040A, line 27; or Form 1040EZ, line 6. If zero or

less, see page J-4.

Enter the amount from line 6

Combine lines 9 and 10. If less than zero, enter as a negative amount

Figure the tax on the amount on line 11 using the 2003 tax rates (see page J-5)

If you used Schedule J to figure your tax for 2004, enter the amount

from your 2004 Schedule J, line 3. Otherwise, enter the taxable

income from your 2004 Form 1040, line 42; Form 1040A, line 27; or

Form 1040EZ, line 6. If zero or less, see page J-6

Enter the amount from line 6

Combine lines 13 and 14. If less than zero, enter as a negative amount

Figure the tax on the amount on line 15 using the 2004 tax rates (see page J-7)

Add lines 4, 8, 12, and 16

If you used Schedule J to figure your tax for:

● 2004, enter the amount from your 2004 Schedule J, line 12.

● 2003 but not 2004, enter the amount from your 2003

Schedule J, line 16.

● 2002 but not 2003 nor 2004, enter the amount from your 2002

Schedule J, line 4.

Otherwise, enter the tax from your 2002 Form 1040, line 42*;

Form 1040A, line 28*; or Form 1040EZ, line 10.

If you used Schedule J to figure your tax for:

● 2004, enter the amount from your 2004 Schedule J, line 16.

● 2003 but not 2004, enter the amount from your 2003

Schedule J, line 4.

Otherwise, enter the tax from your 2003 Form 1040, line 41*;

Form 1040A, line 28*; or Form 1040EZ, line 10.

If you used Schedule J to figure your tax for 2004, enter the amount from

your 2004 Schedule J, line 4. Otherwise, enter the tax from your 2004

Form 1040, line 43*; Form 1040A, line 28*; or Form 1040EZ, line 10

Add lines 18 through 20

Tax. Subtract line 21 from line 17. Also include this amount on Form 1040, line 44

12

13

14

15

16

17

18

19

20

21

22

For Paperwork Reduction Act Notice, see Form 1040 instructions. Schedule J (Form 1040) 2005 Cat. No. 25513Y

11

12

13

14

15

16

17

18

19

20

21

22

*Do not include tax from Form 8814 or 4972 or from recapture of an education credit. Also, do not

include alternative minimum tax from Form 1040A.

Caution. Your tax may be less if you figure it using the 2005 Tax Table, Tax Computation Worksheet, Qualified Dividends and

Capital Gain Tax Worksheet, or the Schedule D Tax Worksheet. Attach Schedule J only if you are using it to figure your tax.

(99)

2005









010

020

030

040

050

060

070

080

090

100

110

120

130

140

150

160

170

180

190

200

210

220

B-17
(Form 1040) Credit for the Elderly or the Disabled

Attachment

 Attach to Form 1040.  See Instructions for Schedule R (Form 1040). Sequence No. 16

Your social security number

You may be able to take this credit and reduce your tax if by the end of 2005:

● You were age 65 or older or

You filed a physician’s statement for this disability for 1983 or an earlier year, or you filed or got a

statement for tax years after 1983 and your physician signed line B on the statement, and

If:

Due to your continued disabled condition, you were unable to engage in any substantial gainful activity

in 2005, check this box 

● If you checked this box, you do not have to get another statement for 2005.

OMB No. 1545-0074 Schedule R

For Paperwork Reduction Act Notice, see Form 1040 instructions.

Department of the Treasury

Internal Revenue Service

Name(s) shown on Form 1040

But you must also meet other tests. See page R-1.

In most cases, the IRS can figure the credit for you. See page R-1.

Check the Box for Your Filing Status and Age

Statement of Permanent and Total Disability (Complete only if you checked box 2, 4, 5, 6, or 9 above.)

1

Schedule R (Form 1040) 2005

2

If your filing status is:

1 You were 65 or older 1

2 You were under 65 and you retired on permanent and total disability 2

3 Both spouses were 65 or older 3

4 Both spouses were under 65, but only one spouse retired on

permanent and total disability 4

5 Both spouses were under 65, and both retired on permanent and total

disability 5

Married filing

jointly

6 One spouse was 65 or older, and the other spouse was under 65 and

retired on permanent and total disability 6

7 One spouse was 65 or older, and the other spouse was under 65 and

not retired on permanent and total disability 7

8 You were 65 or older and you lived apart from your spouse for all of

Married filing 2005 8

separately

9 You were under 65, you retired on permanent and total disability, and

you lived apart from your spouse for all of 2005 9

Did you check

box 1, 3, 7,

or 8?

Single,

Head of household, or 

Qualifying widow(er)

And by the end of 2005: Check only one box:

Cat. No. 11359K

Part I

Part II

● You were under age 65, you retired on permanent and total disability, and

you received taxable disability income.

Yes Skip Part II and complete Part III on back.

No Complete Parts II and III.





● If you did not check this box, have your physician complete the statement on page R-4. You must

keep the statement for your records.

(99)

TIP

2005

010

020

030

040

050

060

070

080

090

100

B-18
Schedule R (Form 1040) 2005 Page 2

Figure Your Credit

Box 1, 2, 4, or 7 $5,000

10 Enter:

10

● Box 6, add $5,000 to the taxable disability income of the

spouse who was under age 65. Enter the total.

11

If you completed line 11, enter the smaller of line 10 or line 11; all others, enter the

amount from line 10

12

12

Enter the following pensions, annuities, or disability income that

you (and your spouse if filing a joint return) received in 2005.

13

a Nontaxable part of social security benefits and

13a Nontaxable part of railroad retirement benefits

treated as social security (see page R-3).

b Nontaxable veterans’ pensions and

13b Any other pension, annuity, or disability benefit that

is excluded from income under any other provision

of law (see page R-3).

Add lines 13a and 13b. (Even though these income items are

not taxable, they must be included here to figure your credit.)

If you did not receive any of the types of nontaxable income

listed on line 13a or 13b, enter -0- on line 13c

c

13c

14

Enter the amount from Form 1040,

line 38

14

15

15

Subtract line 15 from line 14. If zero or

less, enter -0-

16

16

17 Enter one-half of line 16 17

18 Add lines 13c and 17 18

Subtract line 18 from line 12. If zero or less, stop; you cannot take the credit. Otherwise,

go to line 20

19

19

24

20 Multiply line 19 by 15% (.15)

Did you check

box 2, 4, 5, 6,

or 9 in Part I?

Box 3, 5, or 6 $7,500

Box 8 or 9 $3,750

If you checked (in Part I):

Box 1 or 2 $7,500

Enter:

Box 3, 4, 5, 6, or 7 $10,000

Box 8 or 9 $5,000

If you checked (in Part I):

Part III







● Box 2, 4, or 9, enter your taxable disability income.

● Box 5, add your taxable disability income to your spouse’s

taxable disability income. Enter the total.

For more details on what to include on line 11, see page R-3.

11

If you checked (in Part I):



Yes You must complete line 11.

No Enter the amount from line 10

on line 12 and go to line 13.







Schedule R (Form 1040) 2005

21 Enter the amount from Form 1040, line 46

23 Subtract line 22 from line 21

Add the amounts from Form 1040, lines 47 and 48, and enter

the total

22

Credit for the elderly or the disabled. Enter the smaller of line 20 or line 23 here and

on Form 1040, line 49

24

22

21

20

23

TIP

140

150

160

163

167

170

180

190

200

210

220

230

250

B-19

260

270

280

290
SCHEDULE SE OMB No. 1545-0074

(Form 1040) Self-Employment Tax

Department of the Treasury

Internal Revenue Service

Attachment

 Attach to Form 1040.  See Instructions for Schedule SE (Form 1040). Sequence No. 17

Name of person with self-employment income (as shown on Form 1040) Social security number of person

with self-employment income 

Who Must File Schedule SE

You must file Schedule SE if:

● You had net earnings from self-employment from other than church employee income (line 4 of Short Schedule SE or line 4c of

Long Schedule SE) of $400 or more, or

Exception. If your only self-employment income was from earnings as a minister, member of a religious order, or Christian Science

practitioner and you filed Form 4361 and received IRS approval not to be taxed on those earnings, do not file Schedule SE. Instead,

write “Exempt–Form 4361” on Form 1040, line 58.

Section A—Short Schedule SE. Caution. Read above to see if you can use Short Schedule SE.

Net farm profit or (loss) from Schedule F, line 36, and farm partnerships, Schedule K-1 (Form

1065), box 14, code A

1

1

Net profit or (loss) from Schedule C, line 31; Schedule C-EZ, line 3; Schedule K-1 (Form 1065),

box 14, code A (other than farming); and Schedule K-1 (Form 1065-B), box 9. Ministers and

members of religious orders, see page SE-1 for amounts to report on this line. See page SE-2

for other income to report

2

2

3 Combine lines 1 and 2 3

Net earnings from self-employment. Multiply line 3 by 92.35% (.9235). If less than $400,

do not file this schedule; you do not owe self-employment tax 

4

4

5 Self-employment tax. If the amount on line 4 is: 

For Paperwork Reduction Act Notice, see Form 1040 instructions. Schedule SE (Form 1040) 2005

● You had church employee income of $108.28 or more. Income from services you performed as a minister or a member of a

religious order is not church employee income (see page SE-1).

Cat. No. 11358Z

Deduction for one-half of self-employment tax. Multiply line 5 by

50% (.5). Enter the result here and on Form 1040, line 27

● $90,000 or less, multiply line 4 by 15.3% (.153). Enter the result here and on 

Form 1040, line 58.

● More than $90,000, multiply line 4 by 2.9% (.029). Then, add $11,160.00 to the

result. Enter the total here and on Form 1040, line 58.

May I Use Short Schedule SE or Must I Use Long Schedule SE?

Did You Receive Wages or Tips in 2005?

Was the total of your wages and tips subject to social security

or railroad retirement tax plus your net earnings from

self-employment more than $90,000?

Did you receive tips subject to social security or Medicare tax

that you did not report to your employer?

Are you using one of the optional methods to figure your net

earnings (see page SE-3)?

Are you a minister, member of a religious order, or Christian

Science practitioner who received IRS approval not to be taxed

on earnings from these sources, but you owe self-employment

tax on other earnings?

Did you receive church employee income reported on Form

W-2 of $108.28 or more?

You May Use Short Schedule SE Below You Must Use Long Schedule SE on page 2





Yes



No Yes







No

No

No

No

Yes



Yes



Yes



Yes



 







No

Note. Even if you had a loss or a small amount of income from self-employment, it may be to your benefit to file Schedule SE and

use either “optional method” in Part II of Long Schedule SE (see page SE-3).

6

5

6



(99)

2005

010 020

030

040

050 "EXEMPT-NOTARY" 060 070

075

160

165

B-20
Schedule SE (Form 1040) 2005 Attachment Sequence No. 17 Page 2

Name of person with self-employment income (as shown on Form 1040) Social security number of person

with self-employment income 

Section B—Long Schedule SE

A If you are a minister, member of a religious order, or Christian Science practitioner and you filed Form 4361, but you

had $400 or more of other net earnings from self-employment, check here and continue with Part I 

Note. If your only income subject to self-employment tax is church employee income, skip lines 1 through 4b. Enter -0- on line

4c and go to line 5a. Income from services you performed as a minister or a member of a religious order is not church employee

income. See page SE-1.

Self-Employment Tax

1 Net farm profit or (loss) from Schedule F, line 36, and farm partnerships, Schedule K-1 (Form

1065), box 14, code A. Note. Skip this line if you use the farm optional method (see page SE-4) 1

2 Net profit or (loss) from Schedule C, line 31; Schedule C-EZ, line 3; Schedule K-1 (Form 1065), box

14, code A (other than farming); and Schedule K-1 (Form 1065-B), box 9. Ministers and members

of religious orders, see page SE-1 for amounts to report on this line. See page SE-2 for other

income to report. Note. Skip this line if you use the nonfarm optional method (see page SE-4) 2

3 Combine lines 1 and 2 3

4a If line 3 is more than zero, multiply line 3 by 92.35% (.9235). Otherwise, enter amount from line 3 4a

b If you elect one or both of the optional methods, enter the total of lines 15 and 17 here 4b

c Combine lines 4a and 4b. If less than $400, stop; you do not owe self-employment tax. Exception.

If less than $400 and you had church employee income, enter -0- and continue  4c

6

90,000 00 Maximum amount of combined wages and self-employment earnings subject to social security

tax or the 6.2% portion of the 7.65% railroad retirement (tier 1) tax for 2005

5a

7

Total social security wages and tips (total of boxes 3 and 7 on Form(s)

W-2) and railroad retirement (tier 1) compensation. If $90,000 or more,

skip lines 8b through 10, and go to line 11 8a

b Unreported tips subject to social security tax (from Form 4137, line 9) 8b

c Add lines 8a and 8b 8c

8a

9 Subtract line 8c from line 7. If zero or less, enter -0- here and on line 10 and go to line 11  9

10 10

Self-employment tax. Add lines 10 and 11. Enter here and on Form 1040, line 58

Optional Methods To Figure Net Earnings (see page SE-3)

14 Maximum income for optional methods 14 1,600 00

Enter the smaller of: two-thirds (2⁄3 ) of gross farm income1 (not less than zero) or $1,600. Also

include this amount on line 4b above

15

15

16 Subtract line 15 from line 14 16

Nonfarm Optional Method. You may use this method only if (a) your net nonfarm profits3 were less

than $1,733 and also less than 72.189% of your gross nonfarm income4 and (b) you had net earnings

from self-employment of at least $400 in 2 of the prior 3 years.

17

17

3 From Sch. C, line 31; Sch. C-EZ, line 3; Sch. K-1 (Form 1065), box 14, code A; and

Sch. K-1 (Form 1065-B), box 9.

1 From Sch. F, line 11, and Sch. K-1 (Form 1065),

box 14, code B.

4 From Sch. C, line 7; Sch. C-EZ, line 1; Sch. K-1 (Form 1065), box 14, code C; and Sch.

K-1 (Form 1065-B), box 9.

2 From Sch. F, line 36, and Sch. K-1 (Form 1065),

box 14, code A.

Multiply the smaller of line 6 or line 9 by 12.4% (.124)

Multiply line 6 by 2.9% (.029)

Enter your church employee income from Form W-2. See page SE-1

for definition of church employee income

Multiply line 5a by 92.35% (.9235). If less than $100, enter -0-

Net earnings from self-employment. Add lines 4c and 5b

5a

b 5b

6

7

11

12

11

Farm Optional Method. You may use this method only if (a) your gross farm income1 was not more

than $2,400 or (b) your net farm profits2 were less than $1,733.

Enter the smaller of: two-thirds (2⁄3 ) of gross nonfarm income4 (not less than zero) or the amount

on line 16. Also include this amount on line 4b above

Part I

Part II

Caution. You may use this method no more than five times.

Deduction for one-half of self-employment tax. Multiply line 12 by

50% (.5). Enter the result here and on Form 1040, line 27 13

13

Schedule SE (Form 1040) 2005

12

010 020

025

030

040

050 "EXEMPT-NOTARY" 060 070

075

077

079

081

082

084

088

090

100

110

150

159

160

165

170

180

190

B-21
Head of household (with qualifying person). (See page 19.)

If the qualifying person is a child but not your dependent,

enter this child’s name here.  Married filing separately. Enter spouse’s SSN above and

full name here. 

Form Department of the Treasury—Internal Revenue Service

1040A 2005 U.S. Individual Income Tax Return

OMB No. 1545-0074

Your social security number

Your first name and initial Last name Label L

A

B

E

L

H

E

R

E

(See page 18.)

If a joint return, spouse’s first name and initial Last name Spouse’s social security number

Use the

IRS label. Home address (number and street). If you have a P.O. box, see page 18. Apt. no.

City, town or post office, state, and ZIP code. If you have a foreign address, see page 18.

Filing

status

Boxes

checked on

6a and 6b

Yourself. If someone can claim you as a dependent, do not check

box 6a. Exemptions 6a

b Spouse No. of children

on 6c who: (4) if qualifying

child for child

tax credit (see

page 21)

(2) Dependent’s social

security number

c ● lived with

you

● did not live

with you due

to divorce or

separation

(see page 22)

If more than six

dependents,

see page 21.

Dependents

on 6c not

entered above

d

Add numbers

on lines Total number of exemptions claimed. above 

7 Wages, salaries, tips, etc. Attach Form(s) W-2. 7

8a Taxable interest. Attach Schedule 1 if required. 8a

b Tax-exempt interest. Do not include on line 8a. 8b

Attach

Form(s) W-2

here. Also

attach

Form(s)

1099-R if tax

was withheld.

9a Ordinary dividends. Attach Schedule 1 if required. 9a

IRA

distributions.

11a Taxable amount

(see page 25).

11b

Enclose, but do

not attach, any

payment.

11a 11b

Taxable amount

(see page 26).

12a Pensions and 12b

annuities. 12a 12b

13 Unemployment compensation and Alaska Permanent Fund dividends. 13

14a Taxable amount

(see page 28).

Social security

benefits.

14b

14a 14b

15 Add lines 7 through 14b (far right column). This is your total income.  15

17 IRA deduction (see page 28). 17

Student loan interest deduction (see page 31).

Income

18

Add lines 16 through 19. These are your total adjustments. 20

Subtract line 20 from line 15. This is your adjusted gross income. 

18

21

Dependents:



Check only

one box.

If you did not

get a W-2, see

page 24.

Form 1040A (2005)

IRS Use Only—Do not write or staple in this space.

(3) Dependent’s

relationship to

(1) First name Last name you

20

21

Adjusted

gross 

income

Cat. No. 11327A

Otherwise,

please print

or type.

For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see page 58.

(99)

10 Capital gain distributions (see page 25). 10

19 Tuition and fees deduction (see page 32). 19

1 Single

2 Married filing jointly (even if only one had income)

3

Qualifying widow(er) with dependent child (see page 19)

4

5

16 Educator expenses (see page 28). 16

b Qualified dividends (see page 25). 9b

Presidential

Election Campaign  Check here if you, or your spouse if filing jointly, want $3 to go to this fund (see page 18) 

Checking a box below will not

change your tax or refund.

You Spouse

You must enter

your SSN(s) above.

010

030

050

060

055

070

062 080

064 083 066 087 095 097 098 100

110 120

130

@135 "STM nn" 140

160

163

167

*170 +171 +172 +175 +177 +178

180 181 182 185 187 188

190 191 192 195 197 198

200 201 202 205 207 208

210 211 212 215 217 218

355

240

247

350

362"PRI"364/366"HSH"367/368"AB""SNE""PYAB"369/370"FB"/371"DCB"372"SCH"

394

480

485 487 "ROLLOVER"

545 "REPAID" 551

552

553 555 "D" "LSE" 557

600

628

630

740

750

B-22

150 153

380

385

475

477 "ROLLOVER"

626

450

375

020

040

396

373 378"FEC"379

605

@479"STM nn"

495
If you have

a qualifying

child, attach

Schedule

EIC.

Single or

Married filing

separately,

$5,000

30

22 Enter the amount from line 21 (adjusted gross income). 22

Total boxes

checked 

Check You were born before January 2, 1941, Blind

if:

23a

Spouse was born before January 2, 1941, Blind 23a

b

23b

If you are married filing separately and your spouse itemizes

deductions, see page 32 and check here 

Tax,

credits,

and

payments

24 24

25 Subtract line 24 from line 22. If line 24 is more than line 22, enter -0-. 25

26 If line 22 is over $109,475, or you provided housing to a person displaced by

Hurricane Katrina, see page 33. Otherwise, multiply $3,200 by the total number

of exemptions claimed on line 6d. 26

Subtract line 26 from line 25. If line 26 is more than line 25, enter -0-.

This is your taxable income. 

27

27

28 Tax, including any alternative minimum tax (see page 34). 28

31 Education credits. Attach Form 8863. 31

35

36 Subtract line 35 from line 28. If line 35 is more than line 28, enter -0-. 36

37 Advance earned income credit payments from Form(s) W-2. 37

Add lines 36 and 37. This is your total tax.  38

39 Federal income tax withheld from Forms W-2 and 1099. 39

2005 estimated tax payments and amount

applied from 2004 return. 40

Add lines 39, 40, 41a, and 42. These are your total payments.  43

If line 43 is more than line 38, subtract line 38 from line 43.

This is the amount you overpaid.

44

45a

Refund

Amount of line 44 you want applied to your

2006 estimated tax.

46

46

Amount you owe. Subtract line 43 from line 38. For details on how

to pay, see page 54. 

47

47

48 Estimated tax penalty (see page 54). 48

Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to the best of my

knowledge and belief, they are true, correct, and accurately list all amounts and sources of income I received during the tax year. Declaration

of preparer (other than the taxpayer) is based on all information of which the preparer has any knowledge.



Enter your standard deduction (see left margin).

Form 1040A (2005)

44

45a Amount of line 44 you want refunded to you. 

38

Credit for child and dependent care expenses.

Attach Schedule 2.

29

29

Adoption credit. Attach Form 8839.

33

33

32 32

Credit for the elderly or the disabled. Attach

Schedule 3.

30

35 Add lines 29 through 34. These are your total credits.

40

42

43

Additional child tax credit. Attach Form 8812.

Routing

number

Account

number

Checking Savings  b

c

 d

Amount

you owe

Direct

deposit?

See page 53

and fill in

45b, 45c,

and 45d.



41a Earned income credit (EIC). 41a

Page 2

Form 1040A (2005)

Sign

here

Your signature Date

Keep a copy

for your

records.

Spouse’s signature. If a joint return, both must sign. Date

Date Preparer’s SSN or PTIN Preparer’s

signature Check if

self-employed

Paid

preparer’s

use only Firm’s name (or

yours if self-employed),

address, and ZIP code

EIN

Phone no.







Your occupation Joint return?

See page 18.

Daytime phone number

( )

Spouse’s occupation

( )

Head of

household,

$7,300

Married filing

jointly or

Qualifying

widow(er),

$10,000

Standard

Deduction

for—

● People who

checked any

box on line

23a or 23b or

who can be

claimed as a

dependent,

see page 32.

● All others:

Designee’s

name 

Do you want to allow another person to discuss this return with the IRS (see page 55)? Third party

designee Phone

no.  ( )

Yes. Complete the following. No

Personal identification

number (PIN) 

34 34

Retirement savings contributions credit. Attach Form 8880.

Type:

Child tax credit (see page 38). Attach

Form 8901 if required.

42

b Nontaxable combat pay election. 41b

770

772 774

776 778

783

786 787 "SECT 933"

789

800

810

820

840 "ECR" 850

854 "AMT" 857

860

925

930

935

984

989

1020

1030

1105

1150

1155 "FORM 1099"1160

1161 1162 "DIV

@1173 "STM nn" 1170

1175 1176 1178 1800 1183 "NO"

1185

1192

1195 1197 1199 1200 1250

1260

1270

1272 1274 1276

1278

1280

1290

1307

1300

1321 1323

1324 1325 1326 1327

1328 1329

1338 IRS-PREPARED, 

IRS-REVIEWED 1340

1350

1360

1370 1380

1390 1400 1410 1420

1465 "0" "1" or "2" B-23

1303 1305

1309 1313

993

1262 1263
(99)

Schedule 1 Department of the Treasury—Internal Revenue Service

Interest and Ordinary Dividends

for Form 1040A Filers

(Form 1040A)

2005 OMB No. 1545-0074

Name(s) shown on Form 1040A Your social security number

Part I

Interest

(See back

of schedule

and the

instructions

for Form

1040A,

line 8a.)

Note. If you received a Form 1099-INT, Form 1099-OID, or substitute statement from a

brokerage firm, enter the firm’s name and the total interest shown on that form.

1 List name of payer. If any interest is from a seller-financed mortgage

and the buyer used the property as a personal residence, see back of

schedule and list this interest first. Also, show that buyer’s social

security number and address. Amount

1

2 Add the amounts on line 1. 2

Excludable interest on series EE and I U.S. savings bonds issued

after 1989. Attach Form 8815.

3

3

Subtract line 3 from line 2. Enter the result here and on Form 1040A,

line 8a.

4

4

Part II

Ordinary

dividends

Note. If you received a Form 1099-DIV or substitute statement from a brokerage firm,

enter the firm’s name and the ordinary dividends shown on that form.

(See back

of schedule

and the

instructions

for Form

1040A,

line 9a.)

5 List name of payer. Amount

5

6 Add the amounts on line 5. Enter the total here and on Form 1040A,

line 9a. 6

For Paperwork Reduction Act Notice, see Form 1040A instructions. Cat. No. 12075R Schedule 1 (Form 1040A) 2005

*010 STM nn" +011 +012 +015 025

*030 +040

050 060

070 080

090 100

110 120

130 140

160 "INTEREST SUBTOTAL" 220

230 "NOMINEE DISTRIBUTION" 240

250 "ACCRUED INTEREST" 260

270 "TAX-EXEMPT INTEREST" 280

281 "OID ADJUSTMENT" 282

283 "ABP ADJUSTMENT" 284

288

289

290

*300 "STM nn" +310

320 330

340 350

360 370

380 390

400 410

420 430

440 450

460 470

480 490

495 "DIVIDEND SUBTOTAL" 499

510 "NOMINEE DISTRIBUTION" 520

525

B-24
(99)

(d) Amount paid

(see instructions)

(c) Identifying

number (SSN or EIN)

(b) Address (number, street, apt. no., Part I city, state, and ZIP code)(a) Care provider’s

1 name

Persons or

organizations

who provided

the care

You must

complete this

part.

(If you need more space, use the bottom of page 2.)

2 Part II

Credit for child

and dependent

care expenses

Add the amounts in column (c) of line 2. Do not enter more than

$3,000 for one qualifying person or $6,000 for two or more persons.

If you completed Part III, enter the amount from line 26.

3

3

4 4

5

5

6 6

7

Enter your earned income. See the instructions.

8

8

If married filing jointly, enter your spouse’s earned income (if your

spouse was a student or was disabled, see the instructions); all

others, enter the amount from line 4.

9

9

Enter on line 8 the decimal amount shown below that applies to the

amount on line 7.

Decimal

amount is

If line 7 is:

But not

Over over

$0—15,000 .35 $29,000—31,000 .27

15,000—17,000 .34 31,000—33,000 .26

17,000—19,000 .33 33,000—35,000 .25

19,000—21,000 .32 35,000—37,000 .24

21,000—23,000 .31 37,000—39,000 .23

23,000—25,000 .30

 .

Multiply line 6 by the decimal amount on line 8. If you paid 2004

expenses in 2005, see the instructions.

For Paperwork Reduction Act Notice, see Form 1040A instructions. Schedule 2 (Form 1040A) 2005

Before you begin: You need to understand the following terms. See Definitions on page 1 of the separate instructions.

Cat. No. 10749I

Schedule 2 Department of the Treasury—Internal Revenue Service

Child and Dependent Care

Expenses for Form 1040A Filers (Form 1040A) 2005 OMB No. 1545-0074

Name(s) shown on Form 1040A Your social security number

Decimal

amount is

If line 7 is:

But not

Over over

Enter the amount from Form 1040A, line 22.

Enter the smallest of line 3, 4, or 5.

7

Did you receive

dependent care benefits? Yes

No Complete only Part II below.

Complete Part III on the back next.





Caution. If the care was provided in your home, you may owe employment taxes. If you do, you

must use Form 1040. See Schedule H and its instructions for details.

Information about your qualifying person(s). If you have more than two qualifying persons, see

the instructions.

(a) Qualifying person’s name (b) Qualifying person’s social

security number

(c) Qualified expenses

you incurred and paid

in 2005 for the person

listed in column (a) First Last

● Dependent care benefits ● Qualifying person(s) ● Qualified expenses

10 Enter the amount from Form 1040A, line 28.

11 Credit for child and dependent care expenses. Enter the smaller of line 9

or line 10 here and on Form 1040A, line 29.

25,000—27,000

27,000—29,000

.29

.28

39,000—41,000

41,000—43,000

43,000—No limit

.22

.21

.20

10

11

*010 "STM nn"

+020

+030 *+040 "STM nn" +050

060

070

080 090 100

*110 "STM nn" +115

+120

+214 +215

217 218

221

223 225

230

260

270

290

295

300

@315 "STM nn"

318 "CPYE" 320

335

328

324 326

332

+045

095

B-25
Schedule 2 (Form 1040A) 2005

Enter the total amount of dependent care benefits you received

for 2005. This amount should be shown in box 10 of your Form(s)

W-2. Do not include amounts that were reported to you as wages

in box 1 of Form(s) W-2.

Part III 12

12

Enter the amount forfeited or carried forward to 2006, if any. See the

instructions.

Subtract line 13 from line 12.

13

13

14

Enter the total amount of qualified expenses

incurred in 2005 for the care of the qualifying

person(s).

14

15

Enter the smaller of line 14 or 15.

15

16

Enter your earned income. See the instructions.

16

17

Enter the amount shown below that applies to

you.

17

18

18

19

Excluded benefits. Enter here the smaller of the following:

● The amount from line 19, or

19

● $5,000 ($2,500 if married filing separately and you were required to

enter your spouse’s earned income on line 18).

20

Taxable benefits. Subtract line 20 from line 14. Also, include this

amount on Form 1040A, line 7. In the space to the left of line 7, enter

“DCB.”

20

Dependent

care benefits

21

21

Enter the smallest of line 16, 17, or 18.

22

23

24

25

To claim the child and dependent care

credit, complete lines 22–26 below.

Enter $3,000 ($6,000 if two or more qualifying persons).

Enter the amount from line 20.

Subtract line 23 from line 22. If zero or less, stop. You cannot take

the credit. Exception. If you paid 2004 expenses in 2005, see the

instructions for line 9.

Complete line 2 on the front of this schedule. Do not include in

column (c) any benefits shown on line 20 above. Then, add the

amounts in column (c) and enter the total here.

22

23

24

25

26 Enter the smaller of line 24 or 25. Also, enter this amount on line 3

on the front of this schedule and complete lines 4–11. 26

Page 2

Schedule 2 (Form 1040A) 2005

● If married filing jointly, enter your spouse’s

earned income (if your spouse was a

student or was disabled, see the

instructions for line 5).

● If married filing separately, see the

instructions for the amount to enter.

● All others, enter the amount from line 17.

337

339

350

353

356

360

370

380

390

400

550

570

580

590

600

B-26
Due to your continued disabled condition, you were unable to engage in any

substantial gainful activity in 2005, check this box 

(99)

Schedule 3 Department of the Treasury—Internal Revenue Service

Credit for the Elderly or the Disabled

for Form 1040A Filers (Form 1040A) 2005 OMB No. 1545-0074

Name(s) shown on Form 1040A Your social security number

You may be able to take this credit and reduce your tax if by the end of 2005:

or

In most cases, the IRS can figure the credit for you. See the instructions.

Part I If your filing status is:

1 You were 65 or older 1

Check the

box for your

filing status

and age You were under 65 and you retired on permanent

and total disability

2

2

3 Both spouses were 65 or older 3

4 Both spouses were under 65, but only one spouse

retired on permanent and total disability 4

5 Both spouses were under 65, and both retired on

permanent and total disability 5 Married filing

jointly 6 One spouse was 65 or older, and the other spouse

was under 65 and retired on permanent and total

disability 6

7 One spouse was 65 or older, and the other spouse

was under 65 and not retired on permanent and

total disability 7

8 You were 65 or older and you lived apart from your

spouse for all of 2005 8

Married filing

separately 9 You were under 65, you retired on permanent and

total disability, and you lived apart from your

spouse for all of 2005 9

If: 1 You filed a physician’s statement for this disability for 1983 or an earlier year,

or you filed or got a statement for tax years after 1983 and your physician signed

line B on the statement, and

Part II

Statement of

permanent

and total

disability

2

Complete this part

only if you checked

box 2, 4, 5, 6,

or 9 above.

For Paperwork Reduction Act Notice, see Form 1040A instructions. Schedule 3 (Form 1040A) 2005

● You were age 65 or older ● You were under age 65, you retired on permanent

and total disability, and you received taxable

disability income.

Single,

Head of household, or

Qualifying widow(er)

And by the end of 2005: Check only one box:

Cat. No. 12064K

Yes

No

Skip Part II and complete Part III on the back.

Complete Parts II and III.

Did you check

box 1, 3, 7, or

8?





● If you did not check this box, have your physician complete the statement on

page 4 of the instructions. You must keep the statement for your records.

● If you checked this box, you do not have to get another statement for 2005.

But you must also meet other tests. See the separate instructions for Schedule 3.

TIP

010

020

030

040

050

060

070

080

090

100

B-27
Schedule 3 (Form 1040A) 2005

10 If you checked (in Part I): Enter: Part III Box 1, 2, 4, or 7 $5,000

Figure your

credit

Box 3, 5, or 6 $7,500

10

11

● Box 6, add $5,000 to the taxable disability income of the spouse

who was under age 65. Enter the total.

11

If you completed line 11, enter the smaller of line 10 or line 11; all

others, enter the amount from line 10.

12

12

Enter the following pensions, annuities, or

disability income that you (and your spouse if

filing a joint return) received in 2005.

13

Nontaxable part of social security benefits

and

a

Nontaxable part of railroad retirement benefits

treated as social security (see the instructions). 13a

Nontaxable veterans’ pensions

and

b

13b

Add lines 13a and 13b. (Even though these

income items are not taxable, they must be

included here to figure your credit.) If you did not

receive any of the types of nontaxable income

listed on line 13a or 13b, enter -0- on line 13c.

c

13c

14 Enter the amount from Form 1040A, line 22. 14

15 If you checked (in Part I): Enter:

Box 1 or 2 $7,500

Box 3, 4, 5, 6, or 7 $10,000

Box 8 or 9 $5,000 15

Subtract line 15 from line 14. If zero or less,

enter -0-.

16

16

17 Enter one-half of line 16. 17

18 Add lines 13c and 17. 18

Subtract line 18 from line 12. If zero or less, stop; you cannot take

the credit. Otherwise, go to line 20.

19

19

20 Multiply line 19 by 15% (.15). 20

● Box 2, 4, or 9, enter your taxable disability income.

● Box 5, add your taxable disability income to your spouse’s taxable

disability income. Enter the total.

For more details on what to include on line 11, see

the instructions.

Did you check

box 2, 4, 5, 6,

or 9 in Part I?

You must complete line 11.

Enter the amount from line 10

on line 12 and go to line 13.

Yes

No 



Box 8 or 9 $3,750

Page 2

Schedule 3 (Form 1040A) 2005

Any other pension, annuity, or disability benefit

that is excluded from income under any other

provision of law (see the instructions).

If you checked (in Part I):

21

21

Credit for the elderly or the disabled. Enter the smaller of line 20

or line 21 here and on Form 1040A, line 30. 22

TIP

22

Enter the amount from Form 1040A, line 28, minus any amount on

Form 1040A, line 29.

140

150

160

163

167

170

180

190

200

210

220

230

250

B-28

260

290
Check here if you, or your spouse if a joint return, want $3 to go to this fund? 

Taxable interest. If the total is over $1,500, you cannot use Form 1040EZ.

Department of the Treasury—Internal Revenue Service

Form Income Tax Return for Single and 1040EZ Joint Filers With No Dependents 2005 OMB No. 1545-0074

Presidential

Election

Campaign

(page 12)

Wages, salaries, and tips. This should be shown in box 1 of your Form(s) W-2.

Attach your Form(s) W-2.

1

1

Attach

Form(s) W-2

here.

Enclose, but

do not attach,

any payment.

2 2

Add lines 1, 2, and 3. This is your adjusted gross income.

If someone cannot claim you (or your spouse if a joint return), enter $8,200 if single;

$16,400 if married filing jointly. See back for explanation.

5

5

Subtract line 5 from line 4. If line 5 is larger than line 4, enter -0-.

This is your taxable income. 

6

6

Payments

and tax Earned income credit (EIC).

7 7

Tax. Use the amount on line 6 above to find your tax in the tax table on pages

24–32 of the booklet. Then, enter the tax from the table on this line.

10

10

Refund

11a 11a

If line 10 is larger than line 9, subtract line 9 from line 10. This is

the amount you owe. For details on how to pay, see page 19. 

For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see page 23.

Income

Cat. No. 11329W

4 4

12

12

Add lines 7 and 8a. These are your total payments. 

8a 8a

9 9

Federal income tax withheld from box 2 of your Form(s) W-2.

Unemployment compensation and Alaska Permanent Fund dividends

(see page 13).

3

3

Amount

you owe

b Routing number

Account number

c Type: Checking

You Spouse

Have it directly

deposited! See

page 18 and fill

in 11b, 11c,

and 11d.

 d



Form 1040EZ (2005)

(99)

You Spouse

Savings

Under penalties of perjury, I declare that I have examined this return, and to the best of my knowledge and belief, it is true, correct, and

accurately lists all amounts and sources of income I received during the tax year. Declaration of preparer (other than the taxpayer) is based

on all information of which the preparer has any knowledge.

Sign

here

Your signature Date

Keep a copy

for your

records.

Spouse’s signature. If a joint return, both must sign. Date

Date Preparer’s SSN or PTIN Preparer’s

signature Check if

self-employed

Paid

preparer’s

use only Firm’s name (or

yours if self-employed),

address, and ZIP code

EIN

Phone no.







Your occupation Joint return?

See page 11.

Daytime phone number

( )

Spouse’s occupation

( )

Designee’s

name 

Do you want to allow another person to discuss this return with the IRS (see page 19)? Third party

designee Phone

no.  ( )

Yes. Complete the following. No

Personal identification

number (PIN) 

Your first name and initial Last name Your social security number

L

A

B

E

L

H

E

R

E

If a joint return, spouse’s first name and initial Last name Spouse’s social security number

Home address (number and street). If you have a P.O. box, see page 11. Apt. no.

City, town or post office, state, and ZIP code. If you have a foreign address, see page 11.



Label

(See page 11.)

Use the IRS

label.

Otherwise,

please print

or type.



If line 9 is larger than line 10, subtract line 10 from line 9. This is your refund. 

b Nontaxable combat pay election. 8b

Checking a box below will not

change your tax or refund.

You must enter

your SSN(s) above.

If someone can claim you (or your spouse if a joint return) as a dependent, check the applicable

box(es) below and enter the amount from the worksheet on back.

010 020

030 040

050

055

060

062

064 066

070

080

083 087 095 097 100

110 120

@135 "STM nn"

362"PRI"364

366"HSH"368 372"SCH"373

375

382"TEI"385 380

545 "REPAID" 551 552

750

770 775

815

820

1155 "FORM 1099"

1180

1250

1183 "NO"

1195 "FORM 4868" 1197

1185

1256

1270

1272 1274 1276

1278

1290

1321 1323

1324 1325 1326 1327

1338 "IRS-PREPARED" "IRS 

REVIEWED" 1340

1465

B-29

1160

1313

1303 1305

1307 1309

1328

1350

1360

1370 1380

1390 1400 1410 1420

378"FEC"379

1262 1263

098

357 "DFC" 358

1175 "PYEI" 1176 1178
Employee contributions

or insurance premiums

CORRECTED (if checked)

PAYER’S name, street address, city, state, and ZIP code 1 Gross distribution Distributions From

Pensions, Annuities,

Retirement or

Profit-Sharing

Plans, IRAs,

Insurance

Contracts, etc.

$

2a Taxable amount

$

Total

distribution

Taxable amount

not determined

2b

RECIPIENT’S identification

number

PAYER’S Federal identification

number

3 Capital gain (included

in box 2a)

4 Federal income tax

withheld

$ $

RECIPIENT’S name Net unrealized

appreciation in

employer’s securities

5 6

$ $

Distribution

code(s)

Street address (including apt. no.) 7 8 Other

%

City, state, and ZIP code

Account number (see instructions) 10 State tax withheld 11 State/Payer’s state no.

$

13 Local tax withheld 14 Name of locality

$

Form 1099-R Department of the Treasury - Internal Revenue Service

12

15

State distribution

Local distribution

$

Copy B

Report this

income on your

federal tax

return. If this

form shows

federal income

tax withheld in

box 4, attach

this copy to

your return.

This information is

being furnished to

the Internal

Revenue Service.

$

$

$

$ $

$

OMB No. 1545-0119

Your percentage of total

distribution

9a

%

Form 1099-R

9b Total employee contributions

$

IRA/

SEP/

SIMPLE

2005

010

015

020

025

030

040 042 044

050 060

070

080

085

090 092 094

100

110

120

130 140

150 160

170 180

190 200 210 220

230 231

240

280

246/250

286/290

255

300

260

310

270

320

275

330

B-30
1

Control number

Retirement

plan

Third-party

sick pay

Statutory

employee

6

2

Employer’s name, address, and ZIP code

7 Allocated tips

Advance EIC payment

8

9 10

Wages, tips, other compensation Federal income tax withheld

Social security wages Social security tax withheld

11 12a

Employer’s state ID number

3 4

Employer identification number (EIN)

Medicare wages and tips

Social security tips

13

5

Employee’s social security number

Employee’s first name and initial Nonqualified plans

Medicare tax withheld

15

14

16 17

Other

18

Employee’s address and ZIP code

State State wages, tips, etc. State income tax Locality name

Copy B—To Be Filed With Employee’s FEDERAL Tax Return.

This information is being furnished to the Internal Revenue Service.

Department of the Treasury—Internal Revenue Service

Form

Dependent care benefits

See instructions for box 12

a

b

c

d

e

f

W-2 Wage and Tax

Statement 20 50

OMB No. 1545-0008

Last name C

o

d

e

12b

C

o

d

e

12c

C

o

d

e

Local wages, tips, etc. 19 Local income tax 20

12d

C

o

d

e

Safe, accurate,

FAST! Use

Visit the IRS website

at www.irs.gov/efile. 020 030

040

045

050

055

060

070 073 075

080

090

100

110 113 115

120 130

140 150

160 170

180 190

200 210

220 *242"STM nn" +244 +246

270 272

280 282

290 292

265 267 269

370 380 390 400 405 407 410

440 450 460 470 475 477 480

B-31

252 254 256

257 258 259

260 261 262

300 302
CORRECTED (if checked)

OMB No. 1545-0238 1 Gross winnings 2 Federal income tax withheld

3 Type of wager 4 Date won

5 Transaction 6 Race

7 Winnings from identical wagers 8 Cashier

9 Winner’s taxpayer identification no. 10 Window

11 First I.D. 12 Second I.D.

13 State/Payer’s state identification no. 14 State income tax withheld

Under penalties of perjury, I declare that, to the best of my knowledge and belief, the name, address, and taxpayer identification number that I have furnished

correctly identify me as the recipient of this payment and any payments from identical wagers, and that no other person is entitled to any part of these payments.

Signature  Date 

Form W-2G Department of the Treasury - Internal Revenue Service

PAYER’S name, address, ZIP code, federal identification

number, and telephone number

WINNER’S name, address (including apt. no.), and ZIP code

Copy B

Report this income on your

federal tax return. If this

form shows federal income

tax withheld in box 2, attach

this copy to your return.

This information is

being furnished to

the Internal

Revenue Service.

Certain

Gambling

Winnings

Form W-2G

2005 015

020

021

022

023 024 025

026 030

040 050

080 090

100 105

120 130

140

142

144 146 148

150 160

180 190

200/201 210

B-32
Copy B—To Be Filed With Employee’s Guam Tax Return

Department of the Treasury—Internal Revenue Service

Form W-2GU Guam

Wage and Tax Statement This information is being furnished to the

Guam Department of Revenue and Taxation.

2005

1

Control number

Retirement

plan

Third-party

sick pay

Statutory

employee

6

2

Employer’s name, address, and ZIP code

7

Advance EIC payment

8

9 10

Wages, tips, other compensation Guam income tax withheld

Social security wages Social security tax withheld

11 12a

3 4

Employer identification number (EIN)

Medicare wages and tips

Social security tips

13

5

Employee’s social security number

Employee’s first name and initial Nonqualified plans

Medicare tax withheld

14 Other

Employee’s address and ZIP code

a

b

c

d

e

f

OMB No. 1545-0008

Last name C

o

d

e

12b

C

o

d

e

12c

C

o

d

e

12d

C

o

d

e

See instructions for box 12

020

030

040

045

050

055

060

080

090

100

120 130

140 150

160 170

180

200

220 *242 +244 +246

265 267 252 254 256

257 258 259

260 261 262

*270 "STM nn" +272

B-33

269

110 113 115

105

070 073 075

280 282

290 292

300 "N" or "S"

010
Foreign Employer Compensation (FEC) Template 

SSN or ITIN of Employee of Foreign Employer 

Employee Name and Address 

Services Performed While Residing in U.S. 

 Yes (If “Yes” enter “00” in Post of Duty Field) 

Post of Duty Code 

Foreign Employer’s Name and Address 

Foreign Employer’s Identification Number 

Foreign Employer Compensation Amount 

010

020

030

040

050

060 070 080

090 100 110

120

130

140

150

160

170 180 190 200

210

220

B-34
Form 970 Application To Use LIFO Inventory Method OMB No. 1545-0042

(Rev. December 2005)

 Attach to your tax return. Department of the Treasury

Internal Revenue Service

For Paperwork Reduction Act Notice, see the instructions.

Name of filer (name of parent corporation if a consolidated group) (see instructions) Filer’s identification number (see instructions)

Cat. No. 17057T Form 970 (Rev. 12-2005)

Part I

Part II

Statement of Election under Section 472

LIFO Inventory Requirements

Attachment

Sequence No. 122

Name of applicant(s) (if different from filer) and identification number(s)

1

2

3a

4a

The applicant elects to use the LIFO inventory method for the tax year ending (enter month, day, year) 

Yes No

for the following goods (enter here):

See instructions and attach a statement if necessary.

In an attached statement, identify and describe the inventory method(s) used by the applicant in the prior tax year

for the goods covered by this election.

Is the applicant already using the LIFO inventory method for any other goods?

If “Yes” to line 3a, attach a statement identifying and describing the goods and the LIFO methods used.

Has the applicant ever used the LIFO inventory method for the goods covered by this election?

If “Yes” to line 4a, attach a statement listing the tax years for which the LIFO inventory method was used and

explaining why the LIFO inventory method was discontinued.

The applicant will not use the LIFO inventory method to account for the following goods (enter here): 

Attach a statement if necessary.

5

b

b

6a Did the applicant value the closing inventories of goods covered by this election at cost for the tax year immediately

preceding the tax year specified on line 1?

b If “No” to line 6a, did the applicant value the beginning inventories of goods covered by this election at cost for

the tax year specified on line 1 as required by section 472(d)?

If “No” to line 6b, attach an explanation.

c If “Yes” to line 6b, will the applicant account for the adjustment required by section 472(d) over a 3-year period?

If “No” to line 6c, attach an explanation.

7a When determining the beginning inventories of goods covered by this election, did the applicant treat those goods

as being acquired for a unit cost that is equal to the total cost of those goods divided by the total number of units

on hand?

b If “No” to line 7a, attach an explanation.

8a Did the applicant (or any member of the same group of financially related corporations as defined in section 472(g))

issue credit statements or reports to shareholders, partners, other proprietors, or beneficiaries covering the tax

year specified on line 1?

b If “Yes” to line 8a, attach a statement describing the recipient(s), the date(s) of issuance, and the inventory method(s)

used to determine income, profit, or loss in those statements.

9a Will the applicant determine beginning and ending inventories at cost regardless of market value?

b If “No” to line 9a, attach an explanation.

10a As a condition of adopting the LIFO inventory method, Regulations section 1.472-4 requires a taxpayer to agree

to make any adjustments incident to the change to, the change from, or the use of, the LIFO inventory method

that, upon the examination of the taxpayer’s income tax return, the IRS determines are necessary to clearly reflect

income. Does the applicant agree to this condition?

Yes No

Part III

11 Under Regulations section 1.472-1, the types of goods in the opening inventory must be compared with similar types of

goods in the closing inventories. Attach a list of the types or categories of goods that will be compared, describe the

goods that will be included in each type or category, and identify the unit of measure (pounds, barrels, feet, etc.) used for

each type or category.

Specific Goods (Unit) Method

b If “No” to line 10a, the applicant is not eligible to use the LIFO inventory method and does not need to file Form 970.

060

@070 "STM nn"

@125 "STM nn"

B-35

080 090

120

@115 "STM nn"

140

@185 "STM nn"

@225 "STM nn"

@205 "STM nn"

250

@245 "STM nn"

110

@065 "STM nn"

@095 "STM nn"

130

210

150 160

170

190 200

@165 "STM nn"

240

260

@270 "STM nn"

100

180

220

230
Form 970 (Rev. 12-2005) Page 2

Form 970 (Rev. 12-2005)

Part VI

Part III

Part V

Part IV

12

13

14a

15

16

17

18

19

20

21

22

23

Check the box corresponding to the method that the applicant will use to determine the cost of the goods in the closing

inventories in excess of the cost of the goods in the opening inventories (see instructions):

Specific Goods (Unit) Method (Continued)

Actual cost of goods most recently purchased or produced

Average cost of goods purchased or produced during the tax year

Actual cost of goods purchased or produced in the order of acquisition

Other (attach explanation)

Dollar-Value Method

Inventory Price Index Computation (IPIC) Method

Other Information

Attach a statement describing the applicant’s method of defining “items.”

Did the applicant acquire any of the goods covered by this election at below-market prices?

If “Yes” to line 14a, attach a statement explaining whether the applicant did, or will, account for the goods purchased at

below-market prices and similar goods produced or acquired at market prices as separate items. If the applicant did, or will,

account for both types of goods as the same item, explain and justify.

Attach a statement describing the method of pooling the applicant will use for the goods covered by this election. If the

applicant will use more than one dollar-value pool, list and describe the contents of each dollar-value pool (see instructions).

Identify or describe the method the applicant will use to compute the LIFO value of each dollar-value pool containing goods

covered by this election (for example, double-extension method, link-chain method, or index method). 

Check the box corresponding to the method the applicant will use to determine the current-year cost of goods in the closing

inventories and to value the LIFO increments of the dollar-value pool(s) (see instructions).

Actual cost of goods most recently purchased or produced

Average cost of goods purchased or produced during the tax year

Actual cost of goods purchased or produced in the order of acquisition

Other (attach explanation)

Yes No

b

Check the box corresponding to the method the applicant will use to compute the LIFO value of each dollar-value pool

containing goods covered by this election (see instructions).

Double-extension IPIC method

Link-chain IPIC method

Check the box corresponding to the table from which the applicant will select Bureau of Labor Statistics (BLS) price indexes

(see instructions).

Table 3 of the Consumer Price Index (CPI) Detailed Report

Table 6 of the Producer Price Index (PPI) Detailed Report

Other table of the PPI Detailed Report

If the applicant will use “Other table of the PPI Detailed Report,” attach a statement explaining why the other table is more

appropriate than Table 6.

Will the applicant use the 10 percent method (see instructions)? Yes No

If the applicant elects to use a representative month for selecting BLS price indexes from the applicable Detailed Report, enter

the representative month elected for each dollar-value pool.

See instructions and attach a statement if necessary.

Attach a statement describing the applicant’s method of determining the cost of inventory items (for example, standard cost

method, actual invoice cost, joint product cost method, or retail inventory method).

Did the applicant receive IRS consent to change the method of valuing inventories for the tax year specified

on line 1 (see instructions)? Yes No

If the applicant’s method is neither the double-extension method nor the Inventory Price Index Computation method, attach

a statement describing the method in detail and justifying the applicant’s use of the selected method (see instructions).

@405 "STM nn"

330

@365 "STM nn"

340

360

@345 "STM nn"

390

400

@320 "STM nn"

410

460

430

470

@455 "STM nn"

480

450

B-36

500 505

@495 "STM nn"

300

370

440

@485 "STM nn"

290

293

310 @315 "STM nn"

@355 "STM nn"

380

420
Reduction of Tax Attributes Due to Discharge of

Indebtedness (and Section 1082 Basis Adjustment)

Form 982 OMB No. 1545-0046

(Rev. November 2004)

Department of the Treasury

Internal Revenue Service  Attach this form to your income tax return.

Name shown on return Identifying number

General Information (see instructions)

1 Amount excluded is due to (check applicable box(es)):

a Discharge of indebtedness in a title 11 case

b Discharge of indebtedness to the extent insolvent (not in a title 11 case)

c Discharge of qualified farm indebtedness

2 Total amount of discharged indebtedness excluded from gross income 2

Do you elect to treat all real property described in section 1221(a)(1), relating to property held for sale to

customers in the ordinary course of a trade or business, as if it were depreciable property? Yes No

Reduction of Tax Attributes. You must attach a description of any transactions resulting in the reduction in basis under section

1017. See Regulations sections 1.1017-1 and 1.1017-1T for basis reduction ordering rules, and, if applicable, required partnership

consent statements. (For additional information, see the instructions for Part II.)

Enter amount excluded from gross income:

That you elect under section 108(b)(5) to apply first to reduce the basis (under section 1017) of

depreciable property

5

5

Applied to reduce any net operating loss that occurred in the tax year of the discharge or carried

over to the tax year of the discharge

6

6

7 Applied to reduce any general business credit carryover to or from the tax year of the discharge 7

8

Applied to reduce any net capital loss for the tax year of the discharge including any capital loss

carryovers to the tax year of the discharge

8

9

9

10

11a

b 11b

c Other property used or held for use in a trade or business, or for the production of income 11c

Applied to reduce any foreign tax credit carryover to or from the tax year of the discharge

11

Consent of Corporation to Adjustment of Basis of its Property Under Section 1082(a)(2)

Under section 1081(b), the corporation named above has excluded $ from its gross income

for the tax year beginning , and ending .

Under that section the corporation consents to have the basis of its property adjusted in accordance with the regulations prescribed

under section 1082(a)(2) in effect at the time of filing its income tax return for that year. The corporation is organized under the

laws of . (State of incorporation)

Note: You must attach a description of the transactions resulting in the nonrecognition of gain under section 1081.

Form 982 (Rev. 11-2004)

For a discharge of qualified farm indebtedness, applied to reduce the basis of:

Applied to reduce the basis of nondepreciable and depreciable property if not reduced on line

5. DO NOT use in the case of discharge of qualified farm indebtedness

Land used or held for use in a trade or business of farming

Part I

Part II

Part III

3

Cat. No. 17066E

Attachment

Sequence No. 94

Discharge of qualified real property business indebtedness

For a discharge of qualified real property business indebtedness, applied to reduce the basis of

depreciable real property

Depreciable property used or held for use in a trade or business, or for the production of income, if

not reduced on line 5

4

a

4

d

Applied to reduce any minimum tax credit as of the beginning of the tax year immediately after

the tax year of the discharge

Applied to reduce any passive activity loss and credit carryovers from the tax year of the discharge

10

13

12

13

For Paperwork Reduction Act Notice, see page 3 of this form.

12

010

020

030

040

050

060

070 080

@085 "STM nn" or blank

090

100

110

120

130

140

150

160

170

180

190

200

210

220 230

240

@250 "STM nn" or blank

B-37
Expenses definitely related to the income on

line 1 (attach statement)

OMB No. 1545-0121 Foreign Tax Credit

Form 1116 (Individual, Estate, or Trust)

Department of the Treasury

Internal Revenue Service

 Attach to Form 1040, 1040NR, 1041, or 990-T. Attachment

 See separate instructions. Sequence No. 19

Name Identifying number as shown on page 1 of your tax return

Passive income Lump-sum distributions

High withholding tax Dividends from a DISC or former DISC

interest

Financial services income General limitation income

Certain distributions from a foreign

sales corporation (FSC) or former

FSC

Resident of (name of country) 

Note: If you paid taxes to only one foreign country or U.S. possession, use column A in Part I and line A in Part II. If you paid taxes to

more than one foreign country or U.S. possession, use a separate column and line for each country or possession.

Taxable Income or Loss From Sources Outside the United States (for Category Checked Above)

Foreign Country or U.S. Possession Total

A B C (Add cols. A, B, and C.)

Enter the name of the foreign country or U.S.

possession 

Gross income from sources within country

shown above and of the type checked above (see

page 13 of the instructions):

1

1

Deductions and losses (Caution: See pages 13 and 14

of the instructions):

2

3 Pro rata share of other deductions not definitely

related:

Certain itemized deductions or standard

deduction (see instructions)

a

b Other deductions (attach statement)

c Add lines 3a and 3b

d Gross foreign source income (see instructions)

e Gross income from all sources (see instructions)

f Divide line 3d by line 3e (see instructions)

g Multiply line 3c by line 3f

4 Pro rata share of interest expense (see instructions):

a Home mortgage interest (use worksheet on

page 13 of the instructions)

b Other interest expense

5 Losses from foreign sources

6 Add lines 2, 3g, 4a, 4b, and 5 6

7 Subtract line 6 from line 1. Enter the result here and on line 14, page 2  7

Foreign Taxes Paid or Accrued (see page 14 of the instructions)

Credit is claimed Foreign taxes paid or accrued for taxes

(you must check one) In foreign currency In U.S. dollars

Paid (s) Other

foreign taxes

paid or

accrued

(w) Other

foreign taxes

paid or

accrued

(x) Total foreign

taxes paid or

accrued (add cols.

(t) through (w))

Taxes withheld at source on: Taxes withheld at source on: Accrued

Country

(q) Rents

and royalties

(u) Rents

and royalties

(o) Date paid

or accrued (p) Dividends (r) Interest (t) Dividends (v) Interest

A

B

C

8 Add lines A through C, column (x). Enter the total here and on line 9, page 2  8

For Paperwork Reduction Act Notice, see page 18 of the instructions. Form 1116 (2005)

Shipping income

Cat. No. 11440U

Part I

Part II

a

b

c

d

e

g

h

i

k

(m)

(n)

l

Use a separate Form 1116 for each category of income listed below. See Categories of Income on page 3 of the instructions. Check only one

box on each Form 1116. Report all amounts in U.S. dollars except where specified in Part II below.

f

Section 901(j) income

j

Certain income re-sourced by treaty

(99)

2005

010 "AMT"

020

030

040

050

060

070

080

093

096

098

100

130

140

150

160

170

180

185

190

200

@205

"STM nn"

210

220

@225

"STM nn"

230

240

250

260

270

280

290

300

310

320

@325

"STM nn"

330

340

@345

"STM nn"

350

360

370

380

390

400

410

420

430

440

@445

"STM nn"

450

460

@465

"STM nn"

470

480

490

500

510

520

530

540

550 560

570

580

590

600 610 620 630 640 650 660 670 680 690

700 710 720 730 740 750 760 770 780 790

800 810 820 830 840 850 860 870 880 890

@900 "STM nn" 910

B-38

@45 "STN nn"

@645 "STM nn" @745 "STM nn"

@845 "STM nn"
Form 1116 (2005) Page 2

Figuring the Credit

9 Enter the amount from line 8. These are your total foreign taxes paid

or accrued for the category of income checked above Part I 9

10 Carryback or carryover (attach detailed computation) 10

11 Add lines 9 and 10 11

12 Reduction in foreign taxes (see page 15 of the instructions) 12

13 Subtract line 12 from line 11. This is the total amount of foreign taxes available for credit 13

14 Enter the amount from line 7. This is your taxable income or (loss) from

sources outside the United States (before adjustments) for the category

of income checked above Part I (see page 15 of the instructions) 14

15 Adjustments to line 14 (see page 16 of the instructions) 15

16 Combine the amounts on lines 14 and 15. This is your net foreign

source taxable income. (If the result is zero or less, you have no foreign

tax credit for the category of income you checked above Part I. Skip

lines 17 through 21. However, if you are filing more than one Form

1116, you must complete line 19.)

Individuals: Enter the amount from Form 1040, line 41 (minus any

amount on Form 8914, line 2). If you are a nonresident alien, enter the

amount from Form 1040NR, line 38 (minus any amount on Form 8914,

line 2). Estates and trusts: Enter your taxable income without the

deduction for your exemption

17

17

18 Divide line 16 by line 17. If line 16 is more than line 17, enter “1” 18

Individuals: Enter the amount from Form 1040, line 44. If you are a nonresident alien, enter the amount

from Form 1040NR, line 41.

19

19

20 Multiply line 19 by line 18 (maximum amount of credit) 20

Enter the smaller of line 13 or line 20. If this is the only Form 1116 you are filing, skip lines 22 through

30 and enter this amount on line 31. Otherwise, complete the appropriate line in Part IV (see 

page 18 of the instructions) 

21

21

Summary of Credits From Separate Parts III (see page 18 of the instructions)

22 Credit for taxes on passive income 22

23 Credit for taxes on high withholding tax interest 23

24 Credit for taxes on financial services income 24

25 Credit for taxes on shipping income 25

26

Credit for taxes on dividends from a DISC or former DISC and certain

distributions from a FSC or former FSC

26

27

Credit for taxes on certain income re-sourced by treaty

27

28

Credit for taxes on lump-sum distributions

28

29 Credit for taxes on general limitation income 29

30 Add lines 22 through 29 30

32 Reduction of credit for international boycott operations. See instructions for line 12 on page 15 32

33 Subtract line 32 from line 31. This is your foreign tax credit. Enter here and on Form 1040, line 47;

Form 1040NR, line 44; Form 1041, Schedule G, line 2a; or Form 990-T, line 40a  33

Part IV

Part III

Caution: If you figured your tax using the lower rates on qualified dividends or capital gains, see

page 17 of the instructions.

16

Estates and trusts: Enter the amount from Form 1041, Schedule G, line 1a, or the total of Form 990-T,

lines 36 and 37

Form 1116 (2005)

31 Enter the smaller of line 19 or line 30 31

Caution: If you are completing line 19 for separate category g (lump-sum distributions), see page 18 of the instructions.

930

@940 "STM nn" 950

960

@970 "STM nn" 980

990

1000

@1010 "STM nn" 1020

1030

1040

1050

1060

1070

1080 "LSD" 1090

1100

1110

1120

1130

1135

1160

1175

1177

1180

1190

1200

B-39

1185
OMB No. 1545-0074 Statement of Person Claiming

Refund Due a Deceased Taxpayer Form 1310

(Rev. November 2005)

Attachment

Sequence No. 87 Department of the Treasury

Internal Revenue Service  See instructions below and on back.

Tax year decedent was due a refund:

Calendar year , or other tax year beginning , 20 , and ending , 20

Name of decedent Date of death Decedent’s social security number

Name of person claiming refund

Home address (number and street). If you have a P.O. box, see instructions.

City, town or post office, state, and ZIP code. If you have a foreign address, see instructions.

Check the box that applies to you. Check only one box. Be sure to complete Part III below.

A Surviving spouse requesting reissuance of a refund check (see instructions).

B Court-appointed or certified personal representative (defined below). Attach a court certificate showing your appointment,

unless previously filed (see instructions).

Complete this part only if you checked the box on line C above.

1 Did the decedent leave a will?

2a Has a court appointed a personal representative for the estate of the decedent?

3 As the person claiming the refund for the decedent’s estate, will you pay out the refund according to the laws

of the state where the decedent was a legal resident?

Signature and verification. All filers must complete this part.

I request a refund of taxes overpaid by or on behalf of the decedent. Under penalties of perjury, I declare that I have examined this claim, and to

the best of my knowledge and belief, it is true, correct, and complete.

Signature of person claiming refund Date

Form 1310 (Rev. 11-2005)

Part I

Part II

Cat. No. 11566B

Part III

Please

print

or

type

General Instructions

Purpose of Form

Who Must File

● You are a surviving spouse filing an original or amended

joint return with the decedent, or

● You are a personal representative (defined on this page)

filing an original Form 1040, Form 1040A, Form 1040EZ, or

Form 1040NR for the decedent and a court certificate

showing your appointment is attached to the return.

Use Form 1310 to claim a refund on behalf of a deceased

taxpayer.

If you are claiming a refund on behalf of a deceased

taxpayer, you must file Form 1310 unless either of the

following applies:

Example. Assume Mr. Green died on January 4 before

filing his tax return. On April 3 of the same year, you were

appointed by the court as the personal representative for Mr.

Green’s estate and you file Form 1040 for Mr. Green. You do

not need to file Form 1310 to claim the refund on Mr. Green’s

C Person, other than A or B, claiming refund for the decedent’s estate (see instructions). Also, complete Part II.



Personal Representative

Apt. no.

If you answered “No” to 2a, will one be appointed?

If you answered “No” to 3, a refund cannot be made until you submit a court certificate showing your appointment

as personal representative or other evidence that you are entitled under state law to receive the refund.



For purposes of this form, a personal representative is the

executor or administrator of the decedent’s estate, as

appointed or certified by the court. A copy of the decedent’s

For Privacy Act and Paperwork Reduction Act Notice, see page 2.

If you answered “Yes” to 2a or 2b, the personal representative must file for the refund.

Yes No

b

Your social security number

tax return. However, you must attach to his return a copy of

the court certificate showing your appointment.

Where To File 

● Follow the instructions for the form to which you are

attaching Form 1310, or

● Send it to the same Internal Revenue Service Center where

the original return was filed if you are filing Form 1310

separately. If the original return was filed electronically, mail

Form 1310 to the Internal Revenue Service Center

designated for the address shown on Form 1310 above. See

the instructions for the original return for the address.

If you checked the box on line A, you can return the

joint-name check with Form 1310 to your local IRS office or

the Internal Revenue Service Center where you filed your

return. If you checked the box on line B or line C, then:

/ /

010

020 030 040

060

110 120

130 140 150 160

050

170

180

190 200

210 220

230 240

250 260

270 280

290 300

070

B-40
OMB No. 1545-0074 Employee Business Expenses Form 2106

 See separate instructions.

Department of the Treasury

Internal Revenue Service  Attach to Form 1040.

Attachment

Sequence No. 54

Your name Occupation in which you incurred expenses Social security number

Employee Business Expenses and Reimbursements

Column A Column B

Step 1 Enter Your Expenses Meals and

Entertainment

Other Than Meals

and Entertainment

1

Vehicle expense from line 22c or line 29. (Rural mail carriers: See

instructions.)

1

2

Parking fees, tolls, and transportation, including train, bus, etc., that

did not involve overnight travel or commuting to and from work 

2

Travel expense while away from home overnight, including lodging, 

airplane, car rental, etc. Do not include meals and entertainment

3

3

Business expenses not included on lines 1 through 3. Do not

include meals and entertainment

4

4

5 Meals and entertainment expenses (see instructions) 5

Total expenses. In Column A, add lines 1 through 4 and enter the

result. In Column B, enter the amount from line 5

6

6

Note: If you were not reimbursed for any expenses in Step 1, skip line 7 and enter the amount from line 6 on line 8.

Step 2 Enter Reimbursements Received From Your Employer for Expenses Listed in Step 1

Enter reimbursements received from your employer that were not

reported to you in box 1 of Form W-2. Include any reimbursements 

reported under code “L” in box 12 of your Form W-2 (see

instructions)

7

7

Step 3 Figure Expenses To Deduct on Schedule A (Form 1040)

8

Subtract line 7 from line 6. If zero or less, enter -0-. However, if

line 7 is greater than line 6 in Column A, report the excess as

income on Form 1040, line 7

8

Note: If both columns of line 8 are zero, you cannot deduct

employee business expenses. Stop here and attach Form 2106 to 

your return.

9

9

10

In Column A, enter the amount from line 8. In Column B, multiply

line 8 by 50% (.50). (Employees subject to Department of

Transportation (DOT) hours of service limits: Multiply meal

expenses incurred while away from home on business by 70% (.70) 

instead of 50%. For details, see instructions.)

Add the amounts on line 9 of both columns and enter the total here. Also, enter the total on 

Schedule A (Form 1040), line 20. (Reservists, qualified performing artists, fee-basis state or

local government officials, and individuals with disabilities: See the instructions for special rules 

on where to enter the total.)  10

For Paperwork Reduction Act Notice, see instructions. Cat. No. 11700N Form 2106 (2005)

Part I

(99)

2005

008

010

013

017

023

027

033

100

115

B-41

009

025

031

041

105

120

125
Form 2106 (2005) Page 2

Vehicle Expenses

Section A—General Information (You must complete this section if you

are claiming vehicle expenses.) (a) Vehicle 1 (b) Vehicle 2

11 Enter the date the veh 11 / / icle was placed in service

12 Total miles the vehicle was driven during 2005 12 miles miles

13 Business miles included on line 12 13 miles miles

14 Percent of business use. Divide line 13 by line 12 14 % %

15 Average daily roundtrip commuting distance 15 miles miles

16 Commuting miles included on line 12 16 miles miles

17 Other miles. Add lines 13 and 16 and subtract the total from line 12 17 miles miles

18 Do you (or your spouse) have another vehicle available for personal use? Yes No

19 Was your vehicle available for personal use during off-duty hours? Yes No

Yes No

21 If “Yes,” is the evidence written? Yes No

20 Do you have evidence to support your deduction?

Section B—Standard Mileage Rate (See the instructions for Part II to find out whether to complete this section or Section C.)

22a Multiply business miles driven before September 1, 2005 by 40.5¢ (.405) 22a

Section C—Actual Expenses (a) Vehicle 1 (b) Vehicle 2

Gasoline, oil, repairs, vehicle

insurance, etc.

23

23

24a Vehicle rentals 24a

b Inclusion amount (see instructions) 24b

c Subtract line 24b from line 24a 24c

Value of employer-provided

vehicle (applies only if 100% of

annual lease value was included 

on Form W-2—see instructions)

25

25

26 Add lines 23, 24c, and 25 26

Multiply line 26 by the

percentage on line 14

27

27

28 Depreciation (see instructions) 28

29 Add lines 27 and 28. Enter total

here and on line 1 29

Section D—Depreciation of Vehicles (Use this section only if you owned the vehicle and are completing Section C for the vehicle.)

(a) Vehicle 1 (b) Vehicle 2

Enter cost or other basis (see

instructions)

30

30

Enter section 179 deduction

(see instructions) 

31

31

Multiply line 30 by line 14 (see

instructions if you claimed the

section 179 deduction or

special allowance)

32

32

Enter depreciation method and

percentage (see instructions)

33

33

Multiply line 32 by the percentage 

on line 33 (see instructions)

34

34

35 Add lines 31 and 34 35

Enter the applicable limit explained

in the line 36 instructions

36

36

Multiply line 36 by the

percentage on line 14

37

37

Enter the smaller of line 35

or line 37. If you skipped lines 

36 and 37, enter the amount 

from line 35. Also enter this

amount on line 28 above

38

38

Part II

/ /

Form 2106 (2005)

Multiply business miles driven after August 31, 2005 by 48.5¢ (.485)

Add lines 22a and 22b. Enter the result here and on line 1

22b

22c

b

c

*134 "STM nn"

+135

+145

+155

+165

+175

+185

195

205

215

225

235

245

256

270 275

280 283

290 295

300 305

315

325

335

345

355

358

370

375

380

383

437

439

441

443

445

447

449

451

453

490

495

505

515

530

540

544

546

550

560

600

602

604

606

610

612

614

616

B-42

309

312
OMB No. 1545-0074 2106-EZ Unreimbursed Employee Business Expenses Form

Department of the Treasury

Internal Revenue Service  Attach to Form 1040.

Attachment

Sequence No. 54A

Your name Occupation in which you incurred expenses Social security number

1 Vehicle expense using the standard mileage rate. Complete Part II and then go to line 1a below.

2

Parking fees, tolls, and transportation, including train, bus, etc., that did not involve overnight

travel or commuting to and from work

2

Travel expense while away from home overnight, including lodging, airplane, car rental, etc.

Do not include meals and entertainment

3

3

Business expenses not included on lines 1c through 3. Do not include meals and

entertainment

4

4

5

Meals and entertainment expenses: $ × 50% (.50) (Employees subject to

Department of Transportation (DOT) hours of service limits: Multiply meal expenses incurred

while away from home on business by 70% (.70) instead of 50%. For details, see instructions.)

5

Total expenses. Add lines 1c through 5. Enter here and on Schedule A (Form 1040), line

20. (Armed Forces reservists, fee-basis state or local government officials, qualified performing

artists, and individuals with disabilities: See the instructions for special rules on where to enter

this amount.)

6

6

Cat. No. 20604Q Form 2106-EZ (2005)

Part I

Part II

Figure Your Expenses

You May Use This Form Only if All of the Following Apply.

● You are an employee deducting ordinary and necessary expenses attributable to your job. An ordinary expense is one that is

common and accepted in your field of trade, business, or profession. A necessary expense is one that is helpful and appropriate

for your business. An expense does not have to be required to be considered necessary.

● If you are claiming vehicle expense, you are using the standard mileage rate for 2005.

● You do not get reimbursed by your employer for any expenses (amounts your employer included in box 1 of your Form W-2 are

not considered reimbursements for this purpose).

Information on Your Vehicle. Complete this part only if you are claiming vehicle expense on line 1.

7

8

a

9

10

11a

b

When did you place your vehicle in service for business use? (month, day, year)  / /

Of the total number of miles you drove your vehicle during 2005, enter the number of miles you used your vehicle for:

Do you (or your spouse) have another vehicle available for personal use?

Was your vehicle available for personal use during off-duty hours?

Do you have evidence to support your deduction?

If “Yes,” is the evidence written?

Business

Yes No

b Commuting (see instructions) c Other

Yes No

Yes No

Yes No

(99)

For Paperwork Reduction Act Notice, see page 3.

Caution: You can use the standard mileage rate for 2005 only if: (a) you owned the vehicle and used the standard mileage rate for the first year

you placed the vehicle in service, or (b) you leased the vehicle and used the standard mileage rate for the portion of the lease period after 1997.

2005

Mulitply business miles driven before September 1, 2005, by 40.5¢ (.405)

Add lines 1a and 1b

a

b

c

Mulitply business miles driven after August 31, 2005, by 48.5¢ (.485)

1c

1a

1b

008 009

015

017

023

025

031

134

145 175 185

270 275

280 283

290 295

300 305

B-43

027

011

012

014
Form 2120 OMB No. 1545-0074

(Rev. October 2005) Multiple Support Declaration

Attachment

Sequence No. 114 Department of the Treasury

Internal Revenue Service  Attach to Form 1040 or Form 1040A.

Name(s) shown on return Your social security number

During the calendar year , the eligible persons listed below each paid over 10% of the support of:

Name of your qualifying relative

I have a signed statement from each eligible person waiving his or her right to claim this person as a dependent for any tax year

that began in the above calendar year.

Eligible person’s name Social security number

Address (number, street, apt. no., city, state, and ZIP code)

Instructions

Paperwork Reduction Act Notice. We ask for the information on this

form to carry out the Internal Revenue laws of the United States. You are

required to give us the information. We need it to ensure that you are

complying with these laws and to allow us to figure and collect the right

amount of tax.

The average time and expenses required to complete and file this form

will vary depending on individual circumstances. For the estimated

averages, see the instructions for your income tax return.

If you have suggestions for making this form simpler, we would be

happy to hear from you. See the instructions for your income tax return.

Purpose of Form

Cat. No. 11712F Form 2120 (Rev. 10-2005)

Claiming a Qualifying Relative

Generally, to claim a person as a qualifying relative, you must pay

over half of that person’s support. However, even if you did not meet

this support test, you may be able to claim him or her as a

dependent if all five of the following apply.

1. You and one or more other eligible person(s) (see above)

together paid over half of that person’s support.

2. You paid over 10% of the support.

3. No one alone paid over half of that person’s support.

4. The other dependency tests are met. See Step 4, Is Your

Qualifying Relative Your Dependent? in the Form 1040 or Form

1040A instructions.

5. Each other eligible person who paid over 10% of the support

agrees not to claim that person as a dependent by giving you a

signed statement. See Signed Statement on this page.

Additional Information

See Pub. 501 for details.

You are not required to provide the information requested on a form

that is subject to the Paperwork Reduction Act unless the form displays a

valid OMB control number. Books or records relating to a form or its

instructions must be retained as long as their contents may become

material in the administration of any Internal Revenue law. Generally, tax

returns and return information are confidential, as required by Internal

Revenue Code section 6103.

An eligible person is someone who could have claimed a person

as a dependent except that he or she did not pay over half of that

person’s support.

Use Form 2120 to:

Note. To find out what is included in support, see Pub. 501,

Exemptions, Standard Deduction, and Filing Information.

Eligible person’s name Social security number

Address (number, street, apt. no., city, state, and ZIP code)

Eligible person’s name Social security number

Address (number, street, apt. no., city, state, and ZIP code)

Eligible person’s name Social security number

Address (number, street, apt. no., city, state, and ZIP code)

● Identify each other eligible person (see below) who paid over 10%

of the support of your qualifying relative whom you are claiming as a

dependent, and

● Indicate that you have a signed statement from each other eligible

person waiving his or her right to claim that person as a dependent.

If there are more than four other eligible persons, attach a

statement to your return with the required information.

Signed Statement

You must have received, from each other eligible person listed

above, a signed statement waiving his or her right to claim the

person as a dependent for the calendar year indicated on this form.

The statement must include:

● The calendar year the waiver applies to,

● The name of your qualifying relative the eligible person helped to

support, and

● The eligible person’s name, address, and social security number.

Do not file the signed statement with your return. But you must keep

it for your records and be prepared to furnish it and any other

information necessary to show that you qualify to claim the person

as your dependent.

What’s New

The rules for multiple support agreements still apply to claiming an

exemption for a qualifying relative, but they no longer apply to

claiming an exemption for a qualifying child. For the definitions of

“qualifying relative” and “qualifying child,” see your tax return

instruction booklet.

010

020 030

*040 "STM nn" +050

100

120, 130, 140, 150

160, 165

110

170

+045

+ 070 +080 + 090

105

180, 190, 200, 210

220 - 225 230

240, 250, 260, 270

B-44

*+060 "STM nn"
Draft as of

09/22/2005

OMB No. 1545-0140 Underpayment of

Estimated Tax by Individuals, Estates, and Trusts Form 2210

 See separate instructions. Department of the Treasury

Internal Revenue Service

Attachment

 Attach to Form 1040, 1040A, 1040NR, 1040NR-EZ, or 1041. Sequence No. 06

Name(s) shown on tax return Identifying number

Required Annual Payment (see page 2 of the instructions)

Enter your 2005 tax after credits from Form 1040, line 57 (or comparable line of your return) 1

2 Other taxes, including self-employment tax (see page 2 of the instructions) 2

3

3

4 Current year tax. Combine lines 1, 2, and 3. If less than $1,000, see page 2 of the instructions 4

5

Withholding taxes. Do not include estimated tax payments. See page 2 of the instructions 6

Maximum required annual payment based on prior year’s tax (see page 2 of the instructions)

6

8

Required annual payment. Enter the smaller of line 5 or line 8

7

9

Refundable credits. Enter the total of your earned income credit, additional child tax credit, credit

for federal tax paid on fuels, and health coverage tax credit for eligible individuals 

9

Next: Is line 9 more than line 6?

Yes. You may owe a penalty, but do not file Form 2210 unless one or more boxes in Part II below applies.

For Paperwork Reduction Act Notice, see page 6 of separate instructions. Form 2210 (2005)

Reasons for Filing. Check applicable boxes. If none apply, do not file Form 2210.

A You request a waiver (see page 1 of the instructions) of your entire penalty. You must check this box and file page 1

of Form 2210, but you are not required to figure your penalty.

B You request a waiver (see page 1 of the instructions) of part of your penalty. You must figure your penalty and waiver

amount and file Form 2210.

C Your income varied during the year and your penalty is reduced or eliminated when figured using the annualized

income installment method. You must figure the penalty using Schedule Al and file Form 2210.

D

Cat. No. 11744P

Part I

Part II

Your penalty is lower when figured by treating the federal income tax withheld from your wages as paid on the 

dates it was actually withheld, instead of in equal amounts on the payment due dates. You must figure your penalty

and file Form 2210.

● If box B, C, or D applies, you must figure your penalty and file Form 2210.

Multiply line 4 by 90% (.90) 5

Subtract line 6 from line 4. If less than $1,000, you do not owe a penalty; do not file Form 2210 7

8

Do You Have To File Form 2210?

Complete lines 1 through 7 below. Is line 7 less than $1,000?

You are not required to figure your penalty because

the IRS will figure it and send you a bill for any unpaid

amount. If you want to figure it, you may use Part III

or Part IV as a worksheet and enter your penalty

amount on your tax return (see page 2 of the

instructions), but file only page 1 of Form 2210.

Yes

No

No

No









Complete lines 8 and 9 below. Is line 6 equal to or more

than line 9?

No



You may owe a penalty. Does any box in Part II below apply?

Yes

You must file Form 2210. Does box B, C, or D apply?







Yes

Yes

Do not file Form 2210. You do not owe a penalty.

You do not owe a penalty. Do not file Form 2210 (but

if box E below applies, you must file page 1 of

Form 2210 below).

No. You do not owe a penalty. Do not file Form 2210 unless box E below applies.

1

● If only box A or E (or both) applies, file only page 1 of Form 2210. You are not required to figure your penalty; the IRS

will figure it and send you a bill for any unpaid amount. If you want to figure your penalty, you may use Part III or IV as a

worksheet and enter your penalty on your tax return (see page 2 of the instructions), but file only page 1 of Form 2210.

You filed or are filing a joint return for either 2004 or 2005, but not for both years, and line 8 above is smaller than

line 5 above. You must file page 1 of Form 2210, but you are not required to figure your penalty (unless box B,

C, or D applies).

E

Do not file Form 2210. You are not required to figure

your penalty because the IRS will figure it and send

you a bill for any unpaid amount. If you want to figure

it, you may use Part III or Part IV as a worksheet and

enter your penalty amount on your tax return (see

page 2 of the instructions), but do not file Form 2210.

You must figure your penalty.

( )

2005

025

045

035

055

075

085

092

106

173

165

155

145

135

065

115

125

B-45
Draft as of

09/22/2005

Form 2210 (2005) Page 2

Form 2210 (2005)

Short Method

Enter the amount, if any, from Form 2210, line 6 11

Enter the total amount, if any, of estimated tax payments you made

11

12

Add lines 11 and 12

12

Total underpayment for year. Subtract line 13 from line 10. If zero or less, stop here; you do

not owe the penalty. Do not file Form 2210 unless you checked box E on page 1

13 13

14

Multiply line 14 by .XXXXX

14

● If the amount on line 14 was paid on or after 4/15/06, enter -0-.

15

● If the amount on line 14 was paid before 4/15/06, make the following computation to find the

amount to enter on line 16. Number of days paid

before 4/15/06

Amount on

line 14  

15

.XXXXX

16

Penalty. Subtract line 16 from line 15. Enter the result here and on Form 1040, line 76; Form

1040A, line 48; Form 1040NR, line 74; Form 1040NR-EZ, line 26; or Form 1041, line 26 

16

17

17

Part III

● You made any estimated tax payments late,

● You checked box C or D in Part II, or

10 Enter the amount from Form 2210, line 9 10

You must use the regular method (Part IV) instead of the short method if:

● You made no estimated tax payments (or your only payments were

withheld federal income tax), or

● You paid estimated tax in equal amounts on your due dates.

You may use the short method if:

● You are filing Form 1040NR or 1040NR-EZ and you did not receive

wages as an employee subject to U.S. income tax withholding.

Note: If any payment was made earlier than the due date, you may use the

short method, but using it may cause you to pay a larger penalty than the

regular method. If the payment was only a few days early, the difference is

likely to be small.

TIP

You do not need to

file Form 2210 unless

you checked a box in

Part II on page 1.

185

215

205

201

197

195

187

225 "AMOUNT WAIVED"

233 "STM nn"

227 245

B-46
Draft as of

09/22/2005

Form 2210 (2005) Page 3

Regular Method (See page 2 of the instructions if you are filing Form 1040NR or 1040NR-EZ.)

Payment Due Dates

Section A—Figure Your Underpayment (d)

1/15/06

(c)

9/15/05

(b)

6/15/05

(a)

4/15/05

Required installments. If box C in Part II applies, enter

the amounts from Schedule AI, line 25. Otherwise, enter

25% (.25) of line 9, Form 2210, in each column

Complete lines 20 through 26 of one column

before going to the next column.

18

Estimated tax paid and tax withheld (see page 2 of

the instructions). For column (a) only, also enter the

amount from line 19 on line 23. If line 19 is equal to

or more than line 18 for all payment periods, stop

here; you do not owe a penalty. Do not file Form

2210 unless you checked a box in Part II

18

19

Enter the amount, if any, from line 26 in previous

column

19

20

Add lines 19 and 20

20

Add the amounts on lines 24 and 25 in previous column

21 21

22

Subtract line 22 from line 21. If zero or less, enter -0-.

For column (a) only, enter the amount from line 19.

22

If line 23 is zero, subtract line 21 from line 22.

Otherwise, enter -0-

23

23

Underpayment. If line 18 is equal to or more than

line 23, subtract line 23 from line 18. Then go to line

20 of the next column. Otherwise, go to line 26 

24

24

Overpayment. If line 23 is more than line 18, subtract line

18 from line 23. Then go to line 20 of the next column

25

25

Section B—Figure the Penalty (Complete lines 27 through 32 of one column before going to the next column.)

4/15/05 6/15/05

Days: Days: Number of days from the date shown above

line 27 to the date the amount on line 25 was

paid or 9/30/05, whichever is earlier

26

26

Number of

days on line 27

27

Underpayment on line 25

(see page 4 of

the instructions) .06

365 $ $

27

28

28

Part IV

  

Penalty. Add all amounts on lines 28, 30, and 32 in all columns. Enter the total here and on Form

1040, line 76; Form 1040A, line 48; Form 1040NR, line 74; Form 1040NR-EZ, line 26; or Form 1041,

line 26, but do not file Form 2210 unless you checked a box in Part II  33 $

33

9/15/05

Days:

$

Rate Period 1

April 16, 2005—September 30, 2005

Form 2210 (2005)

12/31/05 12/31/05

Days: Days: Number of days from the date shown above

line 31 to the date the amount on line 25 was

paid or 4/15/06, whichever is earlier

Number of

days on line 31

31

Underpayment on line 25

(see page 5 of

the instructions) .05

365 $ $

31

32

32

  

12/31/05

Days:

$

Rate Period 3

January 1, 2006—April 15, 2006 1/15/06

Days:

$

9/30/05 9/30/05

Days: Days: Number of days from the date shown above

line 29 to the date the amount on line 25 was

paid or 12/31/05, whichever is earlier

Number of

days on line 29

29

Underpayment on line 25

(see page 4 of

the instructions) .05

365 $ $

29

30

30

  

9/30/05

Days:

$

Rate Period 2

October 1, 2005—December 31, 2005

265

575

298 303 305 308

275 285 295

355 435 515

365 445 525

375 455 535

315 385 465 545

395 475

325 405 485 565

335 415 495

608

578 611

600

595

605

602

633

628

626

621

644

642

634

663

635

665

667

649

647

@669 "STM nn" 671

B-47
Draft as of

09/22/2005

Schedule AI—Annualized Income Installment Method (See pages 5 and 6 of the instructions.)

(d)

1/1/05–12/31/05

(c)

1/1/05–8/31/05

(b)

1/1/05–5/31/05

(a)

1/1/05–3/31/05

Estates and trusts, do not use the period ending dates shown to the right.

Instead, use the following: 2/28/05, 4/30/05, 7/31/05, and 11/30/05.

Enter your adjusted gross income for each period (see instructions).

(Estates and trusts, enter your taxable income without your

exemption for each period.)

1

1

2 Annualization amounts. (Estates and trusts, see instructions.) 2 4 2.4 1.5 1

3 Annualized income. Multiply line 1 by line 2 3

4 Enter your itemized deductions for the period shown in each column.

If you do not itemize, enter -0- and skip to line 7. (Estates and trusts,

enter -0-, skip to line 9, and enter the amount from line 3 on line 9.) 4

5 Annualization amounts 5 4 1 2.4 1.5

6 Multiply line 4 by line 5 (see instructions if line 3 is more than $72,975) 6

7

In each column, enter the full amount of your standard deduction

from Form 1040, line 40, or Form 1040A, line 24 (Form 1040NR or

1040NR-EZ filers, enter -0-. Exception: Indian students and

business apprentices, enter standard deduction from Form 1040NR,

line 37, or Form 1040NR-EZ, line 11.)

7

8 Enter the larger of line 6 or line 7 8

9 Subtract line 8 from line 3 9

In each column, multiply $3,200 by the total number of exemptions

claimed (see instructions if line 3 is more than $109,475). (Estates

and trusts and Form 1040NR or 1040NR-EZ filers, enter the

exemption amount shown on your tax return.)

10

10

11 Subtract line 10 from line 9 11

12 Figure your tax on the amount on line 11 (see instructions) 12

13 Self-employment tax from line 34 below (complete Part II)

14 Enter other taxes for each payment period (see instructions) 14

15 Total tax. Add lines 12, 13, and 14 15

16 For each period, enter the same type of credits as allowed on Form

2210, lines 1 and 3 (see instructions) 16

17 Subtract line 16 from line 15. If zero or less, enter -0- 17

18 Applicable percentage 18 22.5% 45% 67.5% 90%

19 Multiply line 17 by line 18 19

20 Enter the total of the amounts in all previous columns of line 25 20

21 Subtract line 20 from line 19. If zero or less, enter -0- 21

22 Enter 25% (.25) of line 9 on page 1 of Form 2210 in each column 22

23

Subtract line 25 of the previous column from line 24 of that 

column

23

24 Add lines 22 and 23 24

Enter the smaller of line 21 or line 24 here and on Form 2210,

line 18 

25

25

Annualized Self-Employment Tax (Form 1040 filers only)

26 Net earnings from self-employment for the period (see instructions)

27 Prorated social security tax limit $XX,XXX $XX,XXX $XX,XXX $XX,XXX

Enter actual wages for the period subject to social security tax or

the 6.2% portion of the 7.65% railroad retirement (tier 1) tax

28

29

30

31

32

33

34

Multiply line 30 by the smaller of line 26 or line 29

Multiply line 26 by line 32

Add lines 31 and 33. Enter here and on line 13 above 

Annualized Income Installments

26

27

28

29

30

31

32

33

34

Part I

Part II

Form 2210 (2005) Page 4

13

Printed on recycled paper

Complete lines 20–25 of one column before going to the next

column.

Annualization amounts

Subtract line 28 from line 27. If zero or less, enter -0-

Annualization amounts

0.496 0.2976 0.186 0.124

0.116 0.0696 0.0435 0.029

Form 2210 (2005)

900

905

920

910

930

950

940

990

980

970

960

1030

1020

1010

1000

1070

1060

1050

1040

1080

1090

1100

1120

1110

1130

1150

1140

1190

1180

1170

1160

1230

1220

1210

1200

1290

1270

1260

1240

1300

1310

1320

1340

1330

1350

1370

1360

1410

1400

1390

1380

1450

1440

1430

1420

1510

1490

1480

1460

1520

1280 1500

1530

1540

1550

1560

1570

1580

1590

1600

1610

1620

1630

1640

1650

1660

1670

1680

1700

1710

1720

1730

1740

1750

1800

1790

1780

1770

1760

1810

1820

1830

1840

1850

1860 1920

1910

1900

1890

1880

1870

1980

1970

1960

1950

1940

1930

1250 1470 1690

B-48
Draft as of

09/22/2005

OMB No. 1545-0140 Underpayment of Estimated Tax by

Farmers and Fishermen Form 2210-F

Department of the Treasury

Internal Revenue Service

 Attach to Form 1040, Form 1040NR, or Form 1041. Attachment

 See instructions on back. Sequence No. 06A

Name(s) shown on tax return Identifying number

Figure Your Underpayment

Enter your 2004 tax after credits from Form 1040, line 57; Form 1040NR, line 52; or Form 1041,

Schedule G, line 4

1

2

Other taxes (see instructions)

2

3

Add lines 2 and 3. If less than $1,000, see instructions

3

4

Earned income credit

4

5

Credit for Federal tax paid on fuels

5

7

Add lines 5, 6, 7, and 8

Current year tax. Subtract line 9 from line 4

7

9

Multiply line 10 by 662⁄3%

8

Withholding taxes. Do not include any estimated tax payments on this line (see instructions)

9

11

Subtract line 12 from line 10. If less than $1,000, stop here; you do not owe the penalty. Do not

file Form 2210-F 

10

12

13

Enter the tax shown on your 2004 tax return. Caution: See instructions

11

Required annual payment. Enter the smaller of line 11 or line 14

12

15

Enter the estimated tax payments you made by January 17, 2006, and any Federal income tax

and excess social security or tier 1 railroad retirement tax withheld during 2005

13

Underpayment. Subtract line 16 from line 15. If the result is zero or less, stop here; you do not

owe the penalty. Do not file Form 2210-F unless you checked box 1b above

14

16

Figure the Penalty

/ / 06

17

Enter the date the amount on line 17 was paid or April 15, 2006, whichever is earlier

15

18

Number of days from January 15, 2006, to the date on line 18

16

Number of days on line 19

19

Penalty. .05

17

365

● Form 1040 filers, enter the amount from line 20 on Form 1040, line 76.

● Form 1041 filers, enter the amount from line 20 on Form 1041, line 26.

Form 2210-F (2005)

Note: If line 12 is equal to or more than line 15, stop here; you do not owe the penalty. 

Do not file Form 2210-F unless you checked box 1b above.

Part III

Part I

Part II

In most cases, you do not need to file Form 2210-F. The IRS will figure any penalty you owe and send you a

bill. File Form 2210-F only if one or both of the boxes in Part I apply to you. If you do not need to file Form

2210-F, you still can use it to figure your penalty. Enter the amount from line 20 on the penalty line of your

return but do not attach Form 2210-F.

Reasons for Filing—If box 1a below applies to you, you may be able to lower or eliminate your penalty.

But you must check that box and file Form 2210-F with your tax return. If box 1b below applies to you,

check that box and file Form 2210-F with your tax return.

Check whichever boxes apply (if neither applies, see the text above Part I and do not file Form 2210-F):

You request a waiver. In certain circumstances, the IRS will waive all or part of the penalty. See the instructions for Waiver

of Penalty.

Your required annual payment (line 15 below) is based on your 2004 tax and you filed, or are filing, a joint return for either

2004 or 2005 but not for both years.

● Form 1040NR filers, enter the amount from line 20 on Form 1040NR, line 74.

a

b

14

20

19

× ×

Cat. No. 11745A

Underpayment

on line 17 

For Paperwork Reduction Act Notice, see back of form.

6 Additional child tax credit 6

20

Health coverage tax credit

18

8

10

2005

010

013

016

020

030

040

050

055

060

070

080

090

100

110

120

130

140

150

160

170

176

@177 "STM nn" 180

B-49

065
Draft as of

04/27/2005

VOID CORRECTED

2

OMB No. 1545-0145

Notice to Shareholder of Undistributed

Long-Term Capital Gains

1a

1b

Copy A

1d

Attach to

Form 1120-RIC

or Form 1120-REIT

For Instructions

and Paperwork

Reduction Act

Notice, see back of

Copies A and D.

Form 2439 Cat. No. 11858E Department of the Treasury - Internal Revenue Service

Form 2439

Name, address, and ZIP code of RIC or REIT

Identification number of RIC or REIT

Shareholder’s identifying number

Shareholder’s name, address, and ZIP code

Total undistributed long-term capital gains

Unrecaptured section 1250 gain

Tax paid by the RIC or REIT on the box 1a gains

Section 1202 gain

For calendar year 2005, or other tax year of the

regulated investment company (RIC) or the

real estate investment trust (REIT)

beginning , 2005, and

ending ,

(99)

20

1c Collectibles (28%) gain

2005

010 020

030

040

050

120

130

160 170 180

190

210

220

230

B-50

225

060

070

080

090 100 110

150

140
OMB No. 1545-0074 Child and Dependent Care Expenses Form 2441

 Attach to Form 1040.

Department of the Treasury

Internal Revenue Service

Attachment

 See separate instructions. Sequence No. 21

Name(s) shown on Form 1040 Your social security number

Persons or Organizations Who Provided the Care—You must complete this part. 

(If you need more space, use the bottom of page 2.)

(b) Address

(number, street, apt. no., city, state, and ZIP code)

(d) Amount paid

(see instructions)

(c) Identifying number

(SSN or EIN) 1 (a) Care provider’sname

Credit for Child and Dependent Care Expenses

2

Add the amounts in column (c) of line 2. Do not enter more than $3,000 for one qualifying

person or $6,000 for two or more persons. If you completed Part III, enter the amount from

line 32

Enter your earned income. See instructions

3

3

If married filing jointly, enter your spouse’s earned income (if your spouse was a student

or was disabled, see the instructions); all others, enter the amount from line 4

4 4

Enter the smallest of line 3, 4, or 5

5

5

6

7 Enter the amount from Form 1040, line 38 7



Decimal

amount is

If line 7 is:

Decimal

amount is

If line 7 is:

But not

Over over

But not

Over over

$0—15,000 .35 $29,000—31,000 .27

15,000—17,000 .34 31,000—33,000 .26

17,000—19,000 .33 33,000—35,000 .25

19,000—21,000 .32 35,000—37,000 .24

21,000—23,000 .31 37,000—39,000 .23

23,000—25,000 .30

Multiply line 6 by the decimal amount on line 8. If you paid 2004 expenses in 2005, see

the instructions

9

For Paperwork Reduction Act Notice, see page 4 of the instructions. Form 2441 (2005)

Before you begin: You need to understand the following terms. See Definitions on page 1 of the instructions.

Cat. No. 11862M

Part I

Part II

Enter on line 8 the decimal amount shown below that applies to the amount on line 7

Did you receive

dependent care benefits? Yes

No

8

Complete only Part II below.

Complete Part III on the back next.





Caution. If the care was provided in your home, you may owe employment taxes. See the instructions for Form 1040, line 62.

.

(99)

Information about your qualifying person(s). If you have more than two qualifying persons, see the instructions.

(a) Qualifying person’s name

First Last

(b) Qualifying person’s social

security number

(c) Qualified expenses you

incurred and paid in 2005 for the

person listed in column (a)

8

6

● Dependent Care Benefits ● Qualifying Person(s) ● Qualified Expenses

9

25,000—27,000

27,000—29,000

.29

.28

39,000—41,000

41,000—43,000

43,000—No limit

.22

.21

.20

10

11

10

11

Enter the amount from Form 1040, line 46, minus any amount on Form 1040, line 47

Credit for child and dependent care expenses. Enter the smaller of line 9 or line 10

here and on Form 1040, line 48

2005

*010 "STM nn"

+020

+030

* "STM nn"

+050

060 070

080 100

*110 "STM nn" +115

+120

+214 +215

217 218

221

223 225

230

260

270

290

295

300

@315 "STM nn"

318 "CPYE" 320

324 326

328

B-51

*+040 + 045 

"S" = SSN or 

+015

065

332

339

300

090 "TAXEXEMPT"

095
Form 2441 (2005) Page 2

Dependent Care Benefits

Enter the total amount of dependent care benefits you received in 2005. Amounts you

received as an employee should be shown in box 10 of your Form(s) W-2. Do not include

amounts reported as wages in box 1 of Form(s) W-2. If you were self-employed or a partner,

include amounts you received under a dependent care assistance program from your sole

proprietorship or partnership

Enter the amount forfeited or carried forward to 2006, if any (see the instructions)

Subtract line 13 from line 12

Enter the total amount of qualified expenses incurred

in 2005 for the care of the qualifying person(s)

13

15

Enter the smaller of line 14 or 15 16

14

Enter your earned income. See instructions

15

17

Enter the amount shown below that applies

to you.

18

Enter the smallest of line 16, 17, or 18

16

19

Enter the amount from line 12 that you received from your sole proprietorship or

partnership. If you did not receive any such amounts, enter -0-

17

20

Taxable benefits. Subtract line 26 from line 21. If zero or less, enter -0-. Also, include

this amount on Form 1040, line 7. On the dotted line next to line 7, enter “DCB”

18

27

Part III

To claim the child and dependent care

credit, complete lines 28–32 below.

28

29

30

19

20

27

28 Enter $3,000 ($6,000 if two or more qualifying persons)

Subtract line 29 from line 28. If zero or less, stop. You cannot take the credit.

Exception. If you paid 2004 expenses in 2005, see the instructions for line 9

Enter the smaller of line 30 or 31. Also, enter this amount on line 3 on the front of this

form and complete lines 4–11

Add lines 23 and 26

32

29

30

32

13

14

12

12

Complete line 2 on the front of this form. Do not include in column (c) any benefits shown on

line 29 above. Then, add the amounts in column (c) and enter the total here

31

31

Form 2441 (2005)

● If married filing jointly, enter your

spouse’s earned income (if your spouse

was a student or was disabled, see the

instructions for line 5).

● If married filing separately, see the

instructions for the amount to enter.

● All others, enter the amount from line 17. 

21 Subtract line 20 from line 14

Enter $5,000 ($2,500 if married filing separately and you were required to enter your

spouse’s earned income on line 18)

22

Deductible benefits. Enter the smallest of line 19, 20, or 22. Also, include this amount

on the appropriate line(s) of your return (see the instructions)

23

24 Enter the smaller of line 19 or 22

25 Enter the amount from line 23

26 Excluded benefits. Subtract line 25 from line 24. If zero or less, enter -0-

24

25

21

22

23

26

350

353

356

360

370

380

390

400

500

520

580

590

600

610

620

B-52

510

530

570

550

545

540
OMB No. 1545-0074

Form 2555 Foreign Earned Income

Department of the Treasury

Internal Revenue Service

 See separate instructions.  Attach to Form 1040.

For Use by U.S. Citizens and Resident Aliens Only

Name shown on Form 1040 Your social security number

Your foreign address (including country) Your occupation

Employer’s name 

Employer’s U.S. address 

Employer’s foreign address 

Employer is (check

any that apply):

A foreign entity A U.S. company

Other (specify) 

Self

A foreign affiliate of a U.S. company

If, after 1981, you filed Form 2555 or Form 2555-EZ, enter the last year you filed the form. 

Have you ever revoked either of the exclusions? Yes No

If you answered “Yes,” enter the type of exclusion and the tax year for which the revocation was effective. 

Did you maintain a separate foreign residence for your family because of adverse living conditions at your

tax home? See Second foreign household on page 3 of the instructions

If “Yes,” enter city and country of the separate foreign residence. Also, enter the number of days during your tax year that

you maintained a second household at that address. 

List your tax home(s) during your tax year and date(s) established. 

Next, complete either Part II or Part III. If an item does not apply, enter “NA.” If you do not give

the information asked for, any exclusion or deduction you claim may be disallowed.

Taxpayers Qualifying Under Bona Fide Residence Test (See page 2 of the instructions.)

10 Date bona fide residence began  , and ended 

11 Kind of living quarters in foreign country  Purchased house Rented house or apartment Rented room

Quarters furnished by employer

12a Did any of your family live with you abroad during any part of the tax year?

If “Yes,” who and for what period? 

Have you submitted a statement to the authorities of the foreign country where you claim bona fide residence

that you are not a resident of that country? (See instructions.)

13a

b Are you required to pay income tax to the country where you claim bona fide residence? (See instructions.)

If you answered “Yes” to 13a and “No” to 13b, you do not qualify as a bona fide resident. Do not complete the rest of

this part.

If you were present in the United States or its possessions during the tax year, complete columns (a)–(d) below. Do not

include the income from column (d) in Part IV, but report it on Form 1040.

14

(d) Income earned in

U.S. on business

(attach computation)

(c) Number of

days in U.S.

on business

(d) Income earned in

U.S. on business

(attach computation)

(c) Number of

days in U.S.

on business

(b) Date left

U.S.

(a) Date

arrived in U.S.

(b) Date left

U.S.

(a) Date

arrived in U.S.

15a List any contractual terms or other conditions relating to the length of your employment abroad. 

b Enter the type of visa under which you entered the foreign country. 

c Did your visa limit the length of your stay or employment in a foreign country? If “Yes,” attach explanation

Did you maintain a home in the United States while living abroad?

e If “Yes,” enter address of your home, whether it was rented, the names of the occupants, and their relationship

to you. 

For Paperwork Reduction Act Notice, see page 4 of separate instructions. Cat. No. 11900P Form 2555 (2005)

Yes No

Yes No

Yes No

Yes No

Yes No

Yes No



3

4a

5

6a

c

8a

9

7

1 2

b

a

d

b

e

c

b

a

d

b c

d

d

b

Part I

Part II

General Information

b If you did not file Form 2555 or 2555-EZ after 1981 to claim either of the exclusions, check here  and go to line 7.

Of what country are you a citizen/national? 

Attachment

(99) Sequence No. 34

2005

007

008 "WAIVER" @009 "STM nn"

015 020

030

060 070 080

090 100 105

120

130 140

@150 "STM nn"

160

170 180

*190 "STM nn" +200

*210 "STM nn" +215 YYYYMMDD

220 YYYYMMDD 225 YYYYMMDD "CONTINUE"

230 240

250 260

270 280

*290 +295

300 310

320 330

*340 "STM nn" YYYYMMDD +342 +344 +346 380 382 384 386

348 YYYYMMDD 350 352 354 388 390 392 394

356 358 360 370 396 398 400 402

372 374 376 378 404 406 408 410

420

430

*490 "STM nn" +495 "RENTED"

440 460

470 480

@450 "STM nn"

*+500 "STM nn" +510

B-53

010 013 011 012 014 018

040 041 042 043 044

050 051 052 053 054 055

110 "1982" through "2004"

@415 "STM nn"
Form 2555 (2005) Page 2

Taxpayers Qualifying Under Physical Presence Test (See page 2 of the instructions.)

16 The physical presence test is based on the 12-month period from  through 

17 Enter your principal country of employment during your tax year. 

If you traveled abroad during the 12-month period entered on line 16, complete columns (a)–(f) below. Exclude travel between

foreign countries that did not involve travel on or over international waters, or in or over the United States, for 24 hours or

more. If you have no travel to report during the period, enter “Physically present in a foreign country or countries for the entire

12-month period.” Do not include the income from column (f) below in Part IV, but report it on Form 1040.

18

(f) Income earned in U.S.

on business (attach

computation)

(e) Number of

days in U.S.

on business

(d) Full days

present in

country

(a) Name of country

(including U.S.) (b) Date arrived (c) Date left

All Taxpayers

Note: Enter on lines 19 through 23 all income, including noncash income, you earned and actually or constructively received during

your 2005 tax year for services you performed in a foreign country. If any of the foreign earned income received this tax year was

earned in a prior tax year, or will be earned in a later tax year (such as a bonus), see the instructions. Do not include income from

line 14, column (d), or line 18, column (f). Report amounts in U.S. dollars, using the exchange rates in effect when you actually or

constructively received the income.

If you are a cash basis taxpayer, report on Form 1040 all income you received in 2005, no matter when you performed

the service.

Amount 2005 Foreign Earned Income (in U.S. dollars)

19 Total wages, salaries, bonuses, commissions, etc. 19

20 Allowable share of income for personal services performed (see instructions):

a In a business (including farming) or profession 20a

b In a partnership. List partnership’s name and address and type of income. 

20b

21 Noncash income (market value of property or facilities furnished by employer—attach statement

showing how it was determined):

a Home (lodging) 21a

b Meals 21b

c Car 21c

d Other property or facilities. List type and amount.  

21d

22 Allowances, reimbursements, or expenses paid on your behalf for services you performed:

a Cost of living and overseas differential 22a

b Family 22b

c Education 22c

d Home leave 22d

e Quarters 22e

f For any other purpose. List type and amount. 

22f

g Add lines 22a through 22f 22g

23 Other foreign earned income. List type and amount. 

23

24 Add lines 19 through 21d, line 22g, and line 23 24

25 Total amount of meals and lodging included on line 24 that is excludable (see instructions) 25

Subtract line 25 from line 24. Enter the result here and on line 27 on page 3. This is your 2005

foreign earned income 

26

26

Part III

Part IV

Form 2555 (2005)

530 YYYYMMDD 540 YYYYMMDD "CONTINUE

550

@560 "STM nn"

*570 "STM nn" +580 YYYYMMDD +590 YYYYMMD+600 +610 +620

630 640 650 660 670 680

690 700 710 720 730 740

750 760 770 780 790 800

@805 "STM nn"

810

820

@830 "STM nn" 840

@850 "STM nn" 860

@870 "STM nn" 880

@890 "STM nn" 900

*910 "STM nn" +920 925

930

940

950

960

970

*980 "STM nn" +990 995

1000

*1010 "STM nn" +1020 1025

1030

1040

1050

B-54
Form 2555 (2005) Page 3

Taxpayers Claiming the Housing Exclusion and/or Deduction

28 Qualified housing expenses for the tax year (see instructions) 28

Number of days in your qualifying period that fall within your 2005 tax

year (see instructions)

29

29

30 Multiply $32.59 by the number of days on line 29. If 365 is entered on line 29, enter $11,894.00 here 30

31

Subtract line 30 from line 28. If the result is zero or less, do not complete the rest of this part

or any of Part IX

31

32 Enter employer-provided amounts (see instructions) 32

Divide line 32 by line 27. Enter the result as a decimal (rounded to at least three places), but do

not enter more than “1.000”

33

33

Housing exclusion. Multiply line 31 by line 33. Enter the result but do not enter more than the

amount on line 32. Also, complete Part VIII 

34

34

Note: The housing deduction is figured in Part IX. If you choose to claim the foreign earned

income exclusion, complete Parts VII and VIII before Part IX.

Taxpayers Claiming the Foreign Earned Income Exclusion

35 Maximum foreign earned income exclusion 35 $80,000 00

● All others, enter the number of days in your qualifying period that

fall within your 2005 tax year (see the instructions for line 29).

36

● Otherwise, divide line 36 by the number of days in your 2005 tax year and enter the result

as a decimal (rounded to at least three places).

37

38 Multiply line 35 by line 37 38

39 Subtract line 34 from line 27 39

40 Foreign earned income exclusion. Enter the smaller of line 38 or line 39. Also, complete Part VIII  40

Taxpayers Claiming the Housing Exclusion, Foreign Earned Income Exclusion, or Both

41 Add lines 34 and 40 41

Deductions allowed in figuring your adjusted gross income (Form 1040, line 37) that are allocable

to the excluded income. See instructions and attach computation

42

42

Subtract line 42 from line 41. Enter the result here and in parentheses on Form 1040, line 21.

Next to the amount enter “Form 2555.” On Form 1040, subtract this amount from your income

to arrive at total income on Form 1040, line 22 

43

43

Taxpayers Claiming the Housing Deduction—Complete this part only if (a) line 31 is more than line

34 and (b) line 27 is more than line 41.

44 Subtract line 34 from line 31 44

45 Subtract line 41 from line 27 45

46 Enter the smaller of line 44 or line 45 46

Note: If line 45 is more than line 46 and you could not deduct all of your 2004 housing deduction

because of the 2004 limit, use the worksheet on page 4 of the instructions to figure the amount

to enter on line 47. Otherwise, go to line 48.

47 Housing deduction carryover from 2004 (from worksheet on page 4 of the instructions) 47

48 Housing deduction. Add lines 46 and 47. Enter the total here and on Form 1040 to the left of

line 36. Next to the amount on Form 1040, enter “Form 2555.” Add it to the total adjustments

reported on that line  48

 .

 .

Part VIII

Part VII

Part VI

Part IX

Part V

36 ● If you completed Part VI, enter the number from line 29.

37 ● If line 36 and the number of days in your 2005 tax year (usually 365) are the same, enter “1.000.”

27

All Taxpayers

27 Enter the amount from line 26

Are you claiming the housing exclusion or housing deduction?

No. Go to Part VII.





Printed on recycled paper

Yes. Complete Part VI.

Form 2555 (2005)

days

days

1070

1075 "Y" or "N"

1080

1090

1100

1110

1120

1130

1140

1160

1180

1200

1210

1220

1230

@1240 "STM nn" 1250

1260

1270

1280

1290

1300

1310 B-55
General Information

OMB No. 1545-0074

Foreign Earned Income Exclusion Form 2555-EZ

Department of the Treasury

Internal Revenue Service  Attach to Form 1040.

Name shown on Form 1040 Your social security number

Your foreign address (including country) Your occupation

Employer’s name

For Paperwork Reduction Act Notice, see page 3 of separate instructions. Cat. No. 13272W Form 2555-EZ (2005)

4 5

6

9 Employer is (check any that apply):

A U.S. business

A foreign business

Other (specify) 

10a

If you answered “Yes,” enter the tax year for which the revocation was effective. 

b Of what country are you a citizen/national? 

Have you ever revoked the foreign earned income exclusion? Yes No

7 Employer’s U.S. address (including ZIP code) 8 Employer’s foreign address

● Are a U.S. citizen or a resident alien.

● Earned wages/salaries in a foreign country.

● Had total foreign earned income of

$80,000 or less.

● Do not have self-employment income.

● Do not have business/moving expenses. And You:

You May Use

This Form

If You:

b

c

a

b

c

● Do not claim the foreign housing

exclusion or deduction.

Part II

● Are filing a calendar year return that

covers a 12-month period.

11a List your tax home(s) during 2005 and date(s) established. 

If you filed Form 2555 or 2555-EZ after 1981, enter the last year you filed the form. 

If you did not file Form 2555 or 2555-EZ after 1981, check here  and go to line 11a now.

d

1 Bona Fide Residence Test

Yes No

Enter the date your bona fide residence began  , and ended (see instructions)  .

2 Physical Presence Test

Yes No

b

a

b

a

Tests To See If You Can Take the Foreign Earned Income Exclusion

Were you a bona fide resident of a foreign country or countries for a period that includes an entire tax year

(see page 2 of the instructions)?

Were you physically present in a foreign country or countries for at least 330 full days during—

● If you answered “Yes,” you meet this test. Fill in line 1b and then go to line 3.

● If you answered “No,” you do not meet this test. Go to line 2 to see if you meet the Physical Presence Test.

2005 or

any other period of 12 months in a row starting or ending in 2005?

● If you answered “Yes,” you meet this test. Fill in line 2b and then go to line 3.

● If you answered “No,” you do not meet this test. You cannot take the exclusion unless you meet the

Bona Fide Residence Test above.

The physical presence test is based on the 12-month period from  

● If you answered “No,” you cannot take the exclusion. Do not file this form.

Tax Home Test. Was your tax home in a foreign country or countries throughout your period of bona fide

residence or physical presence, whichever applies?



through  .

3

Yes No

● If you answered “Yes,” you can take the exclusion. Complete Part II below and then go to page 2.

Part I

Attachment

(99) Sequence No. 34A  See separate instructions.

2005

007

010 020

030 040

050 060

070 080

090 100

120

130

160

170

190 180

200 "1982" through "2004" 210

220 230

240

*250 "STM nn" +260

270

B-56

110 111 112 113 114 115 118

140 141 142

143 144

150 151 152

153 154 155
Form 2555-EZ (2005) Page 2

$80,000 00

Enter the number of days in your qualifying period that fall within 2005

Did you enter 365 on line 14?

Multiply line 13 by line 15

 .

Enter, in U.S. dollars, the total foreign earned income you earned and received in 2005 (see

instructions). Be sure to include this amount on Form 1040, line 7

Foreign earned income exclusion. Enter the smaller of line 16 or line 17 here and in parentheses

on Form 1040, line 21. Next to the amount enter “2555-EZ.” On Form 1040, subtract this amount

from your income to arrive at total income on Form 1040, line 22 

18

13

14

15

16

17

Maximum foreign earned income exclusion 13

14

15

17

18

16

Part IV Figure Your Foreign Earned Income Exclusion

Enter “1.000.”

Part III

(d) Income earned in U.S. 

on business (attach computation)

(c) Number of days

in U.S. on business (a) Date arrived in U.S. (b) Date left U.S.

Days Present in the United States—Complete this part if you were in the

United States or its possessions during 2005.

12

Printed on recycled paper

 Divide line 14 by 365 and enter the result as

a decimal (rounded to at least three places).

Yes.

No.

days

Form 2555-EZ (2005)

*290 YYYYMMDD"STM nn" +300 YYYYMMDD +310 +320

330 340 350 360

370 380 390 400

410 420 430 440

450 460 470 480

490 500 510 520

530 540 550 560

570 580 590 600

610 620 630 640

@645 "STM nn"

1160

1165

1175 1180

1200

1210

1260

B-57
Draft as of

11/10/2005

OMB No. 1545-0155 Investment Credit

Form 3468

 Attach to your tax return. Attachment

Sequence No. 52

Name(s) shown on return Identifying number

Current Year Credit

1b

1

c

Energy credit for periods ending before January 1, 2006. Basis of property using solar or geothermal 

energy placed in service during the tax year (see instructions)

2

2

6

7 7

For Paperwork Reduction Act Notice, see instructions. Form 3468 (2005)

Part I

Rehabilitation credit (see instructions for requirements that must be met):

b Pre-1936 buildings × 10% (.10)

Certified historic structures × 20% (.20)

6

× 10% (.10)

Credit from cooperatives. Enter the unused investment credit from cooperatives 

Current year credit. Add lines 1b through 6 

1c

Cat. No. 12276E

Check this box if you are electing under section 47(d)(5) to take your qualified rehabilitation

expenditures into account for the tax year in which paid (or, for self-rehabilitated property,

when capitalized). See instructions. Note: This election applies to the current tax year and to 

all later tax years. You may not revoke this election without IRS consent 

a

Enter the amount of qualified rehabilitation expenditures and multiply by the percentage shown:

e Rehabilitation credit from an electing large partnership (Schedule K-1 (Form 1065-B), box 9) 1e

(99)

Enter the assigned NPS project number or the pass-through entity’s

employer identification number (see instructions)

Enter the date that the NPS approved the Request for Certification of 

Completed Work (see instructions)

Enter the date on which the 24- or

60-month measuring period begins

Enter the adjusted basis of the building as of the beginning date above 

(or the first day of your holding period, if later)

Enter the amount of the qualified rehabilitation expenditures incurred, 

or treated as incurred, during the period on line 1d(1) above 

$

$

(1)

(2)

(1)

(2)

(3)

d

/ /

/ /

$

$

and ends

$

/ /

2005

Department of the Treasury

Internal Revenue Service

3 Energy credit for periods ending after December 31, 2005:

3a

a Basis of property using geothermal energy placed in service during

the tax year (see instructions) $ × 10% (.10)

b Basis of property using solar illumination or solar energy placed in service

during the tax year (see instructions) $ × 30% (.30) 3b

Qualified fuel cell property (see instructions):

$ × 30% (.30) 3c

Basis of property installed during the tax

year

c

× $1,000 3d

Kilowatt capacity of property in c

above 

d

e Enter the lesser of line 3c or 3d 3e

Qualified microturbine property (see instructions):

$ × 10% (.10) 3f

Basis of property installed during the tax

year

f

× $200 3g

Kilowatt capacity of property in f

above 

g

h Enter the lesser of line 3f or 3g 3h

i Total. Add lines 3a, 3b, 3e, and 3h 3i

4 Qualifying advanced coal project credit for periods ending after August 8, 2005 (see instructions):

4a

a Basis of qualified investment in integrated gasification combined cycle property 

placed in service during the tax year $ × 20% (.20)

b Basis of qualified investment in property other than in a above placed

in service during the tax year $ × 15% (.15) 4b

5

c Total. Add lines 4a and 4b 

Qualifying gasification project credit for periods ending after August 8, 2005 (see instructions). Basis of qualified 

investment in property placed in service during the tax year $ × 20% (.20)

4c

5

020

030 040

045 050 060

070

080

081 083

085

@145 "STM nn"

093 095

097 099

101

103 105

109

111

117

113

115

119 121

B-58

@025 "STM nn"

071

074 075

076

077

107

123

087

089 091

125 127

130

135
Draft as of

11/10/2005

Form 3468 (2005) Page 2

Part II Allowable Credit (See Who must file Form 3800 to find out if you complete Part II or file Form 3800.)

8

f

Foreign tax credit 11a

Credits from Form 1040, lines 48 through 54 11b

11a

11d

c Possessions tax credit (Form 5735, line 17 or 27)

d Nonconventional source fuel credit (Form 8907, line 23)

Other specified credits (see instructions)

Add l 11f ines 11a through 11e

12

Net income tax. Subtract line 11f from line 10. If zero, skip lines 13 through 16 and enter -0- on 

line 17

9 Alternative minimum tax: Enter the alternative minimum tax (AMT) from the following line of the 

appropriate form or schedule 9

12

Tentative minimum tax (see instructions)

13

15

Enter 25% (.25) of the excess, if any, of line 13 over $25,000 (see

instructions)

14

Subtract line 16 from line 12. If zero or less, enter -0-

16 16

Credit allowed for the current year. Enter the smaller of line 7 or line 17 here and on Form

1040, line 55; Form 1120, Schedule J, line 6d; Form 1120-A, Part I, line 2; Form 1041, Schedule 

G, line 2c; or the applicable line of your return. If line 17 is smaller than line 7, see instructions. 18

b

11c

8 Regular tax before credits:

10 Add lines 8 and 9 10

13

Enter the greater of line 14 or line 15

14

15

e

Net regular tax. Subtract line 11f from line 8. If zero or less, enter -0-

17 17

18

11e

● Individuals. Enter the amount from Form 1040, line 44

● Corporations. Enter the amount from Form 1120, Schedule J, line 3; Form 1120-A,

Part I, line 1; or the applicable line of your return

● Estates and trusts. Enter the sum of the amounts from Form 1041, Schedule G, lines 

1a and 1b, or the amount from the applicable line of your return  ● Individuals: Form 6251, line 35

● Corporations: Form 4626, line 14

● Estates and trusts: Form 1041, Schedule I, line 56 

170

180

190

310

340

320

355

350

360

380

B-59

200

215

280

290

300

370
Draft as of

10/19/2005

OMB No. 1545–0895 General Business Credit

Form 3800

Department of the Treasury

Internal Revenue Service  Attach to your tax return. Attachment

Sequence No. 22

 See instructions.

Name(s) shown on return Identifying number

Current Year Credit

1a

2

3 3

4 4

5

6

8

7

Passive activity credits included on line 2 (see instructions)

Subtract line 3 from line 2

Passive activity credits allowed for 2005 (see instructions)

Carryforward of general business credit to 2005. See instructions for the schedule to attach 

Carryback of general business credit from 2006 (see instructions) 

Current year credit. Add lines 4 through 7

Part I

2

b

d

e

f

g

6

Current year credit. Add lines 1a through 1z

q

h

i

j

k

l

1h

1i

1j

1k

1p

1a

1b

1d

1e

1f

1g

Investment credit (Form 3468)

Work opportunity credit (Form 5884)

Credit for increasing research activities (Form 6765)

Low-income housing credit (Form 8586)

Disabled access credit (Form 8826)

Enhanced oil recovery credit (Form 8830)

Renewable electricity production credit (Form 8835, Section A only)

Indian employment credit (Form 8845)

Credit for employer social security and Medicare taxes paid on certain employee tips (Form 8846)

Credit for contributions to selected community development corporations (Form 8847)

Trans-Alaska pipeline liability fund credit (see instructions)

1q

p

1l

Orphan drug credit (Form 8820)

c Welfare-to-work credit (Form 8861) 1c

8

7

1r r

General credits from an electing large partnership (Schedule K-1 (Form 1065-B))

(99)

1m

New markets credit (Form 8874)

m

1n

Credit for small employer pension plan startup costs (Form 8881)

n

1o

Credit for employer-provided child care facilities and services (Form 8882)

o

x

w

Biodiesel and renewable diesel fuels credit (Form 8864) 

Low sulfur diesel fuel production credit (Form 8896) 

1x

1w

2005

Qualified railroad track maintenance credit (Form 8900)

y 1y

Distilled spirits credit (Form 8906)

s Nonconventional source fuel credit (Form 8907) 1s

1t t Energy efficient home credit (Form 8908)

u Alternative motor vehicle credit (Form 8910) 1u

v Alternative fuel vehicle refueling property credit (Form 8911) 1v

For Paperwork Reduction Act Notice, see instructions. Cat. No. 12392F Form 3800 (2005)

z Hurricane Katrina employee retention credit (Form 5884-A) 1z

020

030

040

570

060

070

080

090

100

110

120

130

540

550

620

610

640

740

770

780

790 800

810

840

650

660

B-60

590

560

580

690

680

850

600

@825 "STM nn"
Draft as of

10/19/2005

Page 2

Schedule A—Additional General Business Credit Allowed by Code Section 38(c)(2) (Before Repeal by the

Revenue Reconciliation Act of 1990)—Only Applicable to C Corporations

Enter the portion of the credit shown on line 6 that is attributable to the regular investment credit

under section 46 (before amendment by the Revenue Reconciliation Act of 1990)

Tentative minimum tax (from line 16)

Multiply line 21 by 25% (.25)

Enter the amount from line 18

Enter the portion of the credit shown on line 8 that is not attributable 

to the regular investment credit under section 46 (before amendment 

by the Revenue Reconciliation Act of 1990)

21

Subtract line 24 from line 23. If zero or less, enter -0-

22

Subtract line 25 from line 20. If zero or less, enter -0-

For purposes of this line only, refigure the amount on Form 4626, line

10, by using zero on Form 4626, line 6, and enter the result here

Multiply line 27 by 10% (.10)

Net income tax (from line 13)

Enter the amount from line 19 

Subtract line 30 from line 29

Subtract line 28 from line 31

Enter the smallest of line 22, line 26, or line 32

Subtract line 33 from line 21

Enter the greater of line 15 or line 34

Subtract line 35 from line 29. Also enter this amount on line 19 instead of the amount

previously figured on that line. Write “Sec. 38(c)(2)” next to your entry on line 19 

20

23

24

25

26

27

28

29

30

31

32

33

34

35

20

22

25

28

29

30

31

32

33

34

35

24

21

27

23

36

Form 3800 (2005)

26

36

Part II Allowable Credit

Credit allowed for the current year. Enter the smaller of line 8 or line 18 here and on Form

1040, line 55; Form 1120, Schedule J, line 6d; Form 1120-A, Part I, line 2; Form 1041, Schedule 

G, line 2c; or the applicable line of your return. If line 19 is smaller than line 8, see instructions.

Individuals, estates, and trusts: See instructions if claiming the research credit. C corporations:

See Schedule A if claiming any regular investment credit carryforward and the line 19 instructions 

if there has been an ownership change, acquisition, or reorganization 

19

19

9

f

Foreign tax credit 12a

Credits from Form 1040, lines 48 through 54 

12a

c Possessions tax credit (Form 5735, line 17 or 27) 12c

d Nonconventional source fuel credit (Form 8907, line 23) 12d

Other specified credits (see instructions)

Add l 12f ines 12a through 12e

10

Net income tax. Subtract line 12f from line 11. If zero, skip lines 14 through 17 and enter -0- on line 18

10 Alternative minimum tax (see instructions)

Tentative minimum tax (see instructions)

14

11

Enter 25% (.25) of the excess, if any, of line 14 over $25,000 (see instructions)

13

Subtract line 17 from line 13. If zero or less, enter -0-

17

16

b 12b

Regular tax before credits (see instructions)

Add lines 9 and 10

Enter the greater of line 15 or line 16

15

16

e 12e

14 Net regular tax. Subtract line 12f from line 9. If zero or less, enter -0-

18

9

15

17

18

11

13

Form 3800 (2005)

1020

1030

1040

1050

1060

1070

1080

1090

1100

1110

1120

1130

1140

1150

1160

1180

1210

1220

1230

1240

1250

1260

1270

1280

1290

1300

1310

1320

1330

1340

1350

1360

1370

1170 "SECb41(G)" 

1190

1200

B-61
Moving Expenses OMB No. 1545-0074

Form 3903

 Attach to Form 1040.

Department of the Treasury

Internal Revenue Service

Attachment

Sequence No. 62

Name(s) shown on Form 1040 Your social security number

1 1

Travel (including lodging) from your old home to your new home (see instructions). Do not include

the cost of meals

2

3 Add lines 1 and 2

Enter the total amount your employer paid you for the expenses listed on lines 1 and 2 that is

not included in box 1 of your Form W-2 (wages). This amount should be shown in

box 12 of your Form W-2 with code P

4

Moving expense deduction. Subtract line 4 from line 3. Enter the result here and on

Form 1040, line 26 

5

Transportation and storage of household goods and personal effects (see instructions)

Before you begin:

2

3

5

4

For Paperwork Reduction Act Notice, see back of form. Cat. No. 12490K Form 3903 (2005)

Is line 3 more than line 4?

No. You cannot deduct your moving expenses. If line 3 is less than line 4, subtract line 3

from line 4 and include the result on Form 1040, line 7.

General Instructions

Purpose of Form

Use Form 3903 to figure your moving

expense deduction for a move related to

the start of work at a new principal place

of work (workplace). If the new workplace

is outside the United States or its

possessions, you must be a U.S. citizen or

resident alien to deduct your expenses.

For more details, see Pub. 521, Moving

Expenses.

Who Can Deduct Moving

Expenses

If you move to a new home because of a

new principal workplace, you may be able

to deduct your moving expenses whether

you are self-employed or an employee. But

you must meet both the distance test and

time test that follow.

Distance Test

Your new principal workplace must be at

least 50 miles farther from your old home

than your old workplace was. For example,

if your old workplace was 3 miles from

your old home, your new workplace must

What’s New

For 2005, the standard mileage rate for

using your vehicle to move to a new home

is 15 cents a mile (22 cents a mile after

August 31, 2005).

To see if you meet the

distance test, you can

use the worksheet

below.

Distance Test Worksheet

miles 1.

miles 2.

miles 3.

Is line 3 at least 50 miles?

Yes. You meet this test.

No. You do not meet this test. You cannot deduct your moving expenses. Do not complete Form 3903.

If you qualify to deduct expenses for

more than one move, use a separate Form

3903 for each move.

Number of miles from your old home to your new workplace

Number of miles from your old home to your old workplace

Subtract line 2 from line 1. If zero or less, enter -0-

1.

2.

3.

Yes.

Keep a Copy for Your Records

Members of the Armed Forces

may not have to meet these

tests. See instructions on back.

 See Members of the Armed Forces on back, if applicable.

 See the Distance Test and Time Test in the instructions to find out if you can deduct your moving

expenses.

TIP

TIP

2005

You do not have to meet the distance

test if you are in the Armed Forces and the

move is due to a permanent change of

station (see instructions on back).

be at least 53 miles from that home. If you

did not have an old workplace, your new

workplace must be at least 50 miles from

your old home. The distance between the

two points is the shortest of the more

commonly traveled routes between them.

010 "MILITARY MOVE"

040

042

044

052

B-62

060

070

180
OMB No. 1545-0162 Credit for Federal Tax Paid on Fuels

Form 4136

Department of the Treasury

Internal Revenue Service

Attachment

 Attach this form to your income tax return. Sequence No. 23

Name (as shown on your income tax return) Taxpayer identification number

Cat. No. 12625R Form 4136 (2005)

2 Nontaxable Use of Aviation Gasoline

Nontaxable Use of Gasoline

(b) Rate (c) Gallons (d) Amount of credit

Off-highway business use of gasoline

1

(e) CRN

362

3 Nontaxable Use of Undyed Diesel Fuel

Use of gasoline on a farm for farming purposes

a

b

c Other nontaxable use of gasoline

 See the Instructions on page 3.

(a) Type of use

Claimant certifies that the diesel fuel did not contain visible evidence of dye.

Exception. If any of the diesel fuel included in this claim did contain visible evidence of dye, attach an explanation; check here 

For Paperwork Reduction Act Notice, see the instructions.

Use in commercial aviation (other than foreign trade) 354

Other nontaxable use

a

b

Nontaxable use

Use in certain intercity and local buses

a

b

c Use in trains, July 1, 2005 – December 31, 2005

350

353

$

4

$

$



360

$.184/.183*

.184/.183*

.184/.183*

$ .15

.194/.193*

$.244/.243*

.22

.17

324

Nontaxable Use of Undyed Kerosene (Other Than Aviation-Grade Kerosene and Kerosene Used in Aviation)

Claimant certifies that the kerosene did not contain visible evidence of dye.

Exception. If any of the kerosene included in this claim did contain visible evidence of dye, attach an explanation; check here 

Nontaxable use $.244/.243* $ 346

Caution:

2005

 Use in trains, January 1, 2005 – June 30, 2005 .21

Nontaxable Use of Aviation-Grade Kerosene Before Oct. 1, 2005

Use in commercial aviation (other than foreign trade)

Other nontaxable use 369

a

b

$.175

.219

.044

5

355

c Use in foreign trade 377

d

(a) Type of use (b) Rate (c) Gallons (d) Amount of credit (e) CRN

(a) Type of use (b) Rate (c) Gallons (d) Amount of credit (e) CRN

(a) Type of use (b) Rate (c) Gallons (d) Amount of credit (e) CRN

a

b Use in certain intercity and local buses .17 350

(a) Type of use (b) Rate (c) Gallons (d) Amount of credit (e) CRN

$

6 Sales by Registered Ultimate Vendors of Undyed Diesel Fuel

Exception. If any of the diesel fuel included in this claim did contain visible evidence of dye, attach an explanation and check here 

Claimant certifies that it sold the diesel fuel at a tax-excluded price, repaid the amount of tax to the buyer, or has obtained written

consent of the buyer to make the claim. Claimant certifies that the diesel fuel did not contain visible evidence of dye.

Registration No. 

Use on a farm for farming purposes before Oct. 1, 2005 360

Use by a state or local government

a

b

$  $.244

.244/.243*

c Use in certain intercity and local buses .17

(a) Type of use (b) Rate (c) Gallons (d) Amount of credit (e) CRN

350

● There are two credit rates in effect for most fuels during 2005. The * rate is applicable after Sept. 30, 2005.

● Claims for diesel fuel and kerosene (other than kerosene used in aviation) used on a farm for farming purposes on new lines 3e and 4c are made only by the ultimate purchaser after September 30, 2005.

● Claims on lines 5 and 8 for aviation-grade kerosene can be made only for uses or sales before October 1, 2005. See

line 14 and the worksheets in the instructions for claims for kerosene used in aviation after September 30, 2005.

Caution: Claims for diesel fuel used on a farm for farming

purposes are made only by the ultimate purchaser on line 3e

after September 30, 2005.

Use on a farm for farming purposes after Sept. 30, 2005

Caution: Claims for kerosene used on a farm for farming

purposes are made only by the ultimate purchaser on line 4c

after September 30, 2005. See the instructions for an

exception for kerosene used in aviation.

Use on a farm for farming purposes after Sept. 30, 2005

Claimant certifies that the aviation-grade kerosene did not contain visible evidence of dye.

Exception. If any of the aviation-grade kerosene included in this claim did contain visible evidence of dye, attach a detailed

explanation and check here 

Caution: Line 5 applies to claims for aviation-grade kerosene before October 1, 2005. See line 14 and the worksheets in the instructions

for kerosene used in aviation after September 30, 2005.

e .243 360

c .243 346

Caution: Registered ultimate vendors cannot make claims for diesel fuel sold for use on a farm for farming purposes after Sept. 30, 2005.

010

020

"03,04,05,07,13,14" > 030 040

070

411

"01,03,09,10,13,14" > 190 200

"03,09,10,11,13" > 419

343

230

@240 "STM nn"

"02,03,06,07,08,13" > 260 270

347

300

310

320

330 340

400

"02,03,06,07,08,13" > 370

B-63

180

380

@350 "STM nn"

410

395

412

250

170

315

360

@413 "STM nn" 414

415 417

421 423

425 427

429

@431 "STM nn"

433

435

437 439

443 445

@441 "STM nn"
Use in certain intercity and local buses

Form 4136 (2005) Page 2

14 Kerosene For Use in Aviation After September 30, 2005. See the instructions for worksheets to figure the amount of credit.

Sales by Registered Ultimate Vendors of Undyed Kerosene (Other

Than Aviation-Grade Kerosene and Kerosene Used in Aviation)

7

Exception. If any of the kerosene included in this claim did contain visible evidence of dye, attach an explanation and check here 

Claimant certifies that it sold the kerosene at a tax-excluded price, repaid the amount of tax to the buyer, or has obtained the written consent

of the buyer to make the claim. Claimant certifies that the kerosene did not contain visible evidence of dye.

Use on a farm for farming purposes before Oct. 1, 2005

Use by a state or local government

a

b

c Sales from a blocked pump

Nontaxable Use of Liquefied Petroleum Gas (LPG)

Use in qualified local buses or school buses

a

b

Registration No. 

Form 4136 (2005)

8 Sales by Registered Ultimate Vendors of Aviation-Grade Kerosene before Oct. 1, 2005

Use in commercial aviation (other than foreign trade)

Other nontaxable use

a

b

Claimant sold the aviation-grade kerosene at a tax-excluded price and has not collected the amount of tax from the buyer, repaid the

amount of tax to the buyer, or has obtained written consent of the buyer to make the claim.

Reg. No. 

c Other nontaxable use

12 Alcohol Fuel Mixture Credit

Alcohol fuel mixtures containing ethanol

Alcohol fuel mixtures containing alcohol (other than ethanol)

a

b

Claimant produced an alcohol fuel mixture by mixing taxable fuel with alcohol. The alcohol fuel mixture was sold by the claimant to any

person for use as a fuel or was used as a fuel by the claimant.

13 Biodiesel Mixture Credit

Biodiesel (other than agri-biodiesel) mixtures 388

Agri-biodiesel mixtures

a

b 390

Claimant produced a biodiesel mixture by mixing diesel fuel with biodiesel. The biodiesel mixture was sold by the claimant to any person for

use as fuel or was used as a fuel by the claimant. Claimant has a certificate from the producer or importer of the biodiesel which identifies

the percentage of biodiesel and agri-biodiesel in the product, and has no reason to believe the information is false. See the instructions for

line 13 to see if you must attach the certificate.

Registration No. 

(b) Rate (c) Gallons (d) Amount of credit (e) CRN

346

(a) Type of use

$

 $.244

.244/.243*

.244/.243*

(b) Rate (c) Gallons (d) Amount of credit (e) CRN

355

(a) Type of use

$.175 $

.219

c Use on a farm for farming purposes .219 369

d Use by a state or local government .219 

d Use in certain intercity and local buses .17 350

9 Sales by Registered Ultimate Vendors of Gasoline

Claimant sold the gasoline at a tax-excluded price and has not collected the amount of tax from the buyer, repaid the amount of tax to the

buyer, or has obtained written consent of the buyer to make the claim; and obtained an unexpired certificate from the buyer and has no reason

to believe any information in the certificate is false. See the instructions for additional information to be submitted.

Use by a nonprofit educational organization

Use by a state or local government

a

b

(b) Rate (c) Gallons (d) Amount of credit (e) CRN

$.184/.183*

.184/.183*

11

362

10 Sales by Registered Ultimate Vendors of Aviation Gasoline

Registration No. 

Registration No. 

Claimant sold the aviation gasoline at a tax-excluded price and has not collected the amount of tax from the buyer, repaid the amount of tax

to the buyer, or has obtained written consent of the buyer to make the claim; and obtained an unexpired certificate from the buyer and has no

reason to believe any information in the certificate is false. See the instructions for additional information to be submitted.

$

Use by a nonprofit educational organization

Use by a state or local government

a

b

(b) Rate (c) Gallons (d) Amount of credit (e) CRN

$.194/.193*

.194/.193*

324 $

(b) Rate (c) Gallons (d) Amount of credit (e) CRN

352

(a) Type of use

$.062 $

.136 361

.136 395

(b) Rate (c) Gallons (d) Amount of credit (e) CRN

$.51

.60

$ 393

394

Registration No. 

(b) Rate (c) Gallons (d) Amount of credit (e) CRN

$.50

1.00

$

Caution: Registered ultimate vendors cannot make claims for kerosene sold for use on a farm for farming purposes after September 30, 2005.

Caution: Line 8 applies to claims for aviation-grade kerosene before October 1, 2005. See line 14 and the worksheets in the instructions

for sales of kerosene for use in aviation after September 30, 2005.

15 $

15 Total income tax credit claimed. Add lines 1 through 14, column (d). Enter here and on

Form 1040, line 70 (also check box b on line 70); Form 1120, line 32f(2); Form 1120-A, line

28f(2); Form 1120S, line 23c; Form 1041, line 24g; or the proper line of other returns. 

Use in commercial aviation (other than foreign trade)

Sales by registered ultimate vendors

a

b

(d) Amount of credit (e) CRN

$ 355

369

"03,09,10,13" > 735

@665 "STM nn" 660

745

705

715

765

640

@777 "STM nn"

@875 "STM nn"

805

785

795

815

830

825

840 850

860 870

880

910

B-64

775

680

755

650

"01,02,04,13,14" > 920

685

695

@827 "STM nn"

890

900

930 940

950

960

670

610

@630 "STM nn"

970

980 990

1000

1010 1020

1030 1040

1042

1046

1050
2 Unreported tips subject to Medicare tax. Enter the amount from line 5 (Form 4137) above 

1

Cat. No. 12626C

OMB No. 1545-0074 Social Security and Medicare Tax 4137 on Unreported Tip Income Form

 See instructions on back. Department of the Treasury

Internal Revenue Service

Attachment

 Attach to Form 1040. Sequence No. 24

Name of person who received tips (as shown on Form 1040). If married, complete a separate Form 4137 for each spouse with unreported tips. Social security number

Name(s) of employer(s) to whom you were required to, but did not, report your tips:

1 Total cash and charge tips you received in 2005 (see instructions) 1

2 Total cash and charge tips you reported to your employer in 2005 2

Subtract line 2 from line 1. This amount is income you must include in the total on Form 1040,

line 7

3

3

Cash and charge tips you received but did not report to your employer because the total was

less than $20 in a calendar month (see instructions)

4

4

5

Unreported tips subject to Medicare tax. Subtract line 4 from line 3. Enter here and on line 2

of Schedule U below

5

6 Maximum amount of wages (including tips) subject to social security tax 6 90,000 00

Total social security wages and social security tips (total of boxes 3

and 7 on Form(s) W-2) or railroad retirement (tier 1) compensation

7

7

8 Subtract line 7 from line 6. If line 7 is more than line 6, enter -0- here and on line 9 and go to line 11 8

Unreported tips subject to social security tax. Enter the smaller of line 5 or line 8 here and on

line 1 of Schedule U below. If you received tips as a federal, state, or local government

employee, see instructions

9

9

10 Multiply line 9 by .062 10

For Paperwork Reduction Act Notice, see instructions on back. Form 4137 (2005)

Do Not Detach

SCHEDULE U

(Form 1040) U.S. Schedule of Unreported Tip Income

For crediting to your social security record

The amounts you report below are for your social security record. This record is used to figure any benefits, based on your

earnings, payable to you and your dependents or your survivors. Fill in each item accurately and completely.

Note:

Print or type name of person who received tip income (as shown on Form 1040) Social security number

Address (number, street, and apt. no., or P.O. box if mail is not delivered to your home) Occupation

City, town or post office, state, and ZIP code

Unreported tips subject to social security tax. Enter the amount from line 9 (Form 4137) above  1

DLN—

11 Multiply line 5 by .0145

12 Add lines 10 and 11. Enter the result here and on Form 1040, line 59 

11

12

2

Department of the Treasury

Internal Revenue Service

Please do not write in this space

Schedule U (Form 1040) 2005

(99)

2005

2005

010 020

*030 "STM nn"

040

050

060

070

080

090

100

110

120

124 "1.45% TIPS"

130

140

190

200

B-65

127
Draft as of

06/20/2005

OMB No. 1545-0166

Form 4255 Recapture of Investment Credit

(Rev. November 2005) Attachment

Department of the Treasury Sequence No. 65 Internal Revenue Service  Attach to your income tax return.

Name(s) as shown on return Identifying number

Type of property—State whether rehabilitation, energy, or reforestation property. (See the Instructions for Form 3468 for the year the investment

credit property was placed in service for definitions.) If rehabilitation property, also show type of building. If energy property, show type. Properties

A

B

C

D

Computation Steps: Properties

(see Specific Instructions) A B C D

1 Original rate of credit

Date property was placed in service

2 Cost or other basis

3

4

5

6

Original Investment Credit

Original credit. Multiply line 2 by the

percentage on line 1

7

Date property ceased to be qualified

investment credit property

8

Number of full years between the date on line

4 and the date on line 5

9

10

Tentative recapture tax. Multiply line 3 by the

percentage on line 7

11

Add all the amounts on line 8

12

13

Enter the recapture tax from property for which there was an increase in nonqualified nonrecourse

financing (attach separate computation)

Add lines 9 and 10

Portion of original credit (line 3) not used to offset tax in any year, plus any carryback and

carryforward of credits you now can apply to the original credit year because you have freed up

tax liability in the amount of the tax recaptured. Do not enter more than line 11—see instructions

Recapture Tax

Total increase in tax. Subtract line 12 from line 11. Enter here and on the appropriate line of your tax

return. See section 29(b)(4) if you claim the nonconventional source fuel credit. Electing large

partnerships, see instructions

Cat. No. 41488C Form 4255 (Rev. 11-2005)

// // // //

// // // //

1

2

3

4

5

6

7

8

9

10

11

12

13

For Paperwork Reduction Act Notice, see back of form.

Recapture percentage (see instructions)

*010 "STM nn"

+020

*+023 "STM nn"

+080

+084

+090

+100 "00"

+110

+120

130

140

143

200

204

210

220

230

240

250

260

263

320

324

330

340

350

360

370

380

383

440

444

450

460

470

480

490

500

510

520

530

B-66

483 "TAX FROM ATTACHED" 486

495
Draft as of

12/29/2005

Depreciation and Amortization OMB No. 1545-0172

Form 4562 (Including Information on Listed Property)

Department of the Treasury

Internal Revenue Service

Attachment

 See separate instructions. Sequence No. 67

Name(s) shown on return Business or activity to which this form relates Identifying number

Election To Expense Certain Property Under Section 179

Note: If you have any listed property, complete Part V before you complete Part I.

1 Maximum amount. See the instructions for a higher limit for certain businesses 1 $105,000

2 Total cost of section 179 property placed in service (see instructions) 2

3 Threshold cost of section 179 property before reduction in limitation 3 $420,000

4 Reduction in limitation. Subtract line 3 from line 2. If zero or less, enter -0- 4

Dollar limitation for tax year. Subtract line 4 from line 1. If zero or less, enter -0-. If married filing 

separately, see instructions

5

5

(a) Description of property (b) Cost (business use only) (c) Elected cost

6

7 Listed property. Enter the amount from line 29 7

8 Total elected cost of section 179 property. Add amounts in column (c), lines 6 and 7 8

9 Tentative deduction. Enter the smaller of line 5 or line 8 9

10 Carryover of disallowed deduction from line 13 of your 2004 Form 4562 10

11 Business income limitation. Enter the smaller of business income (not less than zero) or line 5 (see instructions) 11

12 Section 179 expense deduction. Add lines 9 and 10, but do not enter more than line 11 12

13 Carryover of disallowed deduction to 2006. Add lines 9 and 10, less line 12  13

Note: Do not use Part II or Part III below for listed property. Instead, use Part V.

MACRS Depreciation (Do not include listed property.) (See instructions.)

(b) Month and

year placed in

service

(c) Basis for depreciation

(business/investment use

only—see instructions)

(d) Recovery

period (a) (e) Convention (f) Method (g) Depreciation deduction

Section B—Assets Placed in Service During 2005 Tax Year Using the General Depreciation System

19a 3-year property

b 5-year property

c 7-year property

d 10-year property

e 15-year property

f 20-year property

Residential rental 27.5 yrs. MM S/L

property

h

27.5 yrs. MM S/L

Nonresidential real MM S/L

property

i

MM S/L

Section C—Assets Placed in Service During 2005 Tax Year Using the Alternative Depreciation System

20a Class life S/L

b 12-year 12 yrs. S/L

c 40-year 40 yrs. MM S/L

Special Depreciation Allowance and Other Depreciation (Do not include listed property.) (See instructions.)

17 MACRS deductions for assets placed in service in tax years beginning before 2005 17

15 Property subject to section 168(f)(1) election 15

16 Other depreciation (including ACRS) 16

Summary (see instructions)

21 Listed property. Enter amount from line 28 21

Total. Add amounts from line 12, lines 14 through 17, lines 19 and 20 in column (g), and line 21.

Enter here and on the appropriate lines of your return. Partnerships and S corporations—see instr.

22

22

23 For assets shown above and placed in service during the current year,

enter the portion of the basis attributable to section 263A costs 23

For Paperwork Reduction Act Notice, see separate instructions. Cat. No. 12906N Form 4562 (2005) (Rev. 1-2006)

Part IV

Part I

Part II

Part III

 Attach to your tax return.

39 yrs.

Section A

18 If you are electing to group any assets placed in service during the tax year into one or more

general asset accounts, check here 

Classification of property

g 25-year property 25 yrs. S/L

Special allowance for certain aircraft, certain property with a long production period, and qualified NYL 

or GO Zone property (other than listed property) placed in service during the tax year (see instructions)

14

14

(Rev. January 2006) 2005

010

012

014

018

*020 "STM nn" +030 +040

050 060 070

080

081

083

088

090

092

094

096

*111 "STM nn" +113 +115 +120 +130

*140 "STM nn" +150 +155 +160 +170

*172 "STM nn" +174 +175 +176 +178

*180 "STM nn" +190 +195 +200 +210

*220 "STM nn" +230 +235 +240 +250

*275 "STM nn" +285 +287 +295 +305

*307 "STM nn" +309 +311

*313 "STM nn" +317 +333

337 343 357

*363 "STM nn" +367 +383

*387 "STM nn" +393 +400 +407

410 415 420 425

430 435 440

445 450 455

@098 "STM nn"

@103 "STM nn"

497

500

505

B-67

101

105

107

109
Draft as of

12/29/2005

Form 4562 (2005) (Rev. 1-2006) Page 2

Listed Property (Include automobiles, certain other vehicles, cellular telephones, certain computers, and

property used for entertainment, recreation, or amusement.)

Note: For any vehicle for which you are using the standard mileage rate or deducting lease expense, complete only

24a, 24b, columns (a) through (c) of Section A, all of Section B, and Section C if applicable.

Section A—Depreciation and Other Information (Caution: See the instructions for limits for passenger automobiles.)

24a Do you have evidence to support the business/investment use claimed? Yes No 24b If “Yes,” is the evidence written? Yes No

(i)

Elected

section 179

cost

(h)

Depreciation

deduction

(g)

Method/

Convention

(f)

Recovery

period

(e)

Basis for depreciation

(business/investment

use only)

(d)

Cost or other

basis

(c)

Business/ investment

use

percentage

(b)

Date placed in

service

(a)

Type of property (list

vehicles first)

26 Property used more than 50% in a qualified business use:

%

%

%

27 Property used 50% or less in a qualified business use:

% S/L –

% S/L –

% S/L –

28 Add amounts in column (h), lines 25 through 27. Enter here and on line 21, page 1 28

29 Add amounts in column (i), line 26. Enter here and on line 7, page 1 29

Section B—Information on Use of Vehicles

(f)

Vehicle 6

(e)

Vehicle 5

(d)

Vehicle 4

(c)

Vehicle 3

(b)

Vehicle 2

(a)

Vehicle 1

Total business/investment miles driven

during the year (do not include commuting

miles)

30

31 Total commuting miles driven during the year

Total other personal (noncommuting)

miles driven 

32

Total miles driven during the year. Add

lines 30 through 32 

33

Was the veh Yes No Yes No Yes No Yes No Yes No Yes No icle available for personal

use during off-duty hours?

34

Was the vehicle used primarily by a

more than 5% owner or related person?

35

Is another vehicle available for personal 

use?

36

Section C—Questions for Employers Who Provide Vehicles for Use by Their Employees

Yes No Do you maintain a written policy statement that prohibits all personal use of vehicles, including commuting, 

by your employees?

37

Do you maintain a written policy statement that prohibits personal use of vehicles, except commuting, by your employees?

See the instructions for vehicles used by corporate officers, directors, or 1% or more owners

38

39 Do you treat all use of vehicles by employees as personal use?

Do you provide more than five vehicles to your employees, obtain information from your employees about 

the use of the vehicles, and retain the information received?

40

41 Do you meet the requirements concerning qualified automobile demonstration use? (See instructions.)

Note: If your answer to 37, 38, 39, 40, or 41 is “Yes,” do not complete Section B for the covered vehicles.

Amortization

(e)

Amortization

period or

percentage

(b)

Date amortization

begins

(c)

Amortizable

amount

(d)

Code

section

(f)

Amortization for

this year

(a)

Description of costs

42 Amortization of costs that begins during your 2005 tax year (see instructions):

43 Amortization of costs that began before your 2005 tax year 43

44 Total. Add amounts in column (f). See the instructions for where to report 44

Complete this section for vehicles used by a sole proprietor, partner, or other “more than 5% owner,” or related person.

If you provided vehicles to your employees, first answer the questions in Section C to see if you meet an exception to completing this section for those vehicles.

Part VI

Part V

Answer these questions to determine if you meet an exception to completing Section B for vehicles used by employees who are

not more than 5% owners or related persons (see instructions).

Form 4562 (2005) (Rev. 1-2006)

Special allowance for certain aircraft, certain property with a long production period, and qualified NYL or GO Zone 

property placed in service during the tax year and used more than 50% in a qualified business use (see instructions)

25

25

762 764 766 768

*775 "STM nn" +780 +790 +800 +810 +815 +822 +830 +840

850 860 870 880 890 895 902 910 920

930 940 950 960 970 975 985 990 1000

*1010 "STM nn" +1020 +1030 +1040 +1050 +1055 +1060 +1070

1090 1100 1110 1120 1130 1135 1140 1150

1170 1180 1190 1200 1210 1215 1220 1230

1500

1600

*1620 "STM nn"

+1630

+1640

+1645

1660

1670

1680

1685

1700

1710

1720

1725

1740

1750

1760

1765

1780

1790

1800

1805

1820

1830

1840

1845

1850 "STM nn"+1860

+1863+1867

+1870+1880

1910 1920

1923 1927

1930 1940

1970 1980

1983 1987

1990 2000

2030 2040

2043 2047

2050 2060

2090 2100

2103 2107

2110 2120

2150 2160

2163 2167

2170 2180

2190 2200

2210 2220

2230 2240

2250 2260

2270 2280

*2290 "STM nn" +2300 +2310 +2320 +2330 +2340

2350 2360 2370 2380 2390 2400

2410

2420 B-68

773
Exclusion of Income for Bona Fide Residents OMB No. 1545-0074

of American Samoa Form 4563

Department of the Treasury  See instructions below and on back.

Internal Revenue Service

Attachment

 Attach to Form 1040. Sequence No. 68

Name(s) shown on Form 1040 Your social security number

1 Date bona fide residence began  , and ended 

2 Type of living quarters in Rented room Rented house or apartment

American Samoa  Quarters furnished by employer Purchased home

3a Did any of your family live with you in American Samoa during any part of the tax year? Yes No

If “Yes,” who and for what period? 

4a Did you maintain any home(s) outside American Samoa? Yes No

If “Yes,” show address of your home(s), whether it was rented, the name of each occupant, and his or her relationship to

you.  

5 Name and address of employer (state if self-employed) 

6 Complete columns (a) through (d) below for days absent from American Samoa during the tax year.

(c) Number of

days absent

(b) Date

returned (a) Date left (d) Reason for absence

7 Wages, salaries, tips, etc. 7

8 Taxable interest 8

9 Ordinary dividends 9

10 Business income 10

11 Capital gain 11

12 Rental real estate, royalties, etc. 12

13 Farm income 13

14 Other income. List type and amount 

14

Add lines 7 through 14. This is the amount you may exclude from your gross income this tax

year 

15

15

Instructions

Section references are to the Internal Revenue Code.

Purpose of Form

If you qualify, use Form 4563 to figure the amount of income

you may exclude from your gross income.

(Rev. December 2005)

Part I

Part II

General Information

b

b

Figure Your Exclusion. Include only income that qualifies for the exclusion. See instructions.

What’s New

● The rules for determining whether you are a bona fide

resident of American Samoa have changed. See Bona Fide

Residence Test on this page.

Who Qualifies

You qualify for the exclusion if you were a bona fide resident

of American Samoa for the entire tax year. See Bona Fide

Residence Test on this page.

TIP

In future years, bona fide residents of Guam and the

Commonwealth of the Northern Mariana Islands

(CNMI) may also qualify for the exclusion. They will

not qualify, however, unless implementation

agreements are in effect with the United States. At the time

this form went to print, the CNMI had not entered into an

implementation agreement. Also, the effective date of the

agreement between the United States and Guam had not been

determined.

Bona Fide Residence Test

To qualify under this test, you must be a bona fide resident of

American Samoa for the entire tax year (January 1 through

December 31 if you file a calendar year return).

● Are present in American Samoa for at least 183 days,

In general, for tax years beginning after October 22, 2004,

you are a bona fide resident of American Samoa if, during the

tax year, you:

● Do not have a tax home outside of American Samoa, and

● Do not have a closer connection to the United States or a

foreign country than to American Samoa.

For Paperwork Reduction Act Notice, see back of form. Cat No. 12909U Form 4563 (Rev. 12-2005)

● If, in tax year 2001 or later, you become or ceased to be a

bona fide resident of a U.S. possession, you may be required

to file Form 8898, Statement for Individuals Who Begin or

End Bona Fide Residence in a U.S. Possession. The penalty

for failure to provide the required information is $1,000. For

details, see the Instructions for Form 8898.

010 020

030 040

050 060

070 080 090 100

*110 +120

130 140

*150 +160 *+170 +180

190 200

*210 +220 +230 +240

250 260 270 280

290 300 310 320

330 340 350 360

370

380

390

400

410

420

430

*440 "AN", "MSA", "LTC", or "STM nn"

450

460

B-69

+445
OMB No. 1545-0177 Casualties and Thefts

Form 4684  See separate instructions.

 Attach to your tax return. Department of the Treasury

Internal Revenue Service

Attachment

 Use a separate Form 4684 for each casualty or theft. Sequence No. 26

Name(s) shown on tax return Identifying number

SECTION A—Personal Use Property (Use this section to report casualties and thefts of property not used in a trade

or business or for income-producing purposes.)

1 Description of properties (show type, location, and date acquired for each property). Use a separate line for each property lost or damaged

from the same casualty or theft.

Property A

Property B

Property C

Property D

Properties

A D B C

Cost or other basis of each property 2 2

Insurance or other reimbursement (whether or not

you filed a claim) (see instructions)

3

3

Note: If line 2 is more than line 3, skip line 4.

Gain from casualty or theft. If line 3 is more than line

2, enter the difference here and skip lines 5 through 9

for that column. See instructions if line 3 includes insurance or other reimbursement you did not claim, or

you received payment for your loss in a later tax year

4

4

5 5 Fair market value before casualty or theft

6 Fair market value after casualty or theft 6

7 Subtract line 6 from line 5 7

8 Enter the smaller of line 2 or line 7 8

9

Subtract line 3 from line 8. If zero or less,

enter -0-

9

10 Casualty or theft loss. Add the amounts on line 9 in columns A through D 10

11

Enter the smaller of line 10 or $100. But if the loss arose in the Hurricane Katrina disaster area after August

24, 2005, and was caused by Hurricane Katrina, enter -0-

11

12 Subtract line 11 from line 10 12

Caution: Use only one Form 4684 for lines 13 through 21.

13 Add the amounts on line 12 of all Forms 4684 13

14 Add the amounts on line 4 of all Forms 4684 14

15

15

16 If line 14 is less than line 13, enter the difference 16

17 Add the amounts on line 12 of all Forms 4684 on which you entered -0- on line 11 17

18 Is line 17 less than line 16?

18

For Paperwork Reduction Act Notice, see page 4 of the instructions. Form 4684 (2005)

● If line 14 is more than line 13, enter the difference here and on Schedule D. Do not

complete the rest of this section (see instructions).

● If line 14 is less than line 13, enter -0- here and go to line 16.

● If line 14 is equal to line 13, enter -0- here. Do not complete the rest of this section.

Cat. No. 12997O



2005

19 Enter 10% of your adjusted gross income from Form 1040, line 38. Estates and trusts, see instructions 19

20 Subtract line 19 from line 18. If zero or less, enter -0- 20

Add lines 17 and 20. Also enter the result on Schedule A (Form 1040), line 19. Estates and trusts, enter the result

on the “Other deductions” line of your tax return

21

21

No. Stop. Enter the amount from line 16 on Schedule A (Form 1040), line 19. Estates and trusts, enter the

amount from line 16 on the “Other deductions” line of your tax return.

Yes. Subtract line 17 from line 16.

+020

+030

*+040 "STM nn"

+050

+060

+070

+080

+090

110

120

130

140

150

160

170

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200

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220

230

240

250

260

270

290

300

310

320

330

340

350

360

370

380

390

400

410

420

430

435

445

B-70

*010 "STM nn"

100

190

280

437

439

447

451

453
Form 4684 (2005) Page 2

Name(s) shown on tax return. Do not enter name and identifying number if shown on other side. Identifying number

SECTION B—Business and Income-Producing Property

Casualty or Theft Gain or Loss (Use a separate Part l for each casualty or theft.)

22 Description of properties (show type, location, and date acquired for each property). Use a separate line for each property lost or damaged from the same casualty or theft.

Property A

Property B

Property C

Property D

Properties

A B C D

23 Cost or adjusted basis of each property 23

Insurance or other reimbursement (whether or not

you filed a claim). See the instructions for line 3

24

24

Note: If line 23 is more than line 24, skip line 25

Gain from casualty or theft. If line 24 is more than line

23, enter the difference here and on line 32 or line 37,

column (c), except as provided in the instructions for

line 36. Also, skip lines 26 through 30 for that column.

See the instructions for line 4 if line 24 includes

insurance or other reimbursement you did not claim, or

you received payment for your loss in a later tax year

25

25

Fair market value before casualty or theft 26 26

27 Fair market value after casualty or theft 27

28 Subtract line 27 from line 26 28

29 Enter the smaller of line 23 or line 28 29

Note: If the property was totally destroyed by

casualty or lost from theft, enter on line 29 the

amount from line 23.

30 Subtract line 24 from line 29. If zero or less, enter -0- 30

31 Casualty or theft loss. Add the amounts on line 30. Enter the total here and on line 32 or line 37 (see instructions) 31

Summary of Gains and Losses (from separate Parts l) (b) Losses from casualties or thefts (c) Gains from

casualties or thefts

includible in income

(i) Trade, business,

rental or royalty

property

(ii) Incomeproducing and

employee property

(a) Identify casualty or theft

Casualty or Theft of Property Held One Year or Less

32

33 Totals. Add the amounts on line 32 33

34 Combine line 33, columns (b)(i) and (c). Enter the net gain or (loss) here and on Form 4797, line 14. If Form 4797

is not otherwise required, see instructions 34

35 Enter the amount from line 33, column (b)(ii) here. Individuals, enter the amount from income-producing property

on Schedule A (Form 1040), line 27, and enter the amount from property used as an employee on Schedule A

(Form 1040), line 22. Estates and trusts, partnerships, and S corporations, see instructions 35

Casualty or Theft of Property Held More Than One Year

36 Casualty or theft gains from Form 4797, line 32 36

37

38 38 Total losses. Add amounts on line 37, columns (b)(i) and (b)(ii)

39 Total gains. Add lines 36 and 37, column (c) 39

40 Add amounts on line 38, columns (b)(i) and (b)(ii) 40

Note: Partnerships, enter the amount from line 41a, 41b, or line 42 on Form 1065, Schedule K, line 11.

S corporations, enter the amount from line 41a or 41b on Form 1120S, Schedule K, line 10.

41 If the loss on line 40 is more than the gain on line 39:

a Combine line 38, column (b)(i) and line 39, and enter the net gain or (loss) here. Partnerships (except electing

large partnerships) and S corporations, see the note below. All others, enter this amount on Form 4797, line 14.

If Form 4797 is not otherwise required, see instructions 41a

b Enter the amount from line 38, column (b)(ii) here. Individuals, enter the amount from income-producing property on 

Schedule A (Form 1040), line 27, and enter the amount from property used as an employee on Schedule A (Form 1040),

line 22. Estates and trusts, enter on the “Other deductions” line of your tax return. Partnerships (except electing large

partnerships) and S corporations, see the note below. Electing large partnerships, enter on Form 1065-B, Part II, line 11 41b

If the loss on line 40 is less than or equal to the gain on line 39, combine lines 39 and 40 and enter here. Partnerships

(except electing large partnerships), see the note below. All others, enter this amount on Form 4797, line 3

42

42

( )

( )

( )

( )

( )

( )

( )

( )

( )

( )

( )( )

Part I

Part II

Form 4684 (2005)

Attachment Sequence No. 26

*470 "STM nn"

+480

+490

*+500 "STM nn"

+510

+520

+530

+540

+550

560

570

580

590

600

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680

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730

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760

770

780

790

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810

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830

*840 "STM nn" +850 +860 +870

880 890 900 910

920 930 940

948 "PAL"

950

958 "PAL"

960

970

*980 "STM nn" +990 +1000 +1010

1020 1030 1040 1050

1060 1070

1080

1090

1098 "PAL"

1100

1108 "PAL"

1110

1120

B-71

*825"STM nn"

+545 725 635

815

1115 "PAL"
Sales of Business Property

(Also Involuntary Conversions and Recapture Amounts

Under Sections 179 and 280F(b)(2)) Department of the Treasury 

Internal Revenue Service

Attachment

Attach to your tax return. Sequence No. 27

Name(s) shown on return Identifying number

Sales or Exchanges of Property Used in a Trade or Business and Involuntary Conversions From Other

Than Casualty or Theft—Most Property Held More Than 1 Year (see instructions)

Enter the gross proceeds from sales or exchanges reported to you for 2005 on Form(s) 1099-B or 1099-S (or substitute

statement) that you are including on line 2, 10, or 20 (see instructions)

1

1

(f) Cost or other

basis, plus

improvements and

expense of sale

(e) Depreciation

allowed or

allowable since

acquisition

(g) Gain or (loss)

Subtract (f) from the

sum of (d) and (e)

(c) Date sold

(mo., day, yr.)

(b) Date acquired

(mo., day, yr.)

(a) Description

of property

(d) Gross

sales price

2

3 Gain, if any, from Form 4684, line 42

4 Section 1231 gain from installment sales from Form 6252, line 26 or 37

Gain, if any, from line 32, from other than casualty or theft

5

Combine lines 2 through 6. Enter the gain or (loss) here and on the appropriate line as follows:

6

7

Partnerships (except electing large partnerships) and S corporations. Report the gain or (loss) following the

instructions for Form 1065, Schedule K, line 10, or Form 1120S, Schedule K, line 9. Skip lines 8, 9, 11, and 12 below.

Individuals, partners, S corporation shareholders, and all others. If line 7 is zero or a loss, enter the amount

from line 7 on line 11 below and skip lines 8 and 9. If line 7 is a gain and you did not have any prior year section

1231 losses, or they were recaptured in an earlier year, enter the gain from line 7 as a long-term capital gain

on the Schedule D filed with your return and skip lines 8, 9, 11, and 12 below.

8 Nonrecaptured net section 1231 losses from prior years (see instructions)

9 Subtract line 8 from line 7. If zero or less, enter -0-. If line 9 is zero, enter the gain from line 7 on line 12 below.

If line 9 is more than zero, enter the amount from line 8 on line 12 below and enter the gain from line 9 as a

long-term capital gain on the Schedule D filed with your return (see instructions)

Ordinary Gains and Losses (see instructions)

Ordinary gains and losses not included on lines 11 through 16 (include property held 1 year or less):

Loss, if any, from line 7

10

Gain, if any, from line 7 or amount from line 8, if applicable

11

Gain, if any, from line 31

12

Net gain or (loss) from Form 4684, lines 34 and 41a

13

Ordinary gain from installment sales from Form 6252, line 25 or 36

14

15

Combine lines 10 through 16

16

b

If the loss on line 11 includes a loss from Form 4684, line 38, column (b)(ii), enter that part of the loss here. Enter

the part of the loss from income-producing property on Schedule A (Form 1040), line 27, and the part of the

loss from property used as an employee on Schedule A (Form 1040), line 22. Identify as from “Form 4797, line

18a.” See instructions

Redetermine the gain or (loss) on line 17 excluding the loss, if any, on line 18a. Enter here and on Form 1040,

line 14

For Paperwork Reduction Act Notice, see separate instructions. Cat. No. 13086I Form 4797 (2005)

Part I

Part II

OMB No. 1545-0184

Section 1231 gain or (loss) from like-kind exchanges from Form 8824

Ordinary gain or (loss) from like-kind exchanges from Form 8824

17

3

4

5

6

7

8

11

12

13

14

15

16

17

18a

18b

(99)

9

( )

Form 4797

a

For all except individual returns, enter the amount from line 17 on the appropriate line of your return and skip

lines a and b below. For individual returns, complete lines a and b below:

18

See separate instructions.

2005

030

*040 "STM nn" +050 +060 +070 +080 +090 +095

120 130 140 150 160 170 175

200 210 220 230 240 250 255

440

450

456

461

482

500

511

*520 "STM nn" +530 +540 +550 +560 +570 +575

600 610 620 630 640 650 655

680 690 700 710 720 730 735

925

930

940

1030

955

970

974

1020

B-72

280 290 300 310 320 330 335

760 770 780 790 800 810 815

1005
Form 4797 (2005) Page 2

Gain From Disposition of Property Under Sections 1245, 1250, 1252, 1254, and 1255

(see instructions)

(c) Date sold

(mo., day, yr.)

(b) Date acquired

(mo., day, yr.) (a) Description of section 1245, 1250, 1252, 1254, or 1255 property:

A

B

C

D

These columns relate to the properties on lines 19A through 19D.  Property A Property B Property C Property D

Gross sales price (Note: See line 1 before completing.)

Cost or other basis plus expense of sale

19

Depreciation (or depletion) allowed or allowable

20

Adjusted basis. Subtract line 22 from line 21

21

Total gain. Subtract line 23 from line 20

22

If section 1245 property:

23

a Depreciation allowed or allowable from line 22

b Enter the smaller of line 24 or 25a

If section 1250 property: If straight line depreciation was used, enter

-0- on line 26g, except for a corporation subject to section 291.

24

a Additional depreciation after 1975 (see instructions)

Applicable percentage multiplied by the smaller of line 24 or

line 26a (see instructions)

b

Subtract line 26a from line 24. If residential rental property or

line 24 is not more than line 26a, skip lines 26d and 26e

c

d Additional depreciation after 1969 and before 1976

e Enter the smaller of line 26c or 26d

f Section 291 amount (corporations only)

g Add lines 26b, 26e, and 26f

25

If section 1252 property: Skip this section if you did not

dispose of farmland or if this form is being completed for a

partnership (other than an electing large partnership).

a Soil, water, and land clearing expenses

b Line 27a multiplied by applicable percentage (see instructions)

c Enter the smaller of line 24 or 27b

If section 1254 property:

26

Intangible drilling and development costs, expenditures for

development of mines and other natural deposits, and

mining exploration costs (see instructions)

a

b Enter the smaller of line 24 or 28a

If section 1255 property:

27

Applicable percentage of payments excluded from income

under section 126 (see instructions)

a

b Enter the smaller of line 24 or 29a (see instructions)

Summary of Part III Gains. Complete property columns A through D through line 29b before going to line 30.

Total gains for all properties. Add property columns A through D, line 24

28

Add property columns A through D, lines 25b, 26g, 27c, 28b, and 29b. Enter here and on line 13

29

Subtract line 31 from line 30. Enter the portion from casualty or theft on Form 4684, line 36. Enter the portion from

other than casualty or theft on Form 4797, line 6

30

31

32

33

Recapture Amounts Under Sections 179 and 280F(b)(2) When Business Use Drops to 50% or Less

(see instructions)

(b) Section 

280F(b)(2)

(a) Section

179

Section 179 expense deduction or depreciation allowable in prior years

34 Recomputed depreciation (see instructions)

35 Recapture amount. Subtract line 34 from line 33. See the instructions for where to report

Part IV

Part III

20

21

22

23

24

25a

26a

27a

28a

29a

26b

26c

26d

26e

26f

26g

27b

27c

28b

29b

25b

30

31

32

33

34

35

Form 4797 (2005)

*1050 "STM nn" +1060 +1070

+1080

+1090

+1100 "STM nn

+1110

+1120

1130 1140 1150

1160

1170

1180

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1200

1210 1220 1230

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"STM nn"

+1380

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"STM nn"

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"STM nn"

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1920

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"STM nn"

+1940

1950

1960

1970

1980

1990

2000

2010

2020

2030

*2070 "STM nn" +2080

2090 2100

B-73 2110 2120
OMB No. 1545-0074 Farm Rental Income and Expenses Form 4835 (Crop and Livestock Shares (Not Cash) Received by Landowner (or Sub-Lessor))

(Income not subject to self-employment tax) Department of the Treasury

Internal Revenue Service

Attachment

 Attach to Form 1040. Sequence No. 37

Name(s) shown on Form 1040 Your social security number

Employer ID number (EIN), if any

A Did you actively participate in the operation of this farm during 2005 (see instructions)? Yes No

Gross Farm Rental Income—Based on Production. Include amounts converted to cash or the equivalent.

1 Income from production of livestock, produce, grains, and other crops 1

2a Cooperative distributions (Form(s) 1099-PATR) 2a 2b 2b Taxable amount

3a Agricultural program payments (see instructions) 3a 3b 3b Taxable amount

4 Commodity Credit Corporation (CCC) loans (see instructions):

a CCC loans reported under election 4a

b CCC loans forfeited 4b 4c Taxable amount 4c

5 Crop insurance proceeds and Federal crop disaster payments (see instructions):

a Amount received in 2005 5a 5b Taxable amount 5b

c If election to defer to 2006 is attached, check here  5d Amount deferred from 2004 5d

6 Other income, including Federal and state gasoline or fuel tax credit or refund (see instructions) 6

Gross farm rental income. Add amounts in the right column for lines 1 through 6. Enter the

total here and on Schedule E (Form 1040), line 42 

7

7

Expenses—Farm Rental Property. Do not include personal or living expenses.

8

8

20

9

20

9 Chemicals

22 Rent or lease:

Conservation expenses (see

instructions)

10

10

a

11

22a

11 Custom hire (machine work) b Other (land, animals, etc.)

12 Depreciation and section 179 23 Repairs and maintenance

expense deduction not

claimed elsewhere

22b

24 Seeds and plants

25 25 Storage and warehousing

26

12

26 Supplies

27 Taxes 27

Employee benefit programs

other than on line 21 (see

Schedule F instructions)

13

13 28 Utilities 28

29

14 Veterinary, breeding, and

medicine

14 Feed 29

15 Fertilizers and lime 15

Other expenses

(specify):

16

30a

16 Freight and trucking

a

17

30b

17 Gasoline, fuel, and oil

b

18

30c

18 Insurance (other than health)

c

30d

19 Interest:

d

30e

a Mortgage (paid to banks, etc.)

e

b Other 19b

Labor hired (less employment

credits) (see Schedule F

instructions)

31 Total expenses. Add lines 8 through 30g  31

Net farm rental income or (loss). Subtract line 31 from line 7. If the result is income, enter

it here and on Schedule E, line 40. If the result is a loss, you must go to line 33

32

32

If line 32 is a loss, check the box that describes your investment in this activity 33a All investment is at risk.

(see instructions)

33  33b Some investment is not at risk.

You may need to complete Form 8582 to determine your deductible loss, regardless of which

box you checked (see instructions). If you checked box 33b, you must complete Form 6198

before going to Form 8582. In either case, enter the deductible loss here and on

Schedule E, line 40 33c

For Paperwork Reduction Act Notice, see instructions on back. Form 4835 (2005)

Part I

Part II

Car and truck expenses (see

Schedule F instructions). Also

attach Form 4562 

19a

30

Cat. No. 13117W

f 30f

21

21

24

 See instructions on back.

Pension and profit-sharing

plans

2005

23

g 30g

Vehicles, machinery,

and equipment (see

instructions)

010

030 035

050

060 075

090 095

@100 "STM nn" 110

112 115

120 122

@123 "STM nn" 124 126

140

150

165

170

180

185

190

200

210

220

230

240

250

@255 "STM nn"

260

@265 "STM nn" 270

280

320

330

335

340

350

370

380

390

400

410

*420 "STM nn" +430

440 450

460 470

480 490

500 510

511 512

513 514

600

610

615

620

630

B-74

605 "PAL"
OMB No. 1545-0191

Form 4952 Investment Interest Expense Deduction

 Attach to your tax return. Department of the Treasury

Internal Revenue Service

Attachment

Sequence No. 51

Name(s) shown on return Identifying number

1 Investment interest expense paid or accrued in 2005 (see instructions) 1

2 Disallowed investment interest expense from 2004 Form 4952, line 7 2

3 Total investment interest expense. Add lines 1 and 2 3

4a

Gross income from property held for investment (excluding any net

gain from the disposition of property held for investment)

4a

5 Investment expenses (see instructions) 5

6 Net investment income. Subtract line 5 from line 4h. If zero or less, enter -0- 6

Cat. No. 13177Y Form 4952 (2005)

General Instructions

Section references are to the Internal

Revenue Code unless otherwise noted.

Total Investment Interest Expense

Net Investment Income

Investment Interest Expense Deduction

b Qualified dividends included on line 4a

c Subtract line 4b from line 4a

d Net gain from the disposition of property held for investment

e Enter the smaller of line 4d or your net capital gain from the disposition

of property held for investment (see instructions)

f Subtract line 4e from line 4d

Disallowed investment interest expense to be carried forward to 2006. Subtract line 6 from

line 3. If zero or less, enter -0-

7

8 Investment interest expense deduction. Enter the smaller of line 3 or 6. See instructions

4f

4b

4c

7

8

Part III

Part I

Part II

Purpose of Form

Use Form 4952 to figure the amount of

investment interest expense you can deduct

for 2005 and the amount you can carry

forward to future years. Your investment

interest expense deduction is limited to your

net investment income.

For more information, see Pub. 550,

Investment Income and Expenses.

Who Must File

If you are an individual, estate, or a trust, you

must file Form 4952 to claim a deduction for

your investment interest expense.

● You have no other deductible investment

expenses.

● Your investment interest expense is not

more than your investment income from

interest and ordinary dividends minus any

qualified dividends.

Allocation of Interest

Expense

If you paid or accrued interest on a loan and

used the loan proceeds for more than one

purpose, you may have to allocate the

interest. This is necessary because different

Specific Instructions

Part I—Total Investment

Interest Expense

Enter the investment interest expense paid or

accrued during the tax year, regardless of

when you incurred the indebtedness.

Investment interest expense is interest paid or

accrued on a loan or part of a loan that is

allocable to property held for investment (as

defined on this page).

Include investment interest expense

reported to you on Schedule K-1 from a

partnership or an S corporation. Include

amortization of bond premium on taxable

bonds purchased after October 22, 1986, but

before January 1, 1988, unless you elected to

offset amortizable bond premium against the

interest payments on the bond. A taxable

bond is a bond on which the interest is

includible in gross income.

Line 1

For Paperwork Reduction Act Notice, see back of form.

● You have no disallowed investment interest

expense from 2004.

Exception. You do not have to file Form 4952

if all of the following apply.

g Enter the amount from lines 4b and 4e that you elect to include in investment income (see

instructions)

h Investment income. Add lines 4c, 4f, and 4g 4h

4g

4d

4e

Property held for investment. Property held

for investment includes property that

produces income, not derived in the ordinary

course of a trade or business, from interest,

dividends, annuities, or royalties. It also

includes property that produces gain or loss,

not derived in the ordinary course of a trade

or business, from the disposition of property

that produces these types of income or is

held for investment. However, it does not

include an interest in a passive activity.

Investment interest expense does not

include any of the following:

● Home mortgage interest.

● Interest expense that is properly allocable

to a passive activity. Generally, a passive

activity is any business activity in which you

do not materially participate and any rental

activity. See the Instructions for Form 8582,

Passive Activity Loss Limitations, for details.

● Any interest expense that is capitalized,

such as construction interest subject to

section 263A.

● Interest expense related to tax-exempt

interest income under section 265.

● Interest expense, disallowed under section

264, on indebtedness with respect to life

insurance, endowment, or annuity contracts

issued after June 8, 1997, even if the

proceeds were used to purchase any

property held for investment.

Exception. A working interest in an oil or

gas property that you held directly or through

an entity that did not limit your liability is

property held for investment, but only if you

did not materially participate in the activity.

(99)

rules apply to investment interest, personal

interest, trade or business interest, home

mortgage interest, and passive activity

interest. See Pub. 535, Business Expenses.

Part II—Net Investment

Income

Gross income from property held for

investment includes income, unless derived in

the ordinary course of a trade or business,

from interest, ordinary dividends (except

Alaska Permanent Fund dividends), annuities,

and royalties.

Line 4a

2005

010

020

030

032

100

110

120

130

140

150

B-75

+070

+070

+090

160

170

102 "ELEC" 104
OMB No. 1545-0192 Tax on Accumulation Distribution of Trusts

Form 4970

 Attach to beneficiary’s tax return.

Department of the Treasury

Internal Revenue Service

Attachment

 See instructions on back. Sequence No. 73

Name(s) as shown on return Social security number

Name and address of trust Employer identification number

Type of trust (see instructions) Beneficiary’s date of birth Enter number of trusts from which you received accumulation

Domestic Foreign distributions in this tax year 

Average Income and Determination of Computation Years

1 Amount of current distribution that is considered distributed in earlier tax years (from Schedule J

(Form 1041), line 37, column (a)) 1

2 Distributions of income accumulated before you were born or reached age 21 2

3 Subtract line 2 from line 1 3

4 Taxes imposed on the trust on amounts from line 3 (from Schedule J (Form 1041), line 37, column (b)) 4

5 Total (add lines 3 and 4) 5

6 Tax-exempt interest included on line 5 (from Schedule J (Form 1041), line 37, column (c)) 6

7 Taxable part of line 5 (subtract line 6 from line 5) 7

8 Number of trust’s earlier tax years in which amounts on line 7 are considered distributed 8

9 Average annual amount considered distributed (divide line 3 by line 8) 9

10 Multiply line 9 by .25 10

11 Number of earlier tax years to be taken into account (see instructions) 11

12 Average amount for recomputing tax (divide line 7 by line 11). Enter here and in each column on line 15 12

(a) 2004 (e) 2000 (b) 2003 (c) 2002 (d) 2001 13 Enter your taxable income before

this distribution for the 5

immediately preceding tax years

Tax Attributable to the Accumulation Distribution

(a) (b) (c)

Enter the amounts from line 13, eliminating the highest and

lowest taxable income years

14

14

15 Enter amount from line 12 in each column 15

16 Recomputed taxable income (add lines 14 and 15) 16

17 Income tax on amounts on line 16 17

18 Income tax before credits on line 14 income 18

19 Additional tax before credits (subtract line 18 from line 17) 19

20 Tax credit adjustment 20

21 Subtract line 20 from line 19 21

22 Alternative minimum tax adjustments 22

23 Combine lines 21 and 22 23

24 Add columns (a), (b), and (c), line 23 24

25 Divide the line 24 amount by 3 25

26 Multiply the amount on line 25 by the number of years on line 11 26

27 Enter the amount from line 4 27

28

28 Partial tax attributable to the accumulation distribution (subtract line 27 from 26) (If zero or less,

enter -0-)

For Paperwork Reduction Act Notice, see back of form. Cat. No. 13180V Form 4970 (2005)

Part II

Part I

A B

E F G

C D

2005

010 020

030

040 050 060

070 080

090 100

110

120

130

140

150

160

170

180

190

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210

220

230 240 250 260 270

280

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460

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510

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580

590

600

610

620

630

640

670

B-76
Cat. No. 13187U

OMB No. 1545-0193

Form 4972 Tax on Lump-Sum Distributions

(From Qualified Plans of Participants Born Before January 2, 1936)

Department of the Treasury

Internal Revenue Service

Attachment

 Attach to Form 1040 or Form 1041. Sequence No. 28

Name of recipient of distribution Identifying number

Complete this part to see if you can use Form 4972

Yes No

1

1

2

Was this a distribution of a plan participant’s entire balance (excluding deductible voluntary employee

contributions and certain forfeited amounts) from all of an employer’s qualified plans of one kind (pension,

profit-sharing, or stock bonus)? If “No,” do not use this form

2

3

4

3 Was this distribution paid to you as a beneficiary of a plan participant who was born before 

January 2, 1936?

5a

5a Did you use Form 4972 after 1986 for a previous distribution from your own plan? If “Yes,” do not use this

form for a 2005 distribution from your own plan

Complete this part to choose the 20% capital gain election (see instructions)

Capital gain part from Form 1099-R, box 3 6

Multiply line 6 by 20% (.20)  7

Complete this part to choose the 10-year tax option (see instructions)

Ordinary income from Form 1099-R, box 2a minus box 3. If you did not complete Part II, enter

the taxable amount from Form 1099-R, box 2a 8

9

10

11

12

14

15

16

17

18

22

For Paperwork Reduction Act Notice, see instructions. Form 4972 (2005)

Did you roll over any part of the distribution? If “Yes,” do not use this form

Death benefit exclusion for a beneficiary of a plan participant who died before August 21, 1996

Total taxable amount. Subtract line 9 from line 8

Current actuarial value of annuity from Form 1099-R, box 8. If none, enter -0-

Part III

Part I

Part II

6

7

8

9

10

11

12

14

15

16

17

18

22

19

20

21

13

19

20

21

If you also choose to use Part III, go to line 8. Otherwise, include the amount from line 7 in the

total on Form 1040, line 44, or Form 1041, Schedule G, line 1b, whichever applies.

13

If you are receiving this distribution as a beneficiary of a plan participant who died, did you use Form 4972

for a previous distribution received for that participant after 1986? If “Yes,” do not use the form for this

distribution 5b

Adjusted total taxable amount. Add lines 10 and 11. If this amount is $70,000 or more, skip

lines 13 through 16, enter this amount on line 17, and go to line 18

Divide line 11 by line 12 and enter the result as a decimal (rounded

to at least three places)

Multiply line 16 by the decimal on line 20

Subtract line 21 from line 11

Multiply line 12 by 50% (.50), but do not enter more than $10,000

Subtract $20,000 from line 12. If line 12 is

$20,000 or less, enter -0-

Multiply line 14 by 20% (.20)

Minimum distribution allowance. Subtract line 15 from line 13

Subtract line 16 from line 12

Federal estate tax attributable to lump-sum distribution

Subtract line 18 from line 17. If line 11 is zero, skip lines 20 through 22 and go to line 23

.

If you answered “No” to both questions 3 and 4, do not use this form.

4 Were you (a) a plan participant who received this distribution, (b) born before January 2, 1936, and (c) a

participant in the plan for at least 5 years before the year of the distribution?

b

Multiply line 19 by 10% (.10) 23

Tax on amount on line 23. Use the Tax Rate Schedule in the instructions 24

25

Multiply line 24 by ten (10). If line 11 is zero, skip lines 26 through 28, enter this amount on line

29, and go to line 30

Multiply line 22 by 10% (.10) 26

27

Tax on amount on line 26. Use the Tax Rate Schedule in the

instructions

Multiply line 27 by ten (10) 28

Subtract line 28 from line 25. Multiple recipients, see instructions  29

23

24

25

26

27

28

29

30

30

Tax on lump-sum distribution. Add lines 7 and 29. Also include this amount in the total on

Form 1040, line 44, or Form 1041, Schedule G, line 1b, whichever applies 

(99)

2005

010 020

024 026

030 040

042 044

084 086

190 200

201 202

204 "NUA" 206 210

220

230 "NUA" 235 240

250

260

270

280

290

300

310

320

330

340

350

351

352

353

605

610

620

660

670

680

695 "MRD" 690

705

B-77
Allocation of Individual Income Tax to Guam or the

Commonwealth of the Northern Mariana Islands (CNMI) Form 5074 OMB No. 1545-0074

 Attach to Form 1040. Department of the Treasury

Internal Revenue Service

Attachment

Sequence No. 60

Name(s) shown on Form 1040 Your social security number

Guam CNMI

Income From Guam or the CNMI Reported on Form 1040

1 Wages, salaries, tips, etc. 1

2 Taxable interest 2

3 Ordinary dividends 3

4 Taxable refunds, credits, or offsets of state and local income taxes 4

5 Alimony received 5

6 Business income or (loss) 6

7 Capital gain or (loss) 7

8 8

9

Other gains or (losses)

9

10

IRA distributions (taxable amount)

10

11

Pensions and annuities (taxable amount)

11

12

Rental real estate, royalties, partnerships, S corporations, trusts, etc.

12

13

Farm income or (loss)

13

14

Unemployment compensation

14

15

Social security benefits (taxable amount)

15

16

Other income. List type and amount 

16 Total income. Add lines 1 through 15 

Adjusted Gross Income From Guam or the CNMI Reported on Form 1040

19

Moving expenses

19

21

Penalty on early withdrawal of savings

21

22

Alimony paid

22

23

IRA deduction

23

24

Student loan interest deduction

24

25

Tuition and fees deduction

25

26

Add lines 17 through 28

26

27

Adjusted gross income. Subtract line 29 from line 16 

27

Payments of Income Tax to Guam or the CNMI

35 35

31 Payments on estimated tax return filed with Guam or the CNMI

Income tax withheld from your wages while employed by the U.S.

Government as a civilian in Guam or the CNMI

31

32

Income tax withheld from your wages while employed as a member of

the U.S. Armed Forces in Guam or the CNMI

32

33

Income tax withheld from your wages earned in Guam or the CNMI other

than amounts on lines 31 through 33

33

34

Total payments. Add lines 31 through 34 

34

Instructions

Form 5074 (2005)

Part III

Part I

Part II

Cat. No. 42243X

20

Self-employed health insurance deduction

20

Section references are to the Internal Revenue Code.

What’s New

28 28

(Continued on back)

For Paperwork Reduction Act Notice, see back of form.

One-half of self-employment tax

17 Educator expenses

18

Health savings account deduction

17

18

Certain business expenses of reservists, performing artists, and fee-basis

government officials

Self-employed SEP, SIMPLE, and qualified plans

29 29

30 30

● For tax years ending after October 22, 2004, you generally file your

income tax return with Guam or the CNMI only if you are a bona fide

resident of the possession for the entire tax year. See Where to file

on page 2. Also, the rules for determining bona fide residence have

changed. See Pub. 570 for information about these rules.

● If, in tax year 2001 or later, you become or ceased to be a bona

fide resident of a U.S. possession, you may be required to file Form

8898, Statement for Individuals Who Begin or End Bona Fide

Residence in a U.S. Possession. The penalty for failure to provide

the required information is $1,000. For details, see the Instructions

for Form 8898.

2005

B-78

003

120 125

130 135

140 145

150 155

160 165

170 175

180 185

190 195

200 205

210 215

220 225

230 235

240 245

250 255

*260

"STM nn"

*265

"STM nn"

+263 +275

280 285

290 295

300 305

310 315

325

335

340 345

350 355

360 365

370 375

380 385

390 395

400 405

450 455

460 465

430 435

440 445

287 288

320

330

490 495

480 485

470 475

*415

"STM nn"

*410

"STM nn"
Draft as of

04/27/2005

Additional Taxes on Qualified Plans OMB No. 1545-0203 5329 (Including IRAs) and Other Tax-Favored Accounts Form

Department of the Treasury

Internal Revenue Service

Attachment

Sequence No. 29

 Attach to Form 1040.

Name of individual subject to additional tax. If married filing jointly, see instructions. Your social security number

Home address (number and street), or P.O. box if mail is not delivered to your home

City, town or post office, state, and ZIP code If this is an amended

return, check here 

Enter your excess contributions from line 16 of your 2004 Form 5329 (see instructions). If zero,

go to line 15

13

14 14

If your traditional IRA contributions for 2005 are less than your

maximum allowable contribution, see instructions. Otherwise, enter -0-

15

2005 traditional IRA distributions included in income (see instructions)

15

2005 distributions of prior year excess contributions (see instructions)

Add lines 10, 11, and 12

Prior year excess contributions. Subtract line 13 from line 9. If zero or less, enter -0-

Excess contributions for 2005 (see instructions)

Additional Tax on Early Distributions

Complete this part if you took a taxable distribution, before you reached age 591⁄2 , from a qualified retirement plan (including

an IRA) or modified endowment contract (unless you are reporting this tax directly on Form 1040—see above). You may also

have to complete this part to indicate that you qualify for an exception to the additional tax on early distributions or for certain

Roth IRA distributions (see instructions).

1 Early distributions included in income. For Roth IRA distributions, see instructions 1

Early distributions included on line 1 that are not subject to the additional tax (see instructions).

Enter the appropriate exception number from the instructions: 

2

2

3 Amount subject to additional tax. Subtract line 2 from line 1 3

4 Additional tax. Enter 10% (.10) of line 3. Include this amount on Form 1040, line 60 4

For Paperwork Reduction Act Notice, see page 5 of the instructions. Cat. No. 13329Q Form 5329 (2005)

Apt. no.

Part I

Part II

If you only owe the additional 10% tax on early distributions, you may be able to report this tax directly

on Form 1040, line 60, without filing Form 5329. See the instructions for Form 1040, line 60.

Fill in Your Address Only

If You Are Filing This

Form by Itself and Not

With Your Tax Return 

Caution: If any part of the amount on line 3 was a distribution from a SIMPLE IRA, you may have

to include 25% of that amount on line 4 instead of 10% (see instructions).

5 5

6

7

8

6

7

8

Additional Tax on Certain Distributions From Education Accounts

Distributions included in income from Coverdell ESAs and QTPs

9

10

Distributions included on line 5 that are not subject to the additional tax (see instructions)

11

Amount subject to additional tax. Subtract line 6 from line 5

12

Additional tax. Enter 10% (.10) of line 7. Include this amount on Form 1040, line 60

9

10

11

12

Part III Additional Tax on Excess Contributions to Traditional IRAs

Complete this part if you contributed more to your traditional IRAs for 2005 than is allowable or you had an amount

on line 17 of your 2004 Form 5329.

Total excess contributions. Add lines 14 and 15 16

Additional tax. Enter 6% (.06) of the smaller of line 16 or the value of your traditional IRAs on December

31, 2005 (including 2005 contributions made in 2006). Include this amount on Form 1040, line 60 17

16

17

Complete this part if you included an amount in income, on Form 1040, line 21, from a Coverdell education savings

account (ESA) or a qualified tuition program (QTP).

 See separate instructions.

13

(99)

2005

Part IV Additional Tax on Excess Contributions to Roth IRAs

Enter your excess contributions from line 24 of your 2004 Form 5329 (see instructions). If zero, go to line 23

If your Roth IRA contributions for 2005 are less than your maximum

allowable contribution, see instructions. Otherwise, enter -0-

18 18

19

Complete this part if you contributed more to your Roth IRAs for 2005 than is allowable or you had an amount on line

25 of your 2004 Form 5329.

20 2005 distributions from your Roth IRAs (see instructions)

21 Add lines 19 and 20

22 Prior year excess contributions. Subtract line 21 from line 18. If zero or less, enter -0-

23 Excess contributions for 2005 (see instructions)

24 Total excess contributions. Add lines 22 and 23

Additional tax. Enter 6% (.06) of the smaller of line 24 or the value of your Roth IRAs on December 31,

2005 (including 2005 contributions made in 2006). Include this amount on Form 1040, line 60

25

21

22

23

24

25

19

20

010 020

030

040 050 060

070

072

073 074

076

078

081

084

087

091

094

100

110

120

130

140

145

150

160

B-79

200

210

220

230

240

250

260

280
Draft as of

04/27/2005

Form 5329 (2005) Page 2

Additional Tax on Excess Accumulation in Qualified Retirement Plans (Including IRAs)

Minimum required distribution for 2005 (see instructions) 50

Amount actually distributed to you in 2005 51

Subtract line 51 from line 50. If zero or less, enter -0- 52

Additional tax. Enter 50% (.50) of line 52. Include this amount on Form 1040, line 60 53

Under penalties of perjury, I declare that I have examined this form, including accompanying schedules and statements, and to the best of my knowledge

and belief, it is true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.

Your signature Date

Date Preparer’s SSN or PTIN Preparer’s

signature

Check if selfemployed

Firm’s name (or yours

if self-employed),

address, and ZIP code

EIN

Phone no.

 





Signature. Complete only if you are filing this form by itself and not with your tax return.

Please

Sign

Here

Paid

Preparer’s

Use Only

Printed on recycled paper

Additional Tax on Excess Contributions to Archer MSAs

Enter the excess contributions from line 40 of your 2004 Form 5329 (see instructions). If zero,

go to line 39

Additional tax. Enter 6% (.06) of the smaller of line 40 or the value of your Archer MSAs on

December 31, 2005 (including 2005 contributions made in 2006). Include this amount on Form

1040, line 60

38

53

34

39

26

27

Part VI

Part V

34

35

Additional Tax on Excess Contributions to Coverdell ESAs

Enter the excess contributions from line 32 of your 2004 Form 5329 (see instructions). If zero,

go to line 31

If the contributions to your Coverdell ESAs for 2005 were less than the

maximum allowable contribution, see instructions. Otherwise, enter -0-

36

37

26

35

39

40

41

50

51

52

36

37

38

If the contributions to your Archer MSAs for 2005 are less than the

maximum allowable contribution, see instructions. Otherwise, enter -0-

2005 distributions from your Archer MSAs from Form 8853, line 10

Add lines 35 and 36

Prior year excess contributions. Subtract line 37 from line 34. If zero or less, enter -0-

Excess contributions for 2005 (see instructions)

Total excess contributions. Add lines 38 and 39

Complete this part if you or your employer contributed more to your Archer MSAs for 2005 than is allowable or you

had an amount on line 41 of your 2004 Form 5329.

Complete this part if you did not receive the minimum required distribution from your qualified retirement plan.

Complete this part if the contributions to your Coverdell ESAs for 2005 were more than is allowable or you had an

amount on line 33 of your 2004 Form 5329.

28 2005 distributions from your Coverdell ESAs (see instructions)

29 Add lines 27 and 28 29

30 Prior year excess contributions. Subtract line 29 from line 26. If zero or less, enter -0- 30

27

28

31 Excess contributions for 2005 (see instructions) 31

32 Total excess contributions. Add lines 30 and 31 32

33 Additional tax. Enter 6% (.06) of the smaller of line 32 or the value of your Coverdell ESAs on

December 31, 2005 (including 2005 contributions made in 2006). Include this amount on Form

1040, line 60 33

40

41

Form 5329 (2005)

( )

Additional Tax on Excess Contributions to Health Savings Accounts (HSAs)

Complete this part if you, someone on your behalf, or your employer contributed more to your

HSAs for 2005 than is allowable or you had an amount on line 43 of your 2004 Form 5329.

Part VII

45 Add lines 43 and 44 45

49

Additional tax. Enter 6% (.06) of the smaller of line 48 or the value of your HSAs on December 31, 2005

(including 2005 contributions made in 2006). Include this amount on Form 1040, line 60

49

Part VIII

42 Enter the excess contributions from line 42 of your 2004 Form 5329. If zero, go to line 47 42

43 If the contributions to your HSAs for 2005 are less than the maximum

allowable contribution, see instructions. Otherwise, enter -0-

44 2005 distributions from your HSAs from Form 8889, line 14

46 Prior year excess contributions. Subtract line 45 from line 42. If zero or less, enter -0- 46

47 Excess contributions for 2005 (see instructions) 47

48 Total excess contributions. Add lines 46 and 47 48

43

44

490

500

510

520

530

540

550

570

580

590

600

610

620

630

640

660

675

685

715

725

735

750

800

810

820

830 "WAIVER"

@840 "STM nn"

850

B-80

695

705
Draft as of

11/09/2005

OMB No. 1545-0704

Attachment

Sequence No. 121

Information Return of U.S. Persons With

Respect To Certain Foreign Corporations Form 5471

(Rev. December 2005) File In Duplicate

Information furnished for the foreign corporation’s annual accounting period (tax year required by

section 898) (see instructions) beginning , 20 , and ending , 20

Department of the Treasury

Internal Revenue Service

Name of person filing this return A Identifying number

Number, street, and room or suite no. (or P.O. box number if mail is not delivered to street address) B Category of filer (See instructions. Check applicable box(es)):

1 2345

City or town, state, and ZIP code Enter the total percentage of the foreign corporation’s voting stock

you owned at the end of its annual accounting period %

C

Filer’s tax year beginning , 20 , and ending , 20

Important: Fill in all applicable lines and schedules. All information must be in English. All amounts must be stated

in U.S. dollars unless otherwise indicated.

1a Name and address of foreign corporation b Employer identification number, if any

c Country under whose laws incorporated

Principal business activity g Principal business activity

code number

Date of incorporation e Principal place of business f

a

2 Provide the following information for the foreign corporation’s accounting period stated above.

b If a U.S. income tax return was filed, enter:

(ii) U.S. income tax paid

(after all credits)

Name, address, and identifying number of branch office or agent (if any) in

the United States

(i) Taxable income or (loss)

Name and address (including corporate department, if applicable) of

person (or persons) with custody of the books and records of the foreign

corporation, and the location of such books and records, if different

Name and address of foreign corporation’s statutory or resident agent in d

country of incorporation

c

Stock of the Foreign Corporation

(b) Number of shares issued and outstanding

(ii) End of annual

accounting period

(i) Beginning of annual

accounting period

(a) Description of each class of stock

For Paperwork Reduction Act Notice, see instructions. Form 5471 (Rev. 12-2005)

 See separate instructions.

(4) Check applicable box(es) (1) Name (2) Address (3) Identifying number

Shareholder Officer Director

D Person(s) on whose behalf this information return is filed:

Schedule A

Cat. No. 49958V

d

(see When and 

Where To File in

the instructions)

h Functional currency

(repealed)

010 020

050

060 070 080

090 100

130 135

@136 "STM nn"

140

160

170 180 182 184 186 190 200 210 220

230 240 242 244 246 250 260 270 280

290 300 302 304 306 310 320 330 340

350 360 362 364 366 370 380 390 400

420 425 430 440 450 460 465

470

480

490 500 510 520 523

 530 540 550 560 570 580

525

590 600

 610 620 630 640 650 655 660 670 680 690 700 705 710

*720 +730 +740

 750 760 770

ALPHA VALUE: "C" = COMMON, "P" = 

PREFERRED, "T" = TREASURY OR "STM nn"

 780 790 800

 810 820 830 835

B-81

110
Draft as of

11/09/2005

Form 5471 (Rev. 12-2005) Page 2

U.S. Shareholders of Foreign Corporation (see instructions)

(c) Number of

shares held at

beginning of

annual

accounting period

(d) Number of

shares held at

end of annual

accounting

period

(b) Description of each class of stock held by

shareholder. Note: This description should match the

corresponding description entered in Schedule A,

column (a).

(a) Name, address, and identifying number of shareholder

Important: Report all information in functional currency in accordance with U.S. GAAP. Also, report each amount in

U.S. dollars translated from functional currency (using GAAP translation rules). However, if the functional currency is 

the U.S. dollar, complete only the U.S. Dollars column. See instructions for special rules for DASTM corporations.

Income Statement (see instructions)

1a Gross receipts or sales 1a

2 Cost of goods sold 2

3 Gross profit (subtract line 2 from line 1c) 3

4 Dividends 4

Income

5 Interest 5

6 Gross rents, royalties, and license fees 6

7 Net gain or (loss) on sale of capital assets 7

8 Other income (attach schedule) 8

9 Total income (add lines 3 through 8) 9

10 Compensation not deducted elsewhere 10

11 Rents, royalties, and license fees 11

12 Interest 12

13 Depreciation not deducted elsewhere 13

14 Depletion 14

15 Taxes (exclude provision for income, war profits, and excess profits taxes) 15

Deductions

16

Other deductions (attach schedule—exclude provision for income, war profits,

and excess profits taxes)

16

17 Total deductions (add lines 10 through 16) 17

18 Net income or (loss) before extraordinary items, prior period adjustments, and

the provision for income, war profits, and excess profits taxes (subtract line

17 from line 9) 18

19 Extraordinary items and prior period adjustments (see instructions) 19

20 Provision for income, war profits, and excess profits taxes (see instructions) 20

Net Income

21 Current year net income or (loss) per books (combine lines 18 through 20) 21

(e) Pro rata share

of subpart F

income (enter as

a percentage)

Schedule B

Schedule C

Functional Currency U.S. Dollars

Returns and allowances

Subtract line 1b from line 1a

b

c

1b

1c

Form 5471 (Rev. 12-2005)

980 990 1000

1010 1020 1030

1040 1050 1060 1065

1070 1080 1090

1100 1110 1120

1130 1140 1150

1170 1180 1190

1200 1210 1220

1230 1240 1250 1255

1260 1270 1280

1290 1300 1310

1320 1330 1340

1360 1370 1380

1390 1400 1410

1420 1430 1440 1445

1450 1460 1470

1480 1490 1500

1510 1520 1530

1550 1560 1570

1580 1590 1600

1610 1620 1630 1635

1640 1650 1660

1670 1680 1690

1700 1710 1720

1740 1750 1760

1770 1780 1790

1800 1810 1820 1825

1830 1840 1850

1860 1870 1880

1890 1900 1910

1930 1940

1950 1960

1970 1980

1990 2000

2010 2020

2030 2040

2050 2060

2070 2080

2090 2100

2110 2130 @2140

2150 2160 "STM nn"

2170 2180

2190 2200

2210 2200

2230 2240

2250 2260

2270 2280

2290 2310 @2320

"STM nn"

2330 2340

2350 2360

2370 2380

2390 2400

2410 2415

@1915 "STM nn"

B-82
Draft as of

11/09/2005

Form 5471 (Rev. 12-2005) Page 3

Income, War Profits, and Excess Profits Taxes Paid or Accrued (see instructions)

Amount of tax

(a)

Name of country or U.S. possession (d)

In U.S. dollars

(b)

In foreign currency

1 U.S.

2

3

4

8 Total 

Balance Sheet

(b)

End of annual

accounting period

(a)

Beginning of annual

accounting period

Assets

1 Cash 1

2a Trade notes and accounts receivable 2a

( ) ( ) b Less allowance for bad debts

3 Inventories 3

4 4

5 5

6

Other current assets (attach schedule)

6

7

Loans to shareholders and other related persons

7

8a

Investment in subsidiaries (attach schedule)

8a

8b

Other investments (attach schedule)

9a 9a

Buildings and other depreciable assets

10

( )( )

9b

b Less accumulated depreciation

10

11

Depletable assets

( ) ( )

11a

b Less accumulated depletion

11b

12

Land (net of any amortization)

11c

13

Intangible assets:

a Goodwill

11d

b Organization costs

12

c Patents, trademarks, and other intangible assets

( )( )

13

d Less accumulated amortization for lines 11a, b, and c

14 14

Other assets (attach schedule)

Total assets

15 15

Liabilities and Shareholders’ Equity

16

Accounts payable

17

Other current liabilities (attach schedule)

18a

Loans from shareholders and other related persons

19

Other liabilities (attach schedule)

20

a Preferred stock

Capital stock:

b Common stock

21

Paid-in or capital surplus (attach reconciliation)

Retained earnings

22

( ) ( ) Less cost of treasury stock

Total liabilities and shareholders’ equity

2b

18b

16

17

18

19

20

21

22

(c)

Conversion rate

Schedule E

Schedule F

5

6

7

Important: Report all amounts in U.S. dollars prepared and translated in accordance with U.S. GAAP. See instructions 

for an exception for DASTM corporations.

Form 5471 (Rev. 12-2005)

2430

*2440 +2450 +2460 +2470

2480 2490 2500 2510

2520 2530 2540 2550

2560 2570 2580 2590

2600 2610 2620 2630

2640 2650 2660 2670

2680

2690 2700

2710 2720

2730 2740

2750 2760

2770 2790 @2800

"STM nn" 2810 2820

2830 2850 @2860

"STM nn" 2870 2890 @2900

2910 2920 "STM nn" 2930 2940

2950 2960

2970 2980

2990 3000

3010 3020

3030 3040

3050 3060

3070 3080

3090 3110 @3120

"STM nn"

3130 3140

3150 3160

3170 3190 @3200

"STM nn"

3270 3280

3290 3300

3305 3315 @3320

"STM nn" 3330 3340

3350 3360

3370 3380

3210 3220

3230 3250 @3260

"STM nn"

B-83
Draft as of

11/09/2005

Form 5471 (Rev. 12-2005) Page 4

1 Current year net income or (loss) per foreign books of account 1

Net adjustments made to line 1 to determine current

earnings and profits according to U.S. financial and tax

accounting standards (see instructions):

2

Net

Subtractions

Net

Additions

a Capital gains or losses

b Depreciation and amortization

c Depletion

d Investment or incentive allowance

e Charges to statutory reserves

f Inventory adjustments

Other (attach schedule) 

g

3 Total net additions 

4 Total net subtractions 

Current earnings and profits (line 1 plus line 3 minus line 4) 

5d

Summary of Shareholder’s Income From Foreign Corporation (see instructions)

1 Subpart F income (line 38b, Worksheet A in the instructions) 1

2 Earnings invested in U.S. property (line 17, Worksheet B in the instructions) 2

3 Previously excluded subpart F income withdrawn from qualified investments (line 6b, Worksheet C 

in the instructions) 3

4 Previously excluded export trade income withdrawn from investment in export trade assets (line 7b, 

Worksheet D in the instructions) 4

6 Total of lines 1 through 5. Enter here and on your income tax return. See instructions 6

● Was any income of the foreign corporation blocked?

Factoring income 

Taxes

h

Schedule H

Schedule I

If the answer to either question is “Yes,” attach an explanation.

5a 5a

d Current earnings and profits in U.S. dollars (line 5c translated at the appropriate exchange rate as

defined in section 989(b) and the related regulations (see instructions)) 

Enter exchange rate used for line 5d 

Dividends received (translated at spot rate on payment date under section 989(b)(1)) 

Exchange gain or (loss) on a distribution of previously taxed income 

7

8

7

8

c

b DASTM gain or (loss) for foreign corporations that use DASTM (see instructions) 

Combine lines 5a and 5b 

5b

5c

5 5

Printed on recycled paper

Current Earnings and Profits (see instructions)

Yes No

● Did any such income become unblocked during the tax year (see section 964(b))?

Important: Enter the amounts on lines 1 through 5c in functional currency.

Schedule G Other Information

During the tax year, did the foreign corporation own at least a 10% interest, directly or indirectly, in any foreign

partnership?

Yes No

During the tax year, did the foreign corporation own an interest in any trust?

During the tax year, did the foreign corporation own any foreign entities that were disregarded as entities separate

from their owners under Regulations sections 301.7701-2 and 301.7701-3 (see instructions)?

If “Yes,” you are generally required to attach Form 8858 for each entity (see instructions).

If “Yes,” see the instructions for required attachment.

1

2

3

Form 5471 (Rev. 12-2005)

3410 3420

 @3425

"STM nn" 3430 3440

3450 3460

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"STM nn"

3470

3480 3490

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nn"

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@3810 "STM nn" @3815 "STM nn"

B-84
SCHEDULE J Accumulated Earnings and Profits (E&P)

of Controlled Foreign Corporation OMB No. 1545-0704 (Form 5471) (Rev. December 2004)

Department of the TreasuryInternal Revenue Service  Attach to Form 5471. See Instructions for Form 5471.

Identifying number Name of person filing Form 5471

Name of foreign corporation

Balance at beginning of year 1Current year E&P

Total current and accumulatedE&P not previously taxed (line 1plus line 2a or line 1 minus line 2b)

3

4 Amounts included under section

951(a) or reclassified undersection 959(c) in current year

Actual distributions orreclassifications ofpreviously taxed E&P

Balance at end of year. (Enteramount from line 6a or line 6b,whichever is applicable.)

7

(b) Pre-1987 E&P

Not Previously Taxed

(pre-87 section

959(c)(3) balance)

(c) Previously Taxed E&P (see instructions)

(sections 959(c)(1) and (2) balances)

(i) Earnings Invested

in U.S. Property (iii) Subpart F Income

Schedule J (Form 5471) (Rev. 12-2004) For Paperwork Reduction Act Notice, see the Instructions for Form 5471.

(d) Total Section

964(a) E&P

(combine columns

(a), (b), and (c))

b Current year deficit in E&P

5a

b Actual distributions of

nonpreviously taxed E&P

Balance of previously taxedE&P at end of year (line 1 plusline 4, minus line 5a)

Balance of E&P not previouslytaxed at end of year (line 3minus line 4, minus line 5b)

6a

b

Important: Enter amounts in

functional currency.

2a

Cat. No. 21111K

(a) Post-1986

Undistributed Earnings

(post-86 section

959(c)(3) balance)

(ii) Earnings Invested

in Excess Passive

Assets

020

030

040

050

060

070

080

090100

110120130140150160

170

180

190200

210

220

230240

250260

270

280

290

300

310

320

330

B-85
Draft as of

06/23/2005

SCHEDULE M Transactions Between Controlled Foreign Corporation

and Shareholders or Other Related Persons OMB No. 1545-0704

(Form 5471)

(Rev. December 2005)

Department of the Treasury

Internal Revenue Service  Attach to Form 5471. See Instructions for Form 5471.

Name of person filing Form 5471 Identifying number

Name of foreign corporation

Important: Complete a separate Schedule M for each controlled foreign corporation. Enter the totals for each type of transaction that

occurred during the annual accounting period between the foreign corporation and the persons listed in columns (b) through (f). All amounts

must be stated in U.S. dollars translated from functional currency at the average exchange rate for the foreign corporation’s tax year. See

instructions.

(c) Any domestic

corporation or

partnership controlled

by U.S. person filing

this return

(a) Transactions

of

foreign corporation

(b) U.S. person

filing this return

(f) 10% or more U.S.

shareholder of any

corporation

controlling the

foreign corporation

(e) 10% or more U.S.

shareholder of controlled

foreign corporation

(other than the U.S.

person filing this return)

(d) Any other foreign

corporation or

partnership controlled

by U.S. person filing

this return

1 Sales of stock in trade

(inventory)

2 Sales of property rights

(patents, trademarks, etc.)

Compensation received for technical, managerial, engineering,

construction, or like services

3

4 Commissions received

5 Rents, royalties, and license

fees received

6 Dividends received (exclude

deemed distributions under

subpart F and distributions of

previously taxed income)

7 Interest received

8 Premiums received for insurance or reinsurance

9

Purchases of stock in trade

(inventory)

Purchases of tangible property

other than stock in trade

11

12 Purchases of property rights

(patents, trademarks, etc.)

Compensation paid for technical, managerial, engineering,

construction, or like services

13

14 Commissions paid

15 Rents, royalties, and license

fees paid

16 Dividends paid

17 Interest paid

19

For Paperwork Reduction Act Notice, see the Instructions for Form 5471. Schedule M (Form 5471) (Rev. 12-2005)

10

18 Add lines 10 through 17

20

Add lines 1 through 8

Amounts loaned (enter the

maximum loan balance during

the year) — see instructions

Amounts borrowed (enter the

maximum loan balance during

the year) — see instructions

Cat. No. 49963O

Printed on recycled paper

Enter the relevant functional currency and the exchange rate used throughout this schedule 

020

022 024

030

040

050

060

070

080

090

100

110

120

130

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510

520

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560

570

580

590

600

610

620

630

640

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660

670

680

690

700

710

720

730

740

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760

770

780

790

800

810

820

830

840

850

860

870

880

890

900

910

920

930

940

950

960

970

980

990

1000

1010

1020

B-86
Draft as of

06/23/2005

SCHEDULE O Organization or Reorganization of Foreign

Corporation, and Acquisitions and

Dispositions of its Stock

(Form 5471)

OMB No. 1545-0704 (Rev. December 2005)

Department of the Treasury

Internal Revenue Service  Attach to Form 5471. See Instructions for Form 5471.

Name of person filing Form 5471 Identifying number

Name of foreign corporation

Important: Complete a separate Schedule O for each foreign corporation for which information must be reported.

To Be Completed by U.S. Officers and Directors

(a) (c) (d) (e) (b) Date of additional

10% acquisition

Date of original

10% acquisition

Identifying number

of shareholder

Name of shareholder for whom

acquisition information is reported Address of shareholder

To Be Completed by U.S. Shareholders

Section A—General Shareholder Information

(c) (b)

Date (if any) shareholder

last filed information

return under section 6046

for the foreign corporation

(a) For shareholder’s latest U.S. income tax return filed, indicate:

Name, address, and identifying number of

shareholder(s) filing this schedule (1)

Type of return

(enter form number)

(3)

Internal Revenue Service Center

where filed

(2)

Date return filed

Note: If this return is required because one or more shareholders became U.S. persons, attach a list showing the

names of such persons and the date each became a U.S. person.

Section B—U.S. Persons Who Are Officers or Directors of the Foreign Corporation

(d)

Check appropriate

box(es)

(a) (b) (c)

Name of U.S. officer or director Address Social security number

Officer Director

Section C—Acquisition of Stock

(e)

(a) (b) (c) (d) Number of shares acquired

Method of

acquisition

Date of

acquisition

Class of stock

acquired

Name of shareholder(s) filing this schedule (1) (2) (3)

Directly Indirectly Constructively

For Paperwork Reduction Act Notice, see the Instructions for Form 5471. Cat. No. 61200O Schedule O (Form 5471) (Rev. 12-2005)

Part I

Part II

020

030 035 040 050 060 070 080 090 100

110 115 120 130 140 150 160 170 180

190 195 200 210 220 230 240 250 260

270 275 280 290 300 310 320 330 340

350 355 360 370

380 390 395 400 410 420 430

440 445 450 460

470 480 485 490 500 510 520

530 535 540 550

560 570 575 580 590 600 610

@615

"STM

nn"

630 635 640 650 660 670 680 690 700

710 715 720 730 740 750 760 770 780

790 795 800 810 820 830 840 850 860

870 880 890 900 910 920 930

940 950 960 970 980 990 1000

1010 1020 1030 1040 1050 1060 1065

ALPHA "C" = COMMON

"P" = PREFERRED "T" 

= TREASURY B-87

@345

"STM nn"

@620

"STM

nn"

@1255

"STM

nn"
Draft as of

06/23/2005

Schedule O (Form 5471) (Rev. 12-2005) Page 2

(f) (g)

Amount paid or value given Name and address of person from whom shares were acquired

Section D—Disposition of Stock

(e)

Number of shares disposed of (d) (a) (b) (c) Method

of disposition Name of shareholder disposing of stock Class of stock Date of disposition (1) (2) (3)

Directly Indirectly Constructively

(f) (g)

Amount received Name and address of person to whom disposition of stock was made

Section E—Organization or Reorganization of Foreign Corporation

(a) (b) (c)

Name and address of transferor Identifying number (if any) Date of transfer

(d)

Assets transferred to foreign corporation

(e)

Description of assets transferred by, or notes or

(1) (2) (3) securities issued by, foreign corporation

Adjusted basis (if transferor

was U.S. person) Description of assets Fair market value

(b) List the date of any reorganization of the foreign corporation that occurred during the last 4 years while any U.S. person held 10% or

more in value or vote (directly or indirectly) of the corporation’s stock 

(c) If the foreign corporation is a member of a group constituting a chain of ownership, attach a chart, for each unit of which a shareholder

owns 10% or more in value or voting power of the outstanding stock. The chart must indicate the corporation’s position in the chain of

ownership and the percentages of stock ownership (see instructions for an example).

(a) If the foreign corporation or a predecessor U.S. corporation filed (or joined with a consolidated group in filing) a U.S. income tax return

for any of the last 3 years, attach a statement indicating the year for which a return was filed (and, if applicable, the name of the corporation

filing the consolidated return), the taxable income or loss, and the U.S. income tax paid (after all credits).

Section F—Additional Information

Printed on recycled paper

Schedule O (Form 5471) (Rev. 12-2005)

1080 1090 1095 1100 1110 1120 1130 1135

1140 1150 1155 1160 1170 1180 1190 1195

1200 1210 1215 1220 1230 1240 1250 1253

1260 1270 1280 1290 1300 1310 1320

1330 1340 1350 1360 1370 1380 1390

1400 1410 1420 1430 1440 1450 1460

1470 1480 1485 1490 1500 1510 1520 1525

1530 1540 1545 1550 1560 1570 1580 1585

1590 1600 1605 1610 1620 1630 1640 1643

1650 1655 1660 1670 1680 1690 1695 1700 1710

1720 1725 1730 1740 1750 1760 1765 1770 1780

1790 1795 1800 1810 1820 1830 1835 1840 1850

1860 1870 1880 1890

1940 1950 1960 1970

@1980 "STM nn"

1990

1900 1910 1920 1930

@2000 "STM nn"

ALPHA: "C" = COMMON

"P" = PREFERRED "

"T" = TREASURY

B-88

1255

@1645

"STM

nn"

@1975

"STM

nn"
International Boycott Report OMB No. 1545-0216

Form 5713

(Rev. December 2004)

For tax year beginning , 20 ,

and ending , 20 .

Attachment

Sequence No. 123

Department of the Treasury

Internal Revenue Service  Controlled groups, see page 3 of instructions.

Name Identifying number

Number, street, and room or suite no. (If a P.O. box, see page 2 of instructions.)

City or town, state, and ZIP code

Address of service center where your tax return is filed

Type of filer (check one):

Individual Partnership Corporation Trust Estate Other

1 Individuals—Enter adjusted gross income from your tax return (see page 2 of instructions)

2 Partnerships and corporations:

a Partnerships—Enter each partner’s name and identifying number.

Corporations—Enter the name and employer identification number of each member of the controlled group (as defined in

section 993(a)(3)). Do not list members included in the consolidated return; instead, attach a copy of Form 851. List all

other members of the controlled group not included in the consolidated return.

b

If you list any corporations below or if you attach Form 851, you must designate a common tax year. Enter on line

4b the name and employer identification number of the corporation whose tax year is designated.

Name Identifying number

If more space is needed, attach additional sheets and check this box 

Code Description

c Enter principal business activity code and description (see instructions)

d IC-DISCs—Enter principal product or service code and description (see instructions)

3 Partnerships—Each partnership filing Form 5713 must give the following information:

a Partnership’s total assets (see instructions)

b Partnership’s ordinary income (see instructions)

4 Corporations—Each corporation filing Form 5713 must give the following information:

a Type of form filed (Form 1120, 1120-F, 1120-FSC, 1120-IC-DISC, 1120-L, 1120-PC, etc.)

b Common tax year election (see page 2 of instructions)

(1) Name of corporation 

(2) Employer identification number

(3) Common tax year beginning , 20 , and ending , 20 .

c Corporations filing this form enter:

(1) Total assets (see instructions)

(2) Taxable income before net operating loss and special deductions (see instructions)

5 Estates or trusts—Enter total income (Form 1041, page 1)

6 Enter the total amount (before reduction for boycott participation or cooperation) of the following tax benefits (see instructions):

a Foreign tax credit

b Deferral of earnings of controlled foreign corporations

c Deferral of IC-DISC income

d FSC exempt foreign trade income

Under penalties of perjury, I declare that I have examined this report, including accompanying schedules and statements, and to the best of my

knowledge and belief, it is true, correct, and complete.

Signature Date Title

For Paperwork Reduction Act Notice, see page 4 of the separate instructions. Form 5713 (Rev. 12-2004)

Please

Sign

Here  

Cat. No. 12030E

File in Duplicate

(See Instructions)

e Foreign trade income qualifying for the extraterritorial income exclusion

003

010

020

050

110

070 080

120 130 140 150

160

170 180

B-89

190 200

210 220

230 240

250 260

270 280

290 300

@305 "STM nn" or blank 310

320 330

340 350

360

370

460

470

380

390

400

410 420

430

440

450

480

490

500

060

090

100
Form 5713 (Rev. 12-2004) Page 2

Yes No 7a Are you a U.S. shareholder (as defined in section 951(b)) of any foreign corporation (including a FSC that does not

use the administrative pricing rules) that had operations reportable under section 999(a)?

If the answer to question 7a is “Yes,” is any foreign corporation a controlled foreign corporation (as defined in

section 957(a))?

b

c Do you own any stock of an IC–DISC?

d Do you claim any foreign tax credit?

Do you control (within the meaning of section 304(c)) any corporation (other than a corporation included in this

report) that has operations reportable under section 999(a)?

e

If “Yes,” did that corporation participate in or cooperate with an international boycott at any time during its tax

year that ends with or within your tax year?

Are you controlled (within the meaning of section 304(c)) by any person (other than a person included in this

report) who has operations reportable under section 999(a)?

f

If “Yes,” did that person participate in or cooperate with an international boycott at any time during its tax year

that ends with or within your tax year?

g Are you treated under section 671 as the owner of a trust that has reportable operations under section 999(a)?

h Are you a partner in a partnership that has reportable operations under section 999(a)?

i Are you a foreign sales corporation (FSC) (as defined in section 922(a), as in effect before its repeal)?

Operations in or Related to a Boycotting Country (See instructions beginning on page 3.)

Yes No

Boycott of Israel—Did you have any operations in or related to any country (or with the government, a company, or

a national of that country) associated in carrying out the boycott of Israel which is on the list maintained by the

Secretary of the Treasury under section 999(a)(3)? (See Boycotting Countries on page 2 of the instructions.)

8

If “Yes,” complete the following table. If more space is needed, attach additional sheets using the exact format and check

this box 

Principal business activity IC-DISCs

only—Enter

product code

Identifying number of Name of country person having operations Code Description

(1) (2) (3) (4) (5)

a

b

c

d

e

f

g

h

i

j

k

l

m

n

o

Part I

Form 5713 (Rev. 12-2004)

j Are you excluding extraterritorial income (defined in section 114(e)) from gross income?

570

580 590

600 610

620 630

640 650

660 670

680 690

700 710

720 730

740 750

*770 "STM nn" +780 +790 *+800 "STM nn"

1020

880 890

520 530

540 550

560

1070

1130

1040

1300

900

1120

980 990

1150

1000

1170

1030

1090

1200

950

1220

1080

1140

1190

1050

1270

1180

1290

1250

1100

1280

1230 1240

1320 1330 1340 1350

1370 1380 1390 1400

1420 1430 1440 1450

1470 1480 1490 1500

B-90

820 830 840 850

870

920 930 940

970

760

732 734
Form 5713 (Rev. 12-2004) Page 3

Yes No Nonlisted countries boycotting Israel—Did you have operations in any nonlisted country which you know or

have reason to know requires participation in or cooperation with an international boycott directed against Israel?

9

If “Yes,” complete the following table. If more space is needed, attach additional sheets using the exact format and check

this box 

IC-DISCs

only—Enter

product code

Identifying number of

person having operations

Principal business activity

Name of country Code Description

(1) (2) (3) (4) (5)

a

b

c

d

e

f

g

h

Yes No Boycotts other than the boycott of Israel—Did you have operations in any other country which you know or have

reason to know requires participation in or cooperation with an international boycott other than the boycott of Israel?

10

If “Yes,” complete the following table. If more space is needed, attach additional sheets using the exact format and check

this box 

IC-DISCs

only—Enter

product code

Identifying number of

person having operations

Principal business activity

Name of country Code Description

(1) (2) (3) (4) (5)

a

b

c

d

e

f

g

h

Yes No

11 Were you requested to participate in or cooperate with an international boycott?

If “Yes,” attach a copy (in English) of any and all such requests received during your tax year. If the request was in

a form other than a written request, attach a separate sheet explaining the nature and form of any and all such

requests. (See page 4 of instructions.)

12 Did you participate in or cooperate with an international boycott?

If “Yes,” attach a copy (in English) of any and all boycott clauses agreed to, and attach a general statement of the agreement.

If the agreement was in a form other than a written agreement, attach a separate sheet explaining the nature and form of

any and all such agreements. (See page 4 of instructions.)

Note: If the answer to either question 11 or 12 is “Yes,” you must complete the rest of Form 5713. If you answered “Yes” to question

12, you must complete Schedules A and C or B and C (Form 5713).

Form 5713 (Rev. 12-2004)

16101620

1630

*1640 "STM nn" +1650 +1660 *+1670 "STM nn"

1690 1700 1710 1720

1740 1750 1760 1770

1790 1800 1810 1820

1840 1850

B-91

1860 1870

1890 1900 1910 1920

1940 1950 1960 1970

1990 2000 2010 2020

20402050

2060

*2070 "STM nn" +2080 +2090 *+2100 "STM nn" 2110

2120 2130 2140 2150 2160

2170 2180 2190 2200 2210

2220 2230 2240 2250 2260

2270 2280 2290 2300 2310

2320 2330 2340 2350 2360

2370 2380 2390 2400 2410

2420 2430 2440 2450 2460

24702480

@2485 "STM nn" or blank

24902500

@2505 "STM nn" or blank
Form 5713 (Rev. 12-2004) Page 4

Requests for and Acts of Participation in or Cooperation With an International

Boycott

13a Did you receive requests to enter into, or did you enter into, any agreement (see page 4 of instructions):

Requests Agreements

Yes No Yes No

As a condition of doing business directly or indirectly within a country or with the government, a

company, or a national of a country to—

Refrain from doing business with or in a country which is the object of an international

boycott or with the government, companies, or nationals of that country?

(a)

Refrain from doing business with any U.S. person engaged in trade in a country which is

the object of an international boycott or with the government, companies, or nationals of

that country?

(b)

Refrain from doing business with any company whose ownership or management is made up, in

whole or in part, of individuals of a particular nationality, race, or religion, or to remove (or refrain

from selecting) corporate directors who are individuals of a particular nationality, race, or religion?

(c)

(d) Refrain from employing individuals of a particular nationality, race, or religion?

(2) As a condition of the sale of a product to the government, a company, or a national of a country,

to refrain from shipping or insuring products on a carrier owned, leased, or operated by a person

who does not participate in or cooperate with an international boycott?

b Requests and agreements—If the answer to any part of 13a is “Yes,” complete the following table. If more space

is needed, attach additional sheets using the exact format and check this box 

IC-DISCs Type of cooperation or participation

only—

Enter

product

code

Identifying number of

person receiving the

request or having the

agreement

Principal business activity

Name of country Number of requests Number of agreements

Code Description Total Code Total Code

(1) (2) (3) (4) (5) (6) (7) (8) (9)

a

b

c

d

e

f

g

h

i

j

k

l

m

n

o

p

(1)

Part II

Printed on recycled paper Form 5713 (Rev. 12-2004)

2530

2540

2550

2560

2570

2580

2590

2600

2610

2620

2630

2640

2650 26602670 2680

2690

2700

2710

2720

2730

*2740 "STM nn" or blank

+2750 +2760 *+2770 "STM nn" +2790 +2800 +2810

+2820

2830 2840 2850 2860 2880 2890 2900 2910

2920 2930 2940 2950 2970 2980 2990 3000

3010 3020 3030 3040 3060 3070 3080 3090

3100 3110 3120 3130 3150 3160 3170 3180

3190 3200 3210 3220 3240 3250 3260 3270

3280 3290 3300 3310 3330 3340 3350 3360

3370 3380 3390 3400 3420 3430 3440 3450

3460 3470 3480 3490 3510 3520 3530 3540

3550 3560 3570 3580 3600 3610 3620 3630

3640 3650 3660 3670 3690 3700 3710 3720

3730 3740 3750 3760 3780 3790 3800 3810

3820 3830 3840 3850 3870 3880 3890 3900

3910 3920 3930 3940 3960 3970 3980 3990

4000 4010 4020 4030 4050 4060 4070 4080

4090 4100 4110 4120 4140 4150 4160 4170

B-92
International

Boycott Factor (Section 999(c)(1))

SCHEDULE A

(Form 5713)

OMB No. 1545-0216

(Rev. December 2004) Complete only if you are not computing a loss of tax benefits using the specifically

attributable taxes and income method on Schedule B (Form 5713) Department of the Treasury

Internal Revenue Service  Attach to Form 5713.

Name Identifying number

Name of country being boycotted (check one): Israel Other (identify) 

Purchases, sales, and payroll attributable to boycotting operations, by operation

Name of Country 

(1)

Boycott payroll

(4)

Boycott sales

(3)

Boycott purchases

(2)

a

b

c

d

e

f

g

h

i

j

k

l

m

n

o

Total

1 Numerator of boycott factor (add totals of columns (2), (3), and (4))

2 Denominator of boycott factor:

a Total purchases from countries other than United States

b Total sales to or from countries other than United States

Total payroll paid or accrued for services performed in countries other

than United States

c

d Total of lines 2a, b, and c

3 International boycott factor (divide line 1 by line 2d). Enter here and on Schedule C

(Form 5713) (see instructions) 

Important: If you are involved in more than one boycott, use a separate Schedule A for each boycott and attach to Form 5713.

For Paperwork Reduction Act Notice, see the Instructions for Form 5713. Cat. No. 12050W Schedule A (Form 5713) (Rev. 12-2004)

 See instructions on page 2.

003

020 030

040

050 060 070 080

090 100 110 120

130 140 150 160

170 180 190 200

210 220 230 240

250 260 270 280

290 300 310 320

330 340 350 360

370 380 390 400

410 420 430 440

450 460 470 480

490 500 510 520

530 540 550 560

570 580 590 600

610 620 630 640

650 660 670

680

690

700

710

720

730

B-93
Specifically Attributable Taxes

and Income (Section 999(c)(2))

SCHEDULE B

(Form 5713)

(Rev. December 2004) OMB No. 1545-0216

Department of the Treasury

Internal Revenue Service  Attach to Form 5713.  See instructions on page 2.

Name Identifying number

Name of country being boycotted (check one) Israel Other (identify) 

Specifically Attributable Taxes and Income by Operation (Use a separate line for each operation.)

Principal business activity Foreign tax credit Subpart F income IC-DISC income FSC income

Name of country

Taxable income

attributable to

boycott

operations

Taxable income

attributable to

boycott

operations

Prorated share of

international

boycott income

Foreign taxes

attributable to

boycott

operations

Code Description

(1) (2) (3) (4) (5) (6) (7)

a

b

c

d

e

f

g

h

i

j

k

l

m

n

o Total 

Important: If you are involved in more than one international boycott, use a separate Schedule B (Form 5713) to compute the

specifically attributable taxes and income for each boycott.

For Paperwork Reduction Act Notice, see the instructions for Form 5713. Schedule B (Form 5713) (Rev. 12-2004) Cat. No. 12060S

 Complete only if you are not computing a loss of tax benefits

using the international boycott factor on Schedule A (Form 5713).

B-94

003

020 030

040

050 060 070 080 090 100 110

120 130 140 150 160 170 180

190 200 210 220 230 240 250

260 270 280 290 300 310 320

330 340 350 360 370 380 390

400 410 420 430 440 450 460

470 480 490 500 510 520 530

540 550 560 570 580 590 600

610 620 630 640 650 660 670

680 690 700 710 720 730 740

750 760 770 780 790 800 810

820 830 840 850 860 870 880

890 900 910 920 930 940 950

960 970 980 990 1000 1010 1020

1030 1040 1050 1060
Draft as of

12/09/2005

SCHEDULE C

(Form 5713) Tax Effect of the International Boycott Provisions

 Attach to Form 5713. OMB No. 1545-0216

(Rev. December 2005)

Department of the Treasury

Internal Revenue Service  Use with the December 2004 revision of Form 5713.

Name Identifying number

1 Method used to compute loss of tax benefits (check one):

a International boycott factor from Schedule A (Form 5713). See lines 2a, 3a, 4a, and 5a below 

Identification of specifically attributable taxes and income from Schedule B (Form 5713). See lines 2b, 3b, 4b, and 5b 

below 

b

2 Reduction of foreign tax credit (section 908(a)):

a International boycott factor. Complete if you checked box 1a above and answered “Yes” to the 

question on line 7d, Form 5713.

(1) Foreign tax credit before adjustment from Form 1116 or 1118 (see instructions)

(2) International boycott factor from Schedule A (Form 5713), line 3

Reduction of foreign tax credit. Multiply line 2a(1) by line 2a(2). Enter here and on Form 1116

or 1118 (see instructions)

(3)

(4) Adjusted foreign tax credit. Subtract line 2a(3) from line 2a(1)

b Specifically attributable taxes and income. Complete if you checked box 1b above and answered 

“Yes” to the question on line 7d, Form 5713. Enter the amount from line o, column (4), Schedule B 

(Form 5713)

Enter the appropriate part of this amount on Form 1116 or 1118 (see instructions).

3 Denial of deferral under subpart F (section 952(a)(3)):

International boycott factor. Complete if you checked box 1a above and answered ‘‘Yes’’ to the 

question on line 7b, Form 5713.

a

(1) Prorated share of total income of controlled foreign corporations (see instructions)

Prorated share of income attributable to earnings and profits of controlled foreign corporations 

included in income under sections 951(a)(1)(A)(ii), 951(a)(1)(A)(iii), 951(a)(1)(B), 952(a)(1), 952(a)(2), 

952(a)(4), 952(a)(5), and 952(b)

(2)

(3) Subtract line 3a(2) from line 3a(1)

(4) International boycott factor from Schedule A (Form 5713), line 3

(5) Prorated share of subpart F international boycott income. Multiply line 3a(3) by line 3a(4). Enter 

here and on line 22 of Worksheet A in the Form 5471 instructions

Specifically attributable taxes and income. Complete if you checked box 1b above and answered 

“Yes” to the question on line 7b, Form 5713. Enter the amount from line o, column (5), Schedule B 

(Form 5713) here and on line 22 of Worksheet A in the Form 5471 instructions

b

4 Denial of IC-DISC benefits (section 995(b)(1)(F)(ii)):

a International boycott factor. Complete if you checked box 1a above and answered “Yes” to the 

question on line 7c, Form 5713.

(1) Prorated share of section 995(b)(1)(F)(i) amount (see instructions)

(2) International boycott factor from Schedule A (Form 5713), line 3

(3) Prorated share of IC-DISC international boycott income. Multiply line 4a(1) by line 4a(2). Enter 

this amount here and the IC-DISC will include it on line 10, Part I, Schedule J, Form 1120-IC-DISC

b Specifically attributable taxes and income. Complete if you checked box 1b above and answered 

“Yes” to the question on line 7c, Form 5713. Enter the amount from line o, column (6), Schedule B 

(Form 5713) here and the IC-DISC will include it on line 10, Part I, Schedule J, Form

1120-IC-DISC

Cat. No. 12070O Schedule C (Form 5713) (Rev. 12-2005)

5 Denial of exemption of foreign trade income (section 927(e)(2), as in effect before its repeal):

International boycott factor. Complete if you checked box 1a above and answered “Yes” to the 

question on line 7i, Form 5713.

a

(1) Add amounts from columns (a) and (b), line 10, Schedule B (Form 1120-FSC)

(2) International boycott factor from Schedule A (Form 5713), line 3

(3) Exempt foreign trade income of a FSC attributable to international boycott operations. Multiply 

line 5a(1) by line 5a(2). Enter here and on line 2, Schedule F, Form 1120-FSC

Specifically attributable taxes and income. Complete if you checked box 1b above and answered 

“Yes” to the question on line 7i, Form 5713. Enter the amount from line o, column (7), 

Schedule B (Form 5713) here and on line 2, Schedule F, Form 1120-FSC

b

 See instructions on page 2.

For Paperwork Reduction Act Notice, see Instructions for Form 5713.

003

020

030

040

050

060

070

080

090

100

110

120

130

140

150

160

170

190

200

210

220

B-95

180
Draft as of

12/09/2005

Schedule C (Form 5713) (Rev. 12-2005) Page 2

Printed on recycled paper

Reduction of foreign trade income qualifying for the extraterritorial income exclusion. Complete if 

you answered “Yes” to the question on line 7j, Form 5713.

6

a

b

c

5

Enter amount from line 49 of Form 8873

International boycott factor from Schedule A (Form 5713), line 3 

Reduction of qualifying foreign trade income. Multiply line 6a by 6b. Enter here and on Form 8873, 

line 50

240

250

260

B-96
Draft as of

10/24/2005

OMB No. 1545-0219

Form 5884 Work Opportunity Credit

Department of the Treasury

Internal Revenue Service  Attach to your tax return. Attachment

Sequence No. 77

Name(s) shown on return Identifying number

Current Year Credit (Members of a controlled group, see instructions.)

1 Enter the total qualified first-year wages paid or incurred during the tax year, and multiply by

the percentage shown, for services of employees who began work for you before the applicable

date in the instructions, are certified (if required) as members of a targeted group, and:

1a

2 Add lines 1a and 1b. You must subtract this amount from your deduction for salaries and wages 2

If you are a— Then enter the total of the current year credits from—

Schedule K-1 (Form 1120S), box 13, code F, G, or J

Schedule K-1 (Form 1065), box 15, code F, G, or J

Schedule K-1 (Form 1041), box 13, code F

Written statement from cooperative

a Shareholder

b Partner

c Beneficiary

d Patron

Work

opportunity

credits from

pass-through

entities:

3

3

Current year credit. Add lines 2 and 3. (S corporations, partnerships, estates, trusts,

cooperatives, regulated investment companies, and real estate investment trusts, see

instructions.)

4

4

Allowable Credit (See Who must file Form 3800 to find out if you complete Part II or file Form 3800.)

Form 5884 (2005)

Part I

Part II



Cat. No. 13570D

Worked for you at least 120 hours but fewer than 400 hours $ 25% (.25)

Worked for you at least 400 hours $ 40% (.40)

a

b 1b

For Paperwork Reduction Act Notice, see instructions.

● Individuals. Enter the amount from Form 1040, line 44

5

Corporations. Enter the amount from Form 1120, Schedule J, line 3; Form 1120-A,

Part I, line 1; or the applicable line of your return

●

●

8a 8a

b Credits from Form 1040, lines 48 through 54 8b

Foreign tax credit

Possessions tax credit (Form 5735, line 17 or 27)

Nonconventional source fuel credit (Form 8907, line 23)

Other specified credits (see instructions)

Add lines 8a through 8e 8f

Net income tax. Subtract line 8f from line 7. If zero, skip lines 10 through 13 and enter -0- on line 14 9

6 Alternative minimum tax:

● Individuals. Enter the amount from Form 6251, line 35

● Corporations. Enter the amount from Form 4626, line 14 6

● Estates and trusts. Enter the amount from Form 1041, Schedule I, line 56

9

Tentative minimum tax (see instructions)

10 10

Enter 25% (.25) of the excess, if any, of line 10 over $25,000 (see instructions)

12

Subtract line 13 from line 9. If zero or less, enter -0-

13 13

Credit allowed for the current year. Enter the smaller of line 4 or line 14 here and on Form

1040, line 55; Form 1120, Schedule J, line 6d; Form 1120-A, Part I, line 2; Form 1041, Schedule

G, line 2c; or the applicable line of your return. If line 14 is smaller than line 4, see instructions 15



5 Regular tax before credits:

7 Add lines 5 and 6 7

11

Enter the greater of line 11 or line 12

11

12

c

d

e

8c

8d

Estates and trusts. Enter the sum of the amounts from Form 1041, Schedule G, lines 1a

and 1b, or the amount from the applicable line of your return

Net regular tax. Subtract line 8f from line 5. If zero or less, enter -0-

14 14



15

8e

f

2005

040 050

060 070

080

@085 "STMnn"

090

100 110

120

130

140

150

165

230

B-97

240

250

260

270

305

290

300

310

320

330
Draft as of

12/14/2005

OMB No. 1545-XXXX

Form 5884-A Hurricane Katrina

Employee Retention Credit

Department of the Treasury

Internal Revenue Service  Attach to your tax return. Attachment

Sequence No. 77A

Name(s) shown on return Identifying number

1 Enter the total qualified wages paid or incurred after August 28, 

2005, and before January 1, 2006 (see instructions) 1a

Enter 40% (.40) of line 1. You must subtract this amount from your deduction for

salaries and wages

2

2

If you are a— Then enter the total of the current year credits from—

Schedule K-1 (Form 1120S), box 13, code F, G, or U

Schedule K-1 (Form 1065), box 15, code F, G, or U

Schedule K-1 (Form 1041), box 13, code R

Written statement from cooperative

a Shareholder

b Partner

c Beneficiary

d Patron

Employee

retention

credits from

pass-through

entities:

3

3

Current year credit. Add lines 2 and 3. Enter here and on line 1z of Form 3800.

Exception: S corporations, partnerships, estates, trusts, cooperatives, regulated

investment companies, and real estate investment trusts, see instructions

4

4

Form 5884-A (2005)



For Paperwork Reduction Act Notice, see page 2. Cat. No. 47425B

2005

020

030

040

045

050

B-98
OMB No. 1545-0712

Form 6198 At-Risk Limitations

 Attach to your tax return. Department of the Treasury

Internal Revenue Service

Attachment  See separate instructions. Sequence No. 31

Name(s) shown on return Identifying number

Description of activity (see page 2 of the instructions)

Current Year Profit (Loss) From the Activity, Including Prior Year Nondeductible Amounts 

(see page 2 of the instructions).

1 Ordinary income (loss) from the activity (see page 2 of the instructions) 1

Gain (loss) from the sale or other disposition of assets used in the activity (or of your interest in

the activity) that you are reporting on:

2

a Schedule D 2a

b Form 4797 2b

c Other form or schedule 2c

Other income and gains from the activity, from Schedule K-1 of Form 1065, Form 1065-B, or

Form 1120S, that were not included on lines 1 through 2c

3

3

Other deductions and losses from the activity, including investment interest expense allowed

from Form 4952, that were not included on lines 1 through 2c

4

4

Current year profit (loss) from the activity. Combine lines 1 through 4. See page 3 of the

instructions before completing the rest of this form

5

5

Simplified Computation of Amount At Risk. See page 3 of the instructions before completing this part.

Adjusted basis (as defined in section 1011) in the activity (or in your interest in the activity) on

the first day of the tax year. Do not enter less than zero

6

6

7 Increases for the tax year (see page 3 of the instructions) 7

8 Add lines 6 and 7 8

9 Decreases for the tax year (see page 4 of the instructions) 9

10a Subtract line 9 from line 8 

10b

Detailed Computation of Amount At Risk. If you completed Part III of Form 6198 for 2004, see page 4

of the instructions.

11

Investment in the activity (or in your interest in the activity) at the effective date. Do not enter

less than zero

11

12 Increases at effective date 12

13 Add lines 11 and 12 13

14 Decreases at effective date 14

15 Amount at risk (check box that applies):

a At effective date. Subtract line 14 from line 13. Do not enter less than zero. 15

b From 2004 Form 6198, line 19b. Do not enter the amount from line 10b of the 2004 form.

16 Increases since (check box that applies):

a Effective date b The end of your 2004 tax year 16

17 Add lines 15 and 16 17

18 Decreases since (check box that applies):

a Effective date b The end of your 2004 tax year 18

19a Subtract line 18 from line 17 

19b

Deductible Loss

20 Amount at risk. Enter the larger of line 10b or line 19b 20

Deductible loss. Enter the smaller of the line 5 loss (treated as a positive number) or line 20.

See page 7 of the instructions to find out how to report any deductible loss and any carryover.

21

21

Note: If the loss is from a passive activity, see the Instructions for Form 8582, Passive Activity Loss Limitations, or the Instructions for

Form 8810, Corporate Passive Activity Loss and Credit Limitations, to find out if the loss is allowed under the passive activity rules.

If only part of the loss is subject to the passive activity loss rules, report only that part on Form 8582 or Form 8810, whichever

applies.

For Paperwork Reduction Act Notice, see page 8 of the instructions. Cat. No. 50012Y Form 6198 (2005)

Part IV

Part III

Part I

Part II



( )

If line 10a is more than zero, enter that amount here and go to line 20 (or complete Part III).

Otherwise, enter -0- and see Pub. 925 for information on the recapture rules

If line 19a is more than zero, enter that amount here and go to line 20. Otherwise, enter -0- and

see Pub. 925 for information on the recapture rules

( )

19a

10a

b

b

2005

009

010

020

030

*033 "STM nn" +037 040

050

060

070

080

090

100

110

120

130

140

150

160

170

180

190

200

210 220 230

240

250 260 270

280

290

300

310

B-99
OMB No. 1545-0074

Form 6251 Alternative Minimum Tax—Individuals

 See separate instructions.

Department of the Treasury

Internal Revenue Service

Attachment

 Attach to Form 1040 or Form 1040NR. Sequence No. 32

Name(s) shown on Form 1040 Your social security number

17

Alternative Minimum Taxable Income (See instructions for how to complete each line.)

1 If filing Schedule A (Form 1040), enter the amount from Form 1040, line 41 (minus any amount on Form

8914, line 2), and go to line 2. Otherwise, enter the amount from Form 1040, line 38 (minus any amount

on Form 8914, line 2), and go to line 7. (If less than zero, enter as a negative amount.)

2

3

Medical and dental. Enter the smaller of Schedule A (Form 1040), line 4, or 21⁄2% of Form 1040, line 38

4

Miscellaneous deductions from Schedule A (Form 1040), line 26

Taxes from Schedule A (Form 1040), line 9

5

6 If Form 1040, line 38, is over $145,950 (over $72,975 if married filing separately), enter the amount from

line 9 of the Itemized Deductions Worksheet on page A-9 of the Instructions for Schedules A & B

(Form 1040)

7

8

12

18

13

14

19

20

21

29

30

31

32

Exemption. (If this form is for a child under age 14, see page 7 of the instructions.)

33

Subtract line 29 from line 28. If zero or less, enter -0- here and on lines 33 and 35 and stop here

● If you reported capital gain distributions directly on Form 1040, line 13; you reported qualified dividends

on Form 1040, line 9b; or you had a gain on both lines 15 and 16 of Schedule D (Form 1040) (as refigured

for the AMT, if necessary), complete Part III on the back and enter the amount from line 55 here.

Alternative minimum tax foreign tax credit (see page 7 of the instructions)

Tentative minimum tax. Subtract line 32 from line 31

Tax from Form 1040, line 44 (minus any tax from Form 4972 and any foreign tax credit from Form 1040,

line 47). If you used Schedule J to figure your tax, the amounts for lines 44 and 47 of Form 1040 must

be refigured without using Schedule J (see page 8 of the instructions)

For Paperwork Reduction Act Notice, see page 9 of the instructions. Cat. No. 13600G Form 6251 (2005)

Enter the home mortgage interest adjustment, if any, from line 6 of the worksheet on page 2 of the instructions

1

2

3

4

5

6

7

8

9

10

11

12

13

30

29

31

32

33

34

( )

IF your filing status is . . .

AND line 28 is

not over . . .

THEN enter on

line 29 . . .

Single or head of household $112,500 $40,250

9

10

11

34

Alternative Minimum Tax

Alternative minimum tax. Subtract line 34 from line 33. If zero or less, enter -0-. Enter here and on Form

1040, line 45

Part I

Part II

16

Married filing jointly or qualifying widow(er) 150,000 58,000

Married filing separately 75,000 29,000

If line 28 is over the amount shown above for your filing status, see page 7 of the instructions.

15

35

35



(99)

Tax refund from Form 1040, line 10 or line 21 ( )

Investment interest expense (difference between regular tax and AMT) 

Depletion (difference between regular tax and AMT)

Net operating loss deduction from Form 1040, line 21. Enter as a positive amount

Interest from specified private activity bonds exempt from the regular tax

Qualified small business stock (7% of gain excluded under section 1202)

Exercise of incentive stock options (excess of AMT income over regular tax income)

Estates and trusts (amount from Schedule K-1 (Form 1041), box 12, code A)

Electing large partnerships (amount from Schedule K-1 (Form 1065-B), box 6) 

Disposition of property (difference between AMT and regular tax gain or loss)

Depreciation on assets placed in service after 1986 (difference between regular tax and AMT)

Passive activities (difference between AMT and regular tax income or loss)

Loss limitations (difference between AMT and regular tax income or loss) 

Circulation costs (difference between regular tax and AMT)

Long-term contracts (difference between AMT and regular tax income)

22 Mining costs (difference between regular tax and AMT)

23 Research and experimental costs (difference between regular tax and AMT) 

24 Income from certain installment sales before January 1, 1987

25 Intangible drilling costs preference

26 Other adjustments, including income-based related adjustments

27 Alternative tax net operating loss deduction

28 Alternative minimum taxable income. Combine lines 1 through 27. (If married filing separately and line

28 is more than $191,000, see page 7 of the instructions.)

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

( )

( )

● All others: If line 30 is $175,000 or less ($87,500 or less if married filing separately), multiply line 30 by 26% (.26).

Otherwise, multiply line 30 by 28% (.28) and subtract $3,500 ($1,750 if married filing separately) from the result. 

2005

035

045

065

085

087

089

092

094

096

098

100

102

134

142

154

104

106

110

114

122

126

130

138

146

150

267

283

287

315

306 "C"

325

330

333

337

340 B-100

118
36 Enter the amount from Form 6251, line 30 36

Enter the amount from line 6 of the Qualified Dividends and Capital Gain Tax

Worksheet in the instructions for Form 1040, line 44, or the amount from line

13 of the Schedule D Tax Worksheet on page D-9 of the instructions for

Schedule D (Form 1040), whichever applies (as refigured for the AMT, if

necessary) (see page 9 of the instructions)

Enter the amount from Schedule D (Form 1040), line 19 (as refigured for the

AMT, if necessary) (see page 9 of the instructions)

If you did not complete a Schedule D Tax Worksheet for the regular tax or

the AMT, enter the amount from line 37. Otherwise, add lines 37 and 38, and

enter the smaller of that result or the amount from line 10 of the Schedule

D Tax Worksheet (as refigured for the AMT, if necessary)

Subtract line 40 from line 36

If line 41 is $175,000 or less ($87,500 or less if married filing separately), multiply line 41 by 26% (.26).

Otherwise, multiply line 41 by 28% (.28) and subtract $3,500 ($1,750 if married filing separately) from the

result 

Enter the smaller of line 45 or line 46

Add lines 42, 48, 50, and 52

If line 36 is $175,000 or less ($87,500 or less if married filing separately), multiply line 36 by 26% (.26).

Otherwise, multiply line 36 by 28% (.28) and subtract $3,500 ($1,750 if married filing separately) from the

result

Enter the smaller of line 53 or line 54 here and on line 31

37

38

39

40

41

42

43

46

48

54

55

39

40

41

42

47

37

38

Form 6251 (2005) Page 2

Tax Computation Using Maximum Capital Gains Rates

Enter the smaller of line 36 or line 39

Multiply line 49 by 15% (.15) 

Form 6251 (2005)

Part III

49

50

51

Multiply line 47 by 5% (.05) 

52

Enter the smaller of line 36 or line 37

47

46

50

48

Subtract line 47 from line 46

Subtract line 46 from line 40

Multiply line 51 by 25% (.25) 

53

49

If line 38 is zero or blank, skip lines 51 and 52 and go to line 53. Otherwise, go to line 51.

51

52

53

54

55

44



Enter:

● $59,400 if married filing jointly or qualifying widow(er),

● $29,700 if single or married filing separately, or

● $39,800 if head of household.

45 45

44

43

Enter the amount from line 7 of the Qualified Dividends and Capital Gain Tax

Worksheet in the instructions for Form 1040, line 44, or the amount from line

14 of the Schedule D Tax Worksheet on page D-9 of the instructions for

Schedule D (Form 1040), whichever applies (as figured for the regular tax). If

you did not complete either worksheet for the regular tax, enter -0-

Subtract line 44 from line 43. If zero or less, enter -0-

360

370

380

390

410

420

430

470

480

485

490

B-101

580

580

515

590

605

610

615

620

615
OMB No. 1545-0228 Installment Sale Income

Form 6252  Attach to your tax return.

Department of the Treasury

Internal Revenue Service

 Use a separate form for each sale or other disposition of

property on the installment method.

Attachment

Sequence No. 79

Name(s) shown on return Identifying number

Description of property 

Date acquired (month, day, year)  / / Date sold (month, day, year) 

Was the property sold to a related party (see instructions) after May 14, 1980? If “No,” skip line 4 Yes No

Was the property you sold to a related party a marketable security? If “Yes,” complete Part III. If “No,”

complete Part III for the year of sale and the 2 years after the year of sale Yes No

Gross Profit and Contract Price. Complete this part for the year of sale only.

1

Selling price including mortgages and other debts. Do not include interest whether stated or unstated

Mortgages, debts, and other liabilities the buyer assumed or took

the property subject to (see instructions)

2a

3

Subtract line 6 from line 5

4

Cost or other basis of property sold

5 5

Depreciation allowed or allowable

6

6

Adjusted basis. Subtract line 9 from line 8

7 7

Commissions and other expenses of sale

8 8

Income recapture from Form 4797, Part III (see instructions)

9 9

Add lines 10, 11, and 12

10 10

Subtract line 13 from line 5. If zero or less, do not complete the rest of this form (see instructions)

11

If the property described on line 1 above was your main home, enter the amount of your excluded

gain (see instructions). Otherwise, enter -0-

11

12

Gross profit. Subtract line 15 from line 14

12

13

Subtract line 13 from line 6. If zero or less, enter -0-

13

Contract price. Add line 7 and line 17

14 14

Installment Sale Income. Complete this part for the year of sale and any year you receive a payment or

have certain debts you must treat as a payment on installment obligations.

15

Gross profit percentage. Divide line 16 by line 18. For years after the year of sale, see instructions

15

16

If this is the year of sale, enter the amount from line 17. Otherwise, enter -0-

16

17

Payments received during year (see instructions). Do not include interest, whether stated or unstated

17

18

Add lines 20 and 21

18

Payments received in prior years (see instructions). Do not include

interest, whether stated or unstated

19 19

20

Installment sale income. Multiply line 22 by line 19

20

21

Enter the part of line 24 that is ordinary income under the recapture rules (see instructions)

21

Subtract line 25 from line 24. Enter here and on Schedule D or Form 4797 (see instructions)

22 22

Related Party Installment Sale Income. Do not complete if you received the final payment this tax year.

Name, address, and taxpayer identifying number of related party

Did the related party resell or dispose of the property (“second disposition”) during this tax year?

If the answer to question 28 is “Yes,” complete lines 30 through 37 below unless one of the following conditions is

met. Check the box that applies.

The second disposition was more than 2 years after the first disposition (other than dispositions

of marketable securities). If this box is checked, enter the date of disposition (month, day, year)  / /

The first disposition was a sale or exchange of stock to the issuing corporation.

The second disposition was an involuntary conversion and the threat of conversion occurred after the first disposition.

The second disposition occurred after the death of the original seller or buyer.

It can be established to the satisfaction of the Internal Revenue Service that tax avoidance was not a principal purpose

for either of the dispositions. If this box is checked, attach an explanation (see instructions).

23

Selling price of property sold by related party (see instructions)

23

24 24

Enter contract price from line 18 for year of first sale

25 25

Enter the smaller of line 30 or line 31

26 26

Total payments received by the end of your 2005 tax year (see instructions)

27

Subtract line 33 from line 32. If zero or less, enter -0-

28

Multiply line 34 by the gross profit percentage on line 19 for year of first sale

29

Enter the part of line 35 that is ordinary income under the recapture rules (see instructions)

30

Subtract line 36 from line 35. Enter here and on Schedule D or Form 4797 (see instructions)

30

For Paperwork Reduction Act Notice, see page 4. Form 6252 (2005)

Part II

Part I

Part III

Yes No

Cat. No. 13601R

b

a

b

c

d

e

31

32

33

34

35

36

37

31

32

33

34

35

36

37

/ /

2005

010

020 030

040 050

060 070

080

090

100

110

120

130

140

150

160

170

185

190

200

210

220

230

240

250

260

270

280

290

300 310

320 330

335

337

340

350

360

370

@380 "STM nn"

390

400

410

420

430

440

450

B-10 460 2
Draft as of

12/07/2005

OMB No. 1545-0231

Form 6478

Department of the Treasury

Internal Revenue Service

Attachment

Sequence No. 83

Name(s) shown on return Identifying number

(b)

Rate

(c)

Column (a) x Column (b)

(a)

Number of Gallons of

Alcohol Sold or Used

Type of Alcohol Fuel

1

2 $.51

Alcohol 190 proof or greater and alcohol 190 proof or greater

in fuel mixtures 

3

3

2

Alcohol less than 190 proof but at least 150 proof and alcohol

less than 190 proof but at least 150 proof in fuel mixtures 

4

4 Alcohol fuel credit(s) from a partnership, S corporation, estate, trust, or cooperative

(see instructions) 

5 Add lines 1 through 4, column (c) 5

6 Alcohol fuel credit included on line 5 from passive activities (see instructions) 6

7 Subtract line 6 from line 5 7

8 Alcohol fuel credit allowed for 2005 from a passive activity (see instructions) 8

9 Carryback of alcohol fuel credit from 2006 (see instructions) 9

10 Current year credit. Add lines 7 through 9 10

Only the rate for ethanol is shown. See instructions for lines 2 and 3 for rates for alcohol other than ethanol.

Allowable Credit Caution: If you have both an alcohol fuel credit and a credit from section B of

Form 8835, do not complete Part II below. Instead, go to Form 8835 (see instructions).

1 $.10

Qualified ethanol fuel production (in gallons)

(see instructions for election)

Cat. No. 13605J

*

Form 6478 (2005)

Credit for Alcohol Used as Fuel

 Attach to your tax return.

For Paperwork Reduction Act Notice, see page 4.

*

11

14a 14a

b Credits from Form 1040, lines 48 through 54 14b

14d

Foreign tax credit

d

f

Possessions tax credit (Form 5735, line 17 or 27)

Add l 14f ines 14a through 14e

15

Net income tax. Subtract line 14f from line 13. If zero, skip lines 16 through 19 and enter -0- on 

line 20

12 Alternative minimum tax (see instructions) 12

15

16 Net regular tax. Subtract line 14f from line 11. If zero or less, enter -0- 

18 Subtract line 17 from line 15. If zero or less, enter -0-

Subtract line 19 from line 18. If zero or less, enter -0-

19 19

Credit allowed for the current year. Enter the smaller of line 10 or line 20 here and on Form

1040, line 55; Form 1120, Schedule J, line 6d; Form 1120-A, Part I, line 2; Form 1041, Schedule 

G, line 2c; or the applicable line of your return. If line 20 is smaller than line 10, see instructions 21

c 14c

11 Regular tax before credits (see instructions)

13 Add lines 11 and 12 13

17

General business credit (see instructions)

17

18

Enter 25% (.25) of the excess, if any, of line 16 over $25,000 (see instructions)

20 20

21

e 14e

2005

Part I

Part II

Current Year Credit

Caution:

● See What’s New on page 2 for important changes to this credit.

● You cannot claim any amounts on Form 6478 that you claimed (or will claim) on Schedule C (Form 720), Form 8849, or Form 4136.

$.3778

16

Other specified credits (see instructions)

Nonconventional source fuel credit (Form 8907, line 23)

020 030

040 050

060 070

095

105

115

145

125

260

135

270

285

225 230

233 235

240

250

350

360

370

380

390

425

420

410

430

440

450

B-103
Draft as of

11/03/2005

OMB No. 1545-0619 6765 Credit for Increasing Research Activities Form

Department of the Treasury

Internal Revenue Service

Attachment

Sequence No. 81

 Attach to your tax return.

Name(s) shown on return Identifying number

Current Year Credit (Members of controlled groups or businesses under common control, see instructions.)

Basic research payments to qualified organizations (see instructions) 2

Qualified organization base period amount

2

3

Subtract line 3 from line 2. If zero or less, enter -0-

3

4

Wages for qualified services (do not include wages used in figuring the 

work opportunity credit)

4

5

Cost of supplies

5

6

Rental or lease costs of computers (see instructions)

6

7

Enter the applicable percentage of contract research expenses (see instructions)

7

8

Total qualified research expenses. Add lines 5 through 8

8

%

9 9

10

Enter average annual gross receipts (see instructions)

10

11

Multiply line 11 by the percentage on line 10

11

12

Subtract line 12 from line 9. If zero or less, enter -0- 

12

13

Multiply line 9 by 50% (.50)

13

14

Enter the smaller of line 13 or line 14

14

15

Add lines 1, 4, and 15

15

Regular credit. If you are not electing the reduced credit under section 280C(c), multiply line 16 

by 20% (.20), enter the result, and see the instructions for the schedule that must be attached.

If you are electing the reduced credit, multiply line 16 by 13% (.13) and enter the result. Also,

write “Sec. 280C” on the dotted line to the left of the entry space. Go to Section C

17

16

For Paperwork Reduction Act Notice, see instructions. Form 6765 (2005)

Part I

Cat. No. 13700H

Enter fixed-base percentage, but not more than 16% (see instructions)

Section A—Regular Credit. Skip this section and go to Section B if you are electing or previously elected the alternative incremental credit.

Section B—Alternative Incremental Credit. Skip this section if you completed Section A.

Multiply line 28 by 1% (.01)

Subtract line 29 from line 27. If zero or less, enter -0-

Multiply line 28 by 1.5% (.015)

Subtract line 31 from line 27. If zero or less, enter -0-

Subtract line 32 from line 30

Multiply line 28 by 2% (.02)

Subtract line 34 from line 27. If zero or less, enter -0-

Subtract line 35 from line 32

Multiply line 33 by 2.65% (.0265) 

Multiply line 36 by 3.2% (.032) 

Multiply line 35 by 3.75% (.0375) 

Add lines 18, 22, 37, 38, and 39

Basic research payments to qualified organizations (see the line 2 instructions)

Qualified organization base period amount (see the line 3 instructions)

Subtract line 20 from line 19. If zero or less, enter -0-

19

Multiply line 21 by 20% (.20)

20

Wages for qualified services (do not include wages used in figuring the 

work opportunity credit)

21

Cost of supplies

22

Rental or lease costs of computers (see the line 7 instructions)

23

Enter the applicable percentage of contract research expenses (see

the line 8 instructions)

24

Total qualified research expenses. Add lines 23 through 26

25

Enter average annual gross receipts (see the line 11 instructions)

26

19

20

21

22

23

24

25

26

27

28

29

30

31

32

33

34

35

36

37

38

39

27

28

29

30

31

32

33

34

35

36

37

38

39

2005

1 Certain amounts paid or incurred to energy consortia after August 8, 2005 (see instructions) 1

17

16

18 Certain amounts paid or incurred to energy consortia after August 8, 2005 (see the line 1 instructions) 18

40 40

Alternative incremental credit. If you are not electing the reduced credit under section 280C(c), 

enter the amount from line 40, and see the line 17 instructions for the schedule that must be

attached. If you are electing the reduced credit, multiply line 40 by 65% (.65) and enter the result.

Also, write “Sec. 280C” on the dotted line to the left of the entry space 41

41

020

030

040

050

060

070

080

090

100

110

120

130

140

150

160

170 "SEC 280C"

180

@190 "STM nn"

200

210

220

230

240

250

260

270

280

290

300

310

320

330

340

350

360

370

380

390

400

410

420 "SEC 280"

430

@440 "STM nn"

B-104

017

198
Draft as of

11/03/2005

Form 6765 (2005) Page 2

Part II Allowable Credit (See Who must file Form 3800 to find out if you complete Part II or file Form 3800.)

Credit allowed for the current year. Individuals, estates, and trusts: Enter the smallest of

line 43, line 53, or the amount from the formula in the instructions for line 54 here and on Form 

1040, line 55; or Form 1041, Schedule G, line 2c. Corporations: Enter the smaller of line 43 or 

line 53 here and on Form 1120, Schedule J, line 6d; Form 1120-A, Part I, line 2; or the applicable 

line of other returns. If line 54 is smaller than line 43, see instructions 

54

54

Form 6765 (2005)

44

47a 47a

Credits from Form 1040, lines 48 through 54 47b b

47d

Foreign tax credit

d

Possessions tax credit (Form 5735, line 17 or 27)

f

Nonconventional source fuel credit (Form 8907, line 23)

Other specified credits (see instructions)

Add l 47f ines 47a through 47e 

48

48 Net income tax. Subtract line 47f from line 46. If zero, skip lines 49 through 52 and enter -0- on 

line 53 

45 Alternative minimum tax (see instructions) 45

49

Tentative minimum tax (see instructions) 

49

50 Enter 25% (.25) of the excess, if any, of line 49 over $25,000 (see

instructions)

52

Subtract line 52 from line 48. If zero or less, enter -0-

52

53

c 47c

44 Regular tax (see instructions) 

46 Add lines 44 and 45 46

51

Enter the greater of line 50 or line 51

50

51

Net regular tax. Subtract line 47f from line 44. If zero or less, enter -0-

53

e 47e

Pass-through research credit(s) from a partnership, S corporation, estate, or trust

43 Current year credit. Add line 17 or line 41 to line 42, and go to Part II 

42

43

Section C—Current Year Credit for Increasing Research Activities

42 450

460

560

570

585

650

660

670

680

690

725

710

720

730

740

750

B-105

540

550
OMB No. 1545-0644 Gains and Losses From Section 1256

Contracts and Straddles Form 6781

Department of the Treasury

Internal Revenue Service

Attachment

Sequence No. 82  Attach to your tax return.

Name(s) shown on tax return Identifying number

A Mixed straddle election

B Straddle-by-straddle identification election

C Mixed straddle account election

D Net section 1256 contracts loss election

Section 1256 Contracts Marked to Market

(a) Identification of account (b) (Loss)

1

2 Add the amounts on line 1 in columns (b) and (c)

4

5

Form 1099-B adjustments. See instructions and attach schedule

Combine lines 3 and 4

If you have a net section 1256 contracts loss and checked box D above, enter the amount of loss to be

carried back. Enter the loss as a positive number

6

7 Combine lines 5 and 6

Short-term capital gain or (loss). Multiply line 7 by 40% (.40). Enter here and include on the appropriate

line of Schedule D (see instructions)

8

Long-term capital gain or (loss). Multiply line 7 by 60% (.60). Enter here and include on the appropriate

line of Schedule D (see instructions)

9

Gains and Losses From Straddles. Attach a separate schedule listing each straddle and its components.

Section A—Losses From Straddles

(h) Recognized loss.

If column (f) is more

than (g), enter

difference.

Otherwise, enter -0-

(f) Loss.

If column (e)

is more than

(d), enter

difference.

Otherwise,

enter -0-

(e) Cost or

other basis

plus

expense of

sale

(g)

Unrecognized

gain on

offsetting

positions

(c) Date

closed out

or sold

(b) Date

entered

into or

acquired

(d) Gross

sales price (a) Description of property

10

( )

11a Enter the short-term portion of losses from line 10, column (h), here and include on the appropriate line of

Schedule D (see instructions)

( )

Enter the long-term portion of losses from line 10, column (h), here and include on the appropriate line of

Schedule D (see instructions)

b

Section B—Gains From Straddles

(f) Gain. If column

(d) is more than (e),

enter difference.

Otherwise, enter -0-

12

Enter the short-term portion of gains from line 12, column (f), here and include on the appropriate line of

Schedule D (see instructions)

13a

b Enter the long-term portion of gains from line 12, column (f), here and include on the appropriate line of

Schedule D (see instructions)

Unrecognized Gains From Positions Held on Last Day of Tax Year. Memo Entry Only (see instructions)

(e) Unrecognized gain. 

If column (c) is more 

than (d), enter difference.

Otherwise, enter -0-

(d) Cost or other basis 

as adjusted

(c) Fair market value on last

business day of tax year

14

Form 6781 (2005)

Part I

Part II

Part III

(e) Cost or other

basis plus

expense of sale

(c) Date

closed out

or sold

(b) Date

entered

into or

acquired

(d) Gross

sales price (a) Description of property

(a) Description of property (b) Date

acquired

Cat. No. 13715G

Check all applicable boxes (see instructions).

(c) Gain

Note: If line 5 shows a net gain, skip line 6 and enter the gain on line 7. Partnerships and S corporations, see

instructions.

For Paperwork Reduction Act Notice, see page 4.

13a

11a

11b

13b

3

4

5

6

7

8

9

3 Net gain or (loss). Combine line 2, columns (b) and (c)

2 ( )

2005

@010 "STM nn"

020

030

040

060

*070 "STM nn" +080 +090

100 110 120

130 140 150

160 170

200

180

220

235

*270 "STM nn" +280 +290 +300 +310 *+320 +330 +340

360 370 380 390 400 410 420 430

@450 "STM nn" 460

470

*490 "STM nn" +500 +510 +520 +530 *+540

560 570 580 590 600 610

@630 "STM nn" 640

650

*670 "STM nn" +680 +690 +700 +710

720 730 740 750 760

770 780 790 800 810

B-106

250

240

210

@815 "STM nn"
Notice of Inconsistent Treatment or Administrative

Adjustment Request (AAR) 8082 OMB No. 1545-0790 Form

(Rev. December 2005)

(For use by partners, S corporation shareholders, estate and domestic trust beneficiaries,

foreign trust owners and beneficiaries, REMIC residual interest holders, and TMPs)

Attachment

Department of the Treasury Sequence No. 84 Internal Revenue Service

Name(s) shown on return Identifying number

General Information

1 Check boxes that apply:

2 If you are a tax matters partner (TMP) filing an AAR on behalf of the pass-through entity, are you

requesting substituted return treatment? (see instructions)

3 Identify type of pass-through entity:

4 Employer identification number of pass-through entity 6 Tax shelter registration number (if applicable) of pass-through entity

5 Name, address, and ZIP code of pass-through entity 7 Internal Revenue Service Center where pass-through entity filed its return

Tax year of pass-through entity

/ / to

8

9 Your tax year

Inconsistent or Administrative Adjustment Request (AAR) Items

(a) Description of inconsistent or 

administrative adjustment request (AAR) items 

(see instructions) Amount of

item

Treatment

of item

10

11

12

13

Explanations—Enter the Part II item number before each explanation. If more space is needed,

continue your explanations on the back.

For Paperwork Reduction Act Notice, see separate instructions. Form 8082 (Rev. 12-2005)

Part III

Part I

Part II

Cat. No. 49975G

Yes No

(a) Partnership (c) S corporation (d) Estate Trust (e) (f) REMIC

(a) Notice of inconsistent treatment (b) Administrative adjustment request (AAR)

(b) Electing large partnership

 See separate instructions.

(b) Inconsistency is in,

or AAR is to correct 

(check boxes that apply)

(c) Amount as shown on

Schedule K-1, Schedule Q, or

similar statement, a foreign

trust statement, or your return,

whichever applies 

(see instructions)

(d) Amount you are reporting (e) Difference between 

(c) and (d)

/ /

/ / to / /

010

020

030

035 040

050 055 060 065 070 075

080

090

100

110 120 130

140

150 "MSPC"

160 165

170 175

180 190 200 210 220 230

240 250 260 270 280 290

300 310 320 330 340 350

360 370 380 390 400 410

420

430

440

450

460

470

480

490

B-107

030
Form 8082 (Rev. 1-2000) Page 2

Part III Explanations (continued)

Form 8082 (Rev. 1-2000)

530

540

550

560

570

580

590

600

610

620

630

640

650

660

670

680

690

700

710

720

730

740

750

760

770

780

790

800

B-108 810
Form Investor Reporting of Tax Shelter Registration Number OMB No. 1545-0881

(Rev. July 1998)  Attach to your tax return.

Attachment

Sequence No. 71 Department of the Treasury

Internal Revenue Service  If you received this form from a partnership, S corporation, or trust, see the instructions.

Investor’s name(s) shown on return Investor’s identifying number Investor’s tax year ended

(b) Tax Shelter Registration

Number (11-digit number)

(c) Tax Shelter

Identifying Number (a) Tax Shelter Name

1

2

3

4

5

6

7

8

9

10

General Instructions

Who Must File

Filing Form 8271

A pass-through entity that is the

registration-required tax shelter does not

have to prepare Form 8271 and give

copies to its partners, shareholders, or

beneficiaries unless the pass-through

entity itself has invested in a

registration-required tax shelter.

A pass-through entity that has invested

in a registration-required tax shelter

must furnish copies of its Form 8271 to

its partners, shareholders, or

beneficiaries.

Note: Even if you have an interest in a

registration-required tax shelter, you do

not have to file Form 8271 if you did not

claim or report any deduction, loss,

credit, or other tax benefit, or report any

income on your tax return from an

interest in the registration-required tax

shelter. This could occur, for example, if

for a particular year you are unable to

claim any portion of a loss because of

the passive activity loss limitations, and

that loss is the only tax item reported to

you from the shelter.

Purpose of Form

However, in the case where (a) the

pass-through entity acquired at least a

50% interest in one tax year in a

registered tax shelter (and in which it

had not held an interest in a prior year),

and (b) the investment would not meet

the definition of a tax shelter

immediately following the acquisition if it

had been offered for sale at that time,

the pass-through entity need not

distribute copies of Form 8271 to its

investors. The pass-through entity alone

is required to prepare Form 8271 and

include it with the entity tax return.

In certain cases, a tax shelter that

does not expect to reduce the

cumulative tax liability of any investor

during the 5-year period ending after the

date the investment is first offered for

sale may be considered a “projected

income investment.” Such a tax shelter

will not have to register, and thus not

have to furnish a tax shelter registration

number to investors, unless and until it

ceases to be a projected income

investment. It is possible, therefore, that

you may not be furnished a tax shelter

registration number, and not have to

report it, for several years after you

purchase or otherwise acquire your

interest in the tax shelter. If you are later

furnished a tax shelter registration

number because the tax shelter ceased

to be a projected income investment,

follow these instructions. However, you

must file Form 8271 only for tax years

ending on or after the date the tax

shelter ceases to be a projected income

investment.

Note: A tax shelter registration number

does not indicate that the tax shelter or

its claimed tax benefits have been

reviewed, examined, or approved by the

IRS.

Form 8271 (Rev. 7-98)

8271

Cat. No. 61924F

Use Form 8271 to report the tax shelter

registration number the IRS assigns to

certain tax shelters required to be

registered under section 6111

(“registration- required tax shelters”) and

to report the name and identifying

number of the tax shelter. This

information must be reported even if the

particular interest is producing net

income for the filer of Form 8271. Use

additional forms to report more than 10

tax shelter registration numbers.

Attach Form 8271 to any return on

which a deduction, loss, credit, or other

tax benefit is claimed or reported, or any

income reported, from an interest in a

registration-required tax shelter. These

returns include applications for tentative

refunds (Forms 1045 and 1139) and

amended returns (Forms 1040X and

1120X).

Any person claiming or reporting any

deduction, loss, credit, or other tax

benefit, or reporting any income on any

tax return from an interest purchased or

otherwise acquired in a registrationrequired tax shelter must file Form 8271.

If you are an investor in a partnership or

an S corporation, look at item G,

Schedule K-1 (Form 1065), or item C,

Schedule K-1 (Form 1120S). If a tax

shelter registration number or the words

“Applied for” appear there, then the

entity is a registration-required tax

shelter. If the interest is purchased or

otherwise acquired by a pass-through

entity, both the pass-through entity and

its partners, shareholders, or

beneficiaries must file Form 8271.

Furnishing Copies of Form

8271 to Investors

Specific Instructions

Investor’s Identifying

Number

Investor’s Tax Year Ended

Enter the social security number or

employer identification number shown

on the return to which this Form 8271 is

attached.

Enter the date the tax year ended for the

return to which this Form 8271 is

attached.

A $250 penalty will be charged for each

failure to include a tax shelter

registration number on a return on which

it is required to be included unless the

failure is due to reasonable cause.

Penalty For Not Including

Registration Number on

Return

Section references are to the Internal

Revenue Code.

 020

030 040 050 060

070 080 090 100

110 120 130 140

150 160 170 180

190 200 210 220

230 240 250 260

270 280 290 300

310 320 330 340

350 360 370 380

390 400 410 420

B-109

 010
Form 8275 Disclosure Statement OMB No. 1545-0889

(Rev. May 2001)

Department of the Treasury

Internal Revenue Service  Attach to your tax return.

Name(s) shown on return Identifying number shown on return

General Information (see instructions)

Information About Pass-Through Entity. To be completed by partners, shareholders, beneficiaries, or

residual interest holders.

Note: A pass-through entity is a partnership, S corporation, estate, trust, regulated investment company (RIC), real estate investment

trust (REIT), or real estate mortgage investment conduit (REMIC).

Complete this part only if you are making adequate disclosure for a pass-through item.

1 Name, address, and ZIP code of pass-through entity 2 Identifying number of pass-through entity

3 Tax year of pass-through entity

/ / to / /

Internal Revenue Service Center where the pass-through entity filed

its return

4

For Paperwork Reduction Act Notice, see separate instructions. Form 8275 (Rev. 5-2001)

Part III

Part I

Cat. No. 61935M

Attachment

Sequence No. 92

Do not use this form to disclose items or positions that are contrary to Treasury

regulations. Instead, use Form 8275-R, Regulation Disclosure Statement.

See separate instructions.

(b)

Item or Group

of Items

Part II Detailed Explanation (see instructions)

(a)

Rev. Rul., Rev. Proc., etc.

1

2

3

1

2

3

(c)

Detailed Description

of Items

(f)

Amount

(d)

Form or

Schedule

(e)

Line

No.

003

020 030

040

050

060 070 080

090 100

110

120

130 140 150

160 170

180

190

200 210 220

230

240

250

260

270

280

290

300

310

320

330

340 350 360

370

380 390

400

B-110
Part IV

Form 8275 (Rev. 5-2001) Page 2

Explanations (continued from Parts I and/or II)

Form 8275 (Rev. 5-2001)

430

440

450

460

470

480

490

500

510

520

530

540

550

560

570

580

590

600

610

620

630

640

650

660

670

680

700

710

B-111
Form 8275-R Regulation Disclosure Statement OMB No. 1545-0889

(Rev. February 2002)

Department of the Treasury

Internal Revenue Service  Attach to your tax return.

Name(s) shown on return Identifying number shown on return

General Information (See instructions.)

(b)

Item or Group

of Items

Detailed Explanation (See instructions.)

For Paperwork Reduction Act Notice, see separate instructions. Form 8275-R (Rev. 2-2002)

Part I

Part II

Cat. No. 14594X

(a)

Regulation Section

Attachment

Sequence No. 92A

Use this form only to disclose items or positions that are contrary to Treasury regulations.

For other disclosures, use Form 8275, Disclosure Statement. See separate instructions.

Information About Pass-Through Entity. To be completed by partners, shareholders, beneficiaries, or

residual interest holders.

Note: A pass-through entity is a partnership, S corporation, estate, trust, regulated investment company (RIC), real estate investment

trust (REIT), or real estate mortgage investment conduit (REMIC).

Complete this part only if you are making adequate disclosure for a pass-through item.

1 Name, address, and ZIP code of pass-through entity 2 Identifying number of pass-through entity

3 Tax year of pass-through entity

/ / to / /

Internal Revenue Service Center where the pass-through entity filed

its return

4

Part III

1

2

3

1

2

3

(c)

Detailed Description

of Items

(f)

Amount

(d)

Form or

Schedule

(e)

Line

No.

010

020 030

040

050

060 070 080

090 100

110

120

130 140 150

160 170

180

190

200 210 220

230

240

250

260

270

280

290

300

310

320

330

340 350 360

370

380 390

400

B-112
Form 8275-R (Rev. 2-2002) Page 2

Part IV Explanations (continued from Parts I and/or II)

430

440

450

460

470

480

490

500

510

520

530

540

550

560

570

580

590

600

610

620

630

640

650

660

670

680

700

B-113
Form 8283 Noncash Charitable Contributions OMB No. 1545-0908

(Rev. October 1998)  Attach to your tax return if you claimed a total deduction of over $500 for all contributed property. Attachment

Sequence No. 55 Department of the Treasury

Internal Revenue Service  See separate instructions.

Name(s) shown on your income tax return Identifying number

Note: Figure the amount of your contribution deduction before completing this form. See your tax return instructions.

Section A—List in this section only items (or groups of similar items) for which you claimed a deduction of $5,000 or

less. Also, list certain publicly traded securities even if the deduction is over $5,000 (see instructions).

Information on Donated Property—If you need more space, attach a statement.

(b) Description of donated property (a) Name and address of the

donee organization 1

D

Note: If the amount you claimed as a deduction for an item is $500 or less, you do not have to complete columns (d), (e), and (f).

(h) Method used to determine the fair

market value

(f) Donor’s cost

or adjusted basis

(e) How acquired

by donor

(d) Date acquired

by donor (mo., yr.)

(c) Date of the

contribution (g) Fair market value

A

B

E

Other Information—Complete line 2 if you gave less than an entire interest in property listed in Part I.

Complete line 3 if conditions were attached to a contribution listed in Part I.

2 If, during the year, you contributed less than the entire interest in the property, complete lines a–e.

a

b Total amount claimed as a deduction for the property listed in Part I:

c Name and address of each organization to which any such contribution was made in a prior year (complete only if different

from the donee organization above):

Name of charitable organization (donee)

Address (number, street, and room or suite no.)

City or town, state, and ZIP code

d For tangible property, enter the place where the property is located or kept 

e Name of any person, other than the donee organization, having actual possession of the property 

If conditions were attached to any contribution listed in Part I, answer questions a – c and attach the required

statement (see instructions).

3

Yes No Is there a restriction, either temporary or permanent, on the donee’s right to use or dispose of the donated

property?

a

b

c

For Paperwork Reduction Act Notice, see page 4 of separate instructions. Form 8283 (Rev. 10-98)

C

D

A

B

C

E

Part I

Part II

Enter the letter from Part I that identifies the property  . If Part II applies to more than one property, attach a

separate statement.

Cat. No. 62299J

(1)

(2) For any prior tax years  .

For this tax year  .

Did you give to anyone (other than the donee organization or another organization participating with the donee

organization in cooperative fundraising) the right to the income from the donated property or to the possession

of the property, including the right to vote donated securities, to acquire the property by purchase or otherwise,

or to designate the person having such income, possession, or right to acquire?

Is there a restriction limiting the donated property for a particular use?

*010 "STM nn"

+020 +030

256

257 259

306

307 309

356

357 359

406

409

*+210 "STM nn" +220 +230 +240 +250 +255

260 270 280 290 300 305

310 320 330 340 350 355

360 370 380 390 400 405

410 420 430 440 450 455

*457

"A","B","C","D","E" or "STM nn"

+460

+470

+480

+490

*+500 "STM nn"

+510

+520

540 530

560

580

B-114

407

570

570
Form 8283 (Rev. 10-98) Page 2

Name(s) shown on your income tax return Identifying number

Section B—Appraisal Summary—List in this section only items (or groups of similar items) for which you claimed a

deduction of more than $5,000 per item or group. Exception. Report contributions of certain publicly

traded securities only in Section A.

If you donated art, you may have to attach the complete appraisal. See the Note in Part I below.

Information on Donated Property—To be completed by the taxpayer and/or appraiser.

4 Check type of property:

Art* (contribution of $20,000 or more) Real Estate Gems/Jewelry

Art* (contribution of less than $20,000) Coin Collections Books Other

*Art includes paintings, sculptures, watercolors, prints, drawings, ceramics, antique furniture, decorative arts, textiles, carpets, silver, rare

manuscripts, historical memorabilia, and other similar objects.

(c) Appraised fair

market value

(b) If tangible property was donated, give a brief summary of the overall

physical condition at the time of the gift

(a) Description of donated property (if you need

more space, attach a separate statement)

5

A

C

D

See instructions (g) For bargain sales, enter

amount received

(f) Donor’s cost or 

adjusted basis

(e) How acquired 

by donor

(d) Date acquired 

by donor (mo., yr.) (i) Average trading price of securities (h) Amount claimed as a 

deduction

A

B

C

D

Taxpayer (Donor) Statement—List each item included in Part I above that the appraisal identifies as

having a value of $500 or less. See instructions.

I declare that the following item(s) included in Part I above has to the best of my knowledge and belief an appraised value of not more than $500

(per item). Enter identifying letter from Part I and describe the specific item. See instructions. 

Signature of taxpayer (donor)  Date 

Declaration of Appraiser

I declare that I am not the donor, the donee, a party to the transaction in which the donor acquired the property, employed by, or related to any

of the foregoing persons, or married to any person who is related to any of the foregoing persons. And, if regularly used by the donor, donee, or

party to the transaction, I performed the majority of my appraisals during my tax year for other persons.

Also, I declare that I hold myself out to the public as an appraiser or perform appraisals on a regular basis; and that because of my qualifications

as described in the appraisal, I am qualified to make appraisals of the type of property being valued. I certify that the appraisal fees were not based

on a percentage of the appraised property value. Furthermore, I understand that a false or fraudulent overstatement of the property value as

described in the qualified appraisal or this appraisal summary may subject me to the penalty under section 6701(a) (aiding and abetting the

understatement of tax liability). I affirm that I have not been barred from presenting evidence or testimony by the Director of Practice.

Sign

Here Signature  Title  Date of appraisal 

Business address (including room or suite no.) Identifying number

City or town, state, and ZIP code

Donee Acknowledgment—To be completed by the charitable organization.

This charitable organization acknowledges that it is a qualified organization under section 170(c) and that it received the donated

property as described in Section B, Part I, above on 

(Date)

Furthermore, this organization affirms that in the event it sells, exchanges, or otherwise disposes of the property described in Section

B, Part I (or any portion thereof) within 2 years after the date of receipt, it will file Form 8282, Donee Information Return, with the

IRS and give the donor a copy of that form. This acknowledgment does not represent agreement with the claimed fair market value.

Name of charitable organization (donee) Employer identification number

Address (number, street, and room or suite no.) City or town, state, and ZIP code

Authorized signature Title Date

B

Stamp Collections

Part III

Part IV

Part I

Part II

Note: If your total art contribution deduction was $20,000 or more, you must attach a complete copy of the signed appraisal. See instructions.

Does the organization intend to use the property for an unrelated use?  Yes No

600

615

*650 "STM nn" +652 +654

+660 *+670 "STM nn" +680 +690 +700 +710

720 722 724

730 740 750 760 770 780

790 792 794

800 810 820 830 840 850

860 870 880

890 900 910 920 930 940

950 "A","B","C","D" 960

970

980 990

1000 1010

B-115

973 976
Draft as of

09/26/2005

Form Injured Spouse Allocation

Department of the Treasury

Internal Revenue Service

Information About the Joint Tax Return for Which This Form Is Filed

Enter the following information exactly as it is shown on the tax return for which you are filing this form.

The spouse’s name and social security number shown first on that tax return must also be shown first below.

First name, initial, and last name shown first on the return

If Injured Spouse,

check here 

Current home address

Check this box only if you are divorced or separated from the spouse with whom you filed the joint return

and you want your refund issued in your name only

Was your main home in a community property state (Arizona, California, Idaho, Louisiana, Nevada, New

Mexico, Texas, Washington, or Wisconsin) at any time during the year entered on line 2?

If “Yes,” which community property state(s)?

Note. Overpayments affected by state community property laws will be allocated by the IRS according to those laws.

8379

Part I

1

Social security number shown first If Injured Spouse,

check here 

Social security number shown second

City State ZIP code

3

5

6

Yes No

OMB No. 1545-0074

(Rev. December 2005)

Attachment

Sequence No. 104

First name, initial, and last name shown second on the return

Note. If you are filing Form 8379 with your tax return, skip to line 5.

2 Enter the tax year for which you are filing this form (for example, 2004)  ______________

4 Is the address on your joint return different from the address shown above? Yes No

Cat. No. 62474Q

 See instructions.

Part II Allocation Between Spouses of Items on the Joint Tax Return (see instructions)

Income: Wages

All other income

Adjustments to income

Standard or Itemized deduction

Number of exemptions

Credits

Other taxes

Federal income tax withheld

7 a.

b.

9

11

12

13

14

Allocated Items (a) Amount shown

on joint return

(b) Allocated to

injured spouse

(c) Allocated to

other spouse

Under penalties of perjury, I declare that I have examined this form and any accompanying schedules or statements and to the best of my knowledge and belief, they

are true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.

Keep a copy of

this form for

your records

Injured spouse’s signature

Date

Phone number (optional)

Check if

self-employed

Preparer’s

signature

Firm’s name (or yours

if self-employed),

address, and ZIP code

Paid

Preparer’s

Use Only

( )

Preparer’s SSN or PTIN 

 EIN

Phone no.

Part III Signature. Complete this part only if you are filing Form 8379 by itself and not with your tax return.

Date

8

10

Form 8379 (Rev. 12-2005)

( )

Payments

For Privacy Act and Paperwork Reduction Act Notice, see page 3.

010 020 030

040 050 060

070

080 090 100 110

120 130

140

150 160

161 AZ

B-116

162 CA 163 ID 164 LA 165 NV 166 NM 167 TX 168 WA

169 WI

180 190 200

+240 "STM nn" 210 +250 290 220 +260 300 230 270 310

280 320 360 400 330 370 410 450340 380 420 460350 390 430 470

480 490 500

540 550 560

570 590 580

600 610 620

630 640 650

660 670 680

690 700 710
Mortgage Interest Credit OMB No. 1545-0074

Form 8396 (For Holders of Qualified Mortgage Credit Certificates Issued by

State or Local Governmental Units or Agencies) Department of the Treasury 

Internal Revenue Service

Attachment

 Attach to Form 1040. Sequence No. 53

Name(s) shown on Form 1040 Your social security number

Enter the address of your main home to which the qualified mortgage certificate relates if it is different from the address shown on Form 1040.

Current Year Mortgage Interest Credit

Interest paid on the certified indebtedness amount. If someone else (other than your spouse

if filing jointly) also held an interest in the home, enter only your share of the interest paid

1

1

2 %

Enter the certificate credit rate shown on your mortgage credit certificate. Do not enter the

interest rate on your home mortgage

2

If line 2 is 20% or less, multiply line 1 by line 2. If line 2 is more than 20%, or you refinanced

your mortgage and received a reissued certificate, see the instructions for the amount to enter.

3

3

4 Enter any 2002 credit carryforward from line 18 of your 2004 Form 8396 4

5 Enter any 2003 credit carryforward from line 16 of your 2004 Form 8396 5

6 Enter any 2004 credit carryforward from line 19 of your 2004 Form 8396 6

7 Add lines 3 through 6 7

8 Enter the amount from Form 1040, line 46 8

9 Enter the total of the amounts from Form 1040, lines 47 through 52 9

10 Subtract line 9 from line 8. If zero or less, enter -0- here and on line 11 and go to Part II 10

11

11

12

Current year mortgage interest credit. Enter the smaller of line 7 or line 10. Also include

this amount in the total on Form 1040, line 54, and check box a on that line

12

Mortgage Interest Credit Carryforward to 2006. (Complete only if line 11 is less than line 7.)

13 13

Add lines 3 and 4

14 14

Enter the amount from line 7

15

Enter the larger of line 11 or line 12

15

16 16

Subtract line 14 from line 13

17

2004 credit carryforward to 2006. Enter the smaller of line 6 or line 15

17

18 18

Subtract line 16 from line 15

19

2003 credit carryforward to 2006. Enter the smaller of line 5 or line 17

19 2005 credit carryforward to 2006. Subtract line 11 from line 3. If zero or less, enter -0-

Part I

Part II

For Paperwork Reduction Act Notice, see back of form. Cat. No. 62502X Form 8396 (2005)

You must reduce your deduction for home mortgage interest on Schedule A (Form 1040)

by the amount on line 3.

 See instructions on back.

2005

010 020

030 040 050 060

070

080

090

100

110

120

130

140

143

145

150

160

170

180

190

200

210

220

230

B-117
Caution: Complete Worksheets 1, 2, and 3 on page 2 before completing Part I.

Rental Real Estate Activities With Active Participation (For the definition of active participation

see Special Allowance for Rental Real Estate Activities on page 3 of the instructions.)

Combine lines 3a, 3b, and 3c

Combine lines 1d, 2c, and 3d. If the result is net income or zero, all losses are allowed, including

any prior year unallowed losses entered on line 1c, 2b, or 3c. Do not complete Form 8582.

Report the losses on the forms and schedules normally used

Note: Enter all numbers in Part II as positive amounts. See page 8 of the instructions for an example.

Subtract line 7 from line 6

10

Combine lines 1a, 1b, and 1c

Part I

Part II

Part III

OMB No. 1545-1008 Passive Activity Loss Limitations Form 8582

 See separate instructions. Department of the Treasury

Internal Revenue Service  Attach to Form 1040 or Form 1041.

Attachment

Sequence No. 88

Name(s) shown on return Identifying number

2005 Passive Activity Loss

1a

Activities with net income (enter the amount from Worksheet 1,

column (a))

1a

1b

Activities with net loss (enter the amount from Worksheet 1,

column (b))

b

1c

Prior years unallowed losses (enter the amount from Worksheet

1, column (c))

c

d 1d

All Other Passive Activities

3a

Activities with net income (enter the amount from Worksheet 3,

column (a))

3a

3b

Activities with net loss (enter the amount from Worksheet 3,

column (b))

b

3c

c

d

Prior years unallowed losses (enter the amount from Worksheet 3,

column (c))

4

4

Special Allowance for Rental Real Estate With Active Participation

5 Enter the smaller of the loss on line 1d or the loss on line 4 5

6 Enter $150,000. If married filing separately, see page 8 6

7 Enter modified adjusted gross income, but not less than zero (see page 8) 7

Note: If line 7 is greater than or equal to line 6, skip lines 8 and

9, enter -0- on line 10. Otherwise, go to line 8.

8 8

9 Multiply line 8 by 50% (.5). Do not enter more than $25,000. If married filing separately, see page 8 9

Enter the smaller of line 5 or line 9 10

Special Allowance for Commercial Revitalization Deductions From Rental Real Estate Activities

12

11

Add the income, if any, on lines 1a and 3a and enter the total

Total losses allowed from all passive activities for 2005. Add lines 10, 14, and 15. See

pages 10 and 11 of the instructions to find out how to report the losses on your tax return

For Paperwork Reduction Act Notice, see page 12 of the instructions. Form 8582 (2005)

3d

Cat. No. 63704F

( )

( )

( )

( )

If line 4 is a loss and: ● Line 1d is a loss, go to Part II. 

(99)

Add lines 2a and 2b

2a Commercial revitalization deductions from Worksheet 2, column (a) 2a

2b

Prior year unallowed commercial revitalization deductions from

Worksheet 2, column (b)

b

c 2c

( )

( )

Commercial Revitalization Deductions From Rental Real Estate Activities

Caution: If your filing status is married filing separately and you lived with your spouse at any time during the year, do not complete

Part II or Part III. Instead, go to line 15.

If line 2c is a loss, go to Part III. Otherwise, go to line 15.

Note: Enter all numbers in Part III as positive amounts. See the example for Part II on page 8 of the instructions.

Enter $25,000 reduced by the amount, if any, on line 10. If married filing separately, see instructions

Enter the loss from line 4

Reduce line 12 by the amount on line 10

Enter the smallest of line 2c (treated as a positive amount), line 11, or line 13

Part IV Total Losses Allowed

13

14

15

16

11

12

13

14

15

16

( )

● Line 2c is a loss (and line 1d is zero or more), skip Part II and go to Part III. 

● Line 3d is a loss (and lines 1d and 2c are zero or more), skip Parts II and III and go to line 15.

2005

010

020

030

035

040

045

065

070

080

090

095

105

115

125

135

160

235

B-118

060

055

050

140

150

170

230
Caution: The worksheets must be filed with your tax return. Keep a copy for your records.

Form 8582 (2005) Page 2

Worksheet 1—For Form 8582, Lines 1a, 1b, and 1c (See page 7 of the instructions.)

Current year Prior years Overall gain or loss

(c) Unallowed

loss (line 1c)

(b) Net loss

(line 1b)

(a) Net income

(line 1a) (d) Gain (e) Loss

Name of activity

Total. Enter on Form 8582, lines 1a,

1b, and 1c 

Worksheet 3—For Form 8582, Lines 3a, 3b, and 3c (See page 8 of the instructions.)

Current year Prior years Overall gain or loss

(a) Net income

(line 3a)

(b) Net loss

(line 3b)

(c) Unallowed

loss (line 3c) (d) Gain (e) Loss

Name of activity

Total. Enter on Form 8582, lines 3a,

3b, and 3c 

Worksheet 4—Use this worksheet if an amount is shown on Form 8582, line 10 or 14 (See page 9 of the instructions.)

(d) Subtract column

(c) from column (a)

(c) Special

allowance (a) Loss (b) Ratio

Form or schedule

and line number

to be reported on

(see instructions)

Total  1.00

Name of activity

Worksheet 5—Allocation of Unallowed Losses (See page 9 of the instructions.)

(a) Loss (b) Ratio (c) Unallowed loss

Form or schedule

and line number 

to be reported on

(see instructions)

Name of activity

Total  1.00

Form 8582 (2005)

Worksheet 2—For Form 8582, Lines 2a and 2b (See pages 7 and 8 of the instructions.)

(c) Overall loss (b) Prior year 

unallowed deductions (line 2b)

(a) Current year 

deductions (line 2a) Name of activity

Total. Enter on Form 8582, lines 2a

and 2b 

*250 "STM nn" +260 +270 +280 +290 +300

310 320 330 340 350 360

370 380 390 400 410 420

430 440 450 460 470 480

490 500 510 520 530 540

550 560 570

*600 "STM nn" +610 +620 +630

640 650 660 670

680 700 710

720 730 740 750

760 770

1080

1090 1100 1110 1120 1130 1140

1150 1160 1170 1180 1190 1200

1210 1220 1550

*1560 "STM nn" +1570 +1580 +1590 +1600 +1610

1620 1630 1640 1650 1660 1670

1680 1690 1700 1710 1720 1730

1740 1750 1760 1770 1780 1790

1800 1810 1820 1830 1840 1850

1860 1870 1880

*1900 "STM nn" +1910 +1920 +1930 +1940

1950 1960 1970 1980 1990

2000 2010 2020 2030 2040

2050 2060 2070 2080 2090

2100 2110 2120 2130 2140

2150 2155

B-119

690

1040 1050 1060 1070

1000 1010 1020

1030

960 970 980

*900 "STM nn" +910 +920 +930 +940 +950
Form 8582 (2004) Page 3

Worksheet 7—Activities With Losses Reported on Two or More Different Forms or Schedules (See page 10.)

(a) (b) (c) Ratio (d) Unallowed

loss (e) Allowed loss Name of Activity:

Form or schedule and line number

to be reported on (see

instructions):

Net loss plus prior year unallowed

loss from form or schedule 

1a

Net income from form or

schedule 

b

c Subtract line 1b from line 1a. If zero or less, enter -0- 

Net loss plus prior year unallowed

loss from form or schedule 

1a

Net income from form or

schedule 

b

c Subtract line 1b from line 1a. If zero or less, enter -0- 

Net loss plus prior year unallowed

loss from form or schedule 

1a

Net income from form or

schedule 

b

c Subtract line 1b from line 1a. If zero or less, enter -0- 

Total  1.00

Form or schedule and line number

to be reported on (see

instructions):

Form or schedule and line number

to be reported on (see

instructions):

Printed on recycled paper Form 8582 (2004)

Worksheet 6—Allowed Losses (See pages 9 and 10 of the instructions.)

(a) Loss (b) Unallowed loss (c) Allowed loss

Form or schedule

and line number to

be reported on (see

instructions)

Name of activity

Total 

*2458 "STMbnn"

+2461

+2470

+2490

+2500 +2510 +2520 "STMnn +2530

2541

2550

2570

2580 2590 2600 2610

2620

2630

2650

2660 2670 2680 2690

2700 2710 2720

B-120

*2170 "STM nn"

2220

2270

2320

2370

+2180

2230

2280

2330

2380

+2190

2240

2290

2340

2390

2420

+2200

2250

2300

2350

2400

2430

+2210

2260

2310

2360

2410

2440
OMB No. 1545-1034

Form 8582-CR Passive Activity Credit Limitations

 See separate instructions.

Department of the Treasury

Internal Revenue Service

Attachment

 Attach to Form 1040 or 1041. Sequence No. 89

Name(s) shown on return Identifying number

2005 Passive Activity Credits

Caution: If you have credits from a publicly traded partnership, see Publicly Traded Partnerships (PTPs) on page 15

of the instructions.

Credits From Rental Real Estate Activities With Active Participation (Other Than Rehabilitation

Credits and Low-Income Housing Credits) (See Lines 1a through 1c on page 9.)

1a Credits from Worksheet 1, column (a) 1a

b Prior year unallowed credits from Worksheet 1, column (b) 1b

c Add lines 1a and 1b 1c

Rehabilitation Credits From Rental Real Estate Activities and Low-Income Housing Credits for

Property Placed in Service Before 1990 (or From Pass-Through Interests Acquired Before 1990)

(See Lines 2a through 2c on page 9.)

2a Credits from Worksheet 2, column (a) 2a

b Prior year unallowed credits from Worksheet 2, column (b) 2b

c Add lines 2a and 2b 2c

Low-Income Housing Credits for Property Placed in Service After 1989 (See Lines 3a through

3c on page 9.)

3a Credits from Worksheet 3, column (a) 3a

b Prior year unallowed credits from Worksheet 3, column (b) 3b

c Add lines 3a and 3b 3c

All Other Passive Activity Credits (See Lines 4a through 4c on page 9.)

4a Credits from Worksheet 4, column (a) 4a

b Prior year unallowed credits from Worksheet 4, column (b) 4b

c Add lines 4a and 4b 4c

5 Add lines 1c, 2c, 3c, and 4c 5

6 Enter the tax attributable to net passive income (see page 9) 6

7 Subtract line 6 from line 5. If line 6 is more than or equal to line 5, enter -0- and see page 10 7

Special Allowance for Rental Real Estate Activities With Active Participation

Note: Complete this part only if you have an amount on line 1c. Otherwise, go to Part IIl.

8 Enter the smaller of line 1c or line 7 8

9 Enter $150,000. If married filing separately, see page 10 9

Enter modified adjusted gross income, but not less than zero (see

page 10). If line 10 is equal to or more than line 9, skip lines 11 through

15 and enter -0- on line 16

10

10

11 Subtract line 10 from line 9 11

Multiply line 11 by 50% (.50). Do not enter more than $25,000. If

married filing separately, see page 11

12

12

Enter the amount, if any, from line 10 of

Form 8582

13a

14 Subtract line 13c from line 12 14

15 Enter the tax attributable to the amount on line 14 (see page 11) 15

16 Enter the smaller of line 8 or line 15 16

For Paperwork Reduction Act Notice, see page 16 of the instructions. Form 8582-CR (2005)

Part I

Part II

Cat. No. 64641R

Note: If your filing status is married filing separately and you lived with your spouse at any time

during the year, do not complete Part II, III, or IV. Instead, go to line 37.

Enter the amount, if any, from line 14 of

Form 8582

b

c Add lines 13a and 13b 13c

13a

13b

2005

010

020

030

040

050

060

070

080

090

100

110

120

130

140

150

160

170

180

190

200

210

220

230

240 B-121

203

206
Form 8582-CR (2005) Page 2

17 Enter the amount from line 7 17

18 Enter the amount from line 16 18

19

19 Subtract line 18 from line 17. If zero, enter -0- here and on lines 30 and 36, and then go to

Part V

20 Enter the smaller of line 2c or line 19 20

21 Enter $250,000. If married filing separately, see page 12. (See page 12

to find out if you can skip lines 21 through 26.) 21

Enter modified adjusted gross income, but not less than zero. (See

instructions for line 10 on page 10.) If line 22 is equal to or more than

line 21, skip lines 23 through 29 and enter -0- on line 30

22

22

23 Subtract line 22 from line 21 23

Multiply line 23 by 50% (.50). Do not enter more than $25,000. If married

filing separately, see page 12

24

24

25a

Enter the amount, if any, from line 10 of

Form 8582

25a

26 Subtract line 25c from line 24 26

27 Enter the tax attributable to the amount on line 26 (see page 12) 27

28 Enter the amount, if any, from line 18 28

25c

29

30 Enter the smaller of line 20 or line 29 30

Special Allowance for Low-Income Housing Credits for Property Placed in Service After 1989

Note: Complete this part only if you have an amount on line 3c. Otherwise, go to Part V.

31 If you completed Part III, enter the amount from line 19. Otherwise, subtract line 16 from line 7 31

32 Enter the amount from line 30 32

33 Subtract line 32 from line 31. If zero, enter -0- here and on line 36 33

34 Enter the smaller of line 3c or line 33 34

35 Tax attributable to the remaining special allowance (see page 12) 35

36 Enter the smaller of line 34 or line 35 36

Passive Activity Credit Allowed

37 Passive Activity Credit Allowed. Add lines 6, 16, 30, and 36. See page 12 to find out how to

report the allowed credit on your tax return and how to allocate allowed and unallowed credits if

you have more than one credit or credits from more than one activity. If you have any credits from

a publicly traded partnership, see Publicly Traded Partnerships (PTPs) on page 15 37

Part V

Part IV

Part III

Printed on recycled paper

Part VI Election To Increase Basis of Credit Property

38 If you disposed of your entire interest in a passive activity or former passive activity in a fully taxable transaction, and you

elect to increase your basis in credit property used in that activity by the unallowed credit that reduced your basis in the

property, check this box. See page 16 

39 Name of passive activity disposed of 

40 Description of the credit property for which the election is being made 

41 Amount of unallowed credit that reduced your basis in the property  $

Special Allowance for Rehabilitation Credits From Rental Real Estate Activities and Low-Income Housing

Credits for Property Placed in Service Before 1990 (or From Pass-Through Interests Acquired Before 1990)

Note: Complete this part only if you have an amount on line 2c. Otherwise, go to Part IV.

Form 8582-CR (2005)

25b

Enter the amount, if any, from line 14 of

Form 8582

b

c Add lines 25a and 25b

Subtract line 28 from line 27 29

260

270

280

290

300

310

320

330

340

350

360

370

380

390

400

410

420

430

440

450

460

470

480

490

500

B-122

333

336
Cat. No. 63987I

OMB No. 1545-0984

Form 8586 Low-Income Housing Credit

Department of the Treasury

Internal Revenue Service

Attachment

 Attach to your tax return. Sequence No. 36a

Name(s) shown on return Identifying number

Current Year Credit

1 Number of Forms 8609-A attached 

2

3 3

Has there been a decrease in the qualified basis of any buildings since the close of the preceding

(i) (ii) (iii) (iv)

Current year credit from attached Form(s) 8609-A (see instructions)

4

If you are a— Then enter the total of the current year credits from—

a Shareholder Schedule K-1 (Form 1120S), box 13, codes A and B

5

Low-income housing credits from pass-through entities (if more than one entity, see instructions):

4

6

Add lines 3 and 4. See instructions to find out if you complete lines 6 through 17 or file Form 3800 5

Allowable Credit

Form 8586 (2005)

Part I

 EIN of pass-through entity

–

7

Current year credit or passive activity credit (see instructions) 6

tax year?

buildings that had a decreased basis. If you need more space, attach a schedule.

Yes No If “Yes,” enter the building identification numbers (BINs) of the

Part II

For Paperwork Reduction Act Notice, see back of form.

b Partner

c Beneficiary

Schedule K-1 (Form 1065), box 15, codes A and B; or

Schedule K-1 (Form 1065-B), box 8

Schedule K-1 (Form 1041), box 13, code C

● Individuals. Enter the amount from Form 1040, line 44

7

Corporations. Enter the amount from Form 1120, Schedule J, line 3; Form 1120-A,

Part I, line 1; or the applicable line of your return

●

●

11

10a

b Credits from Form 1040, lines 48 through 54 10b

Foreign tax credit

Possessions tax credit (Form 5735, line 17 or 27)

Nonconventional source fuel credit (Form 8907, line 23)

Other specified credits (see instructions)

Add lines 10a through 10e 10f

11

12

Net income tax. Subtract line 10f from line 9. If zero, skip lines 12 through 15 and enter -0- on

line 16

9

Alternative minimum tax:

● Individuals. Enter the amount from Form 6251, line 35

● Corporations. Enter the amount from Form 4626, line 14 8

● Estates and trusts. Enter the amount from Form 1041, Schedule I, line 56

15

Tentative minimum tax (see instructions):

14

13 Enter 25% (.25) of the excess, if any, of line 12 over $25,000 (see

instructions)

16 Subtract line 15 from line 11. If zero or less, enter -0-

15

17 Credit allowed for the current year. Enter the smaller of line 6 or line 16 here and on Form

1040, line 55; Form 1120, Schedule J, line 6d; Form 1120-A, Part I, line 2; Form 1041, Schedule

G, line 2c; or the applicable line of your return. If line 16 is smaller than line 6, see instructions 17



8

Regular tax before credits:

10a

Add lines 7 and 8 9

14

Enter the greater of line 13 or line 14

c

d

e

10c

10d

Estates and trusts. Enter the sum of the amounts from Form 1041, Schedule G, lines 1a

and 1b, or the amount from the applicable line of your return

Net regular tax. Subtract line 10f from line 7. If zero or less, enter -0-

16



(99)

10e

f

12

13

 See instructions on back.

● Individuals. Enter the amount from Form 6251, line 33

● Corporations. Enter the amount from Form 4626, line 12

● Estates and trusts. Enter the amount from Form 1041,

Schedule I, line 54 

2005

020 @025 "STM

050 060

+070 +080 +090 +100

@105 "STM nn"

110

115

@125 "STM nn"

120

130

140

150

160

170

180

195

260

270

280

290

300

320

330

340

350

360

B-123

335
Draft as of

06/24/2005

8594 Asset Acquisition Statement OMB No. 1545-1021 Form

(Rev. December 2005) Under Section 1060

Department of the Treasury

Internal Revenue Service

Attachment

Sequence No. 61  Attach to your income tax return.

Name as shown on return

Seller

Check the box that identifies you:

1 Name of other party to the transaction Other party’s identifying number

Address (number, street, and room or suite no.)

City or town, state, and ZIP code

For Paperwork Reduction Act Notice, see separate instructions. Cat. No. 63768Z Form 8594 (Rev. 12-2005)

Purchaser

Identifying number as shown on return

General Information

2 Date of sale 3 Total sales price (consideration)

Part I

Part II Original Statement of Assets Transferred

4 Assets Aggregate fair market value (actual amount for Class I) Allocation of sales price

Class I $ $

Class II $ $

Class V $ $

Total $

Did the purchaser and seller provide for an allocation of the sales price in the sales contract or in another

written document signed by both parties?

5

Yes No

If “Yes,” are the aggregate fair market values (FMV) listed for each of asset Classes I, II, III, IV, V, VI, and

VII the amounts agreed upon in your sales contract or in a separate written document? Yes No

In the purchase of the group of assets (or stock), did the purchaser also purchase a license or a covenant

not to compete, or enter into a lease agreement, employment contract, management contract, or similar

arrangement with the seller (or managers, directors, owners, or employees of the seller)?

6

Yes No

If “Yes,” attach a schedule that specifies (a) the type of agreement and (b) the maximum amount of

consideration (not including interest) paid or to be paid under the agreement. See instructions.

$

Class IV $ $

Class VI and VII $ $

Class III $ $

 See separate instructions.

B-124

010

020 030

040 050

060

070 080 090

100 110

120 130

140 150

160 170

180 190

200 210

220 230

240 250

260 270

280 290

300 310

@315 "STM nn"
Draft as of

06/24/2005

Form 8594 (Rev. 12-2005) Page 2

Supplemental Statement—Complete only if amending an original statement or previously filed

supplemental statement because of an increase or decrease in consideration. See instructions.

8 Assets Allocation of sales price as previously reported Redetermined allocation of sales price Increase or (decrease)

Class I $ $ $

Class II $ $ $

Class III $ $ $

Total $

Reason(s) for increase or decrease. Attach additional sheets if more space is needed.

7

9

Tax year and tax return form number with which the original Form 8594 and any supplemental statements were filed.

Class VI and VII $ $ $

Class IV $ $ $

Class V $ $ $

Printed on recycled paper Form 8594 (Rev. 12-2005)

$

Part III

B-125

340 350 360

*330

370 380 390

400 410 420

430 440 450

460 470 480

490 500 510

520 530

*540 "STM nn" *550 *560
Draft as of

12/16/2005

OMB No. 1545-0074

Form 8606 Nondeductible IRAs

 See separate instructions. Department of the Treasury

Internal Revenue Service

Attachment

 Attach to Form 1040, Form 1040A, or Form 1040NR. Sequence No. 48

Name. If married, file a separate form for each spouse required to file Form 8606. See page 5 of the instructions. Your social security number

Home address (number and street, or P.O. box if mail is not delivered to your home) Apt. no. Fill in Your Address Only

if You Are Filing This

Form by Itself and Not

With Your Tax Return

City, town or post office, state, and ZIP code

1

1 Enter your nondeductible contributions to traditional IRAs for 2005, including those made for

2005 from January 1, 2006, through April 17, 2006 (see page 5 of the instructions) 

2 Enter your total basis in traditional IRAs (see page 6 of the instructions) 2

3 Add lines 1 and 2 

4

3

Enter those contributions included on line 1 that were made from January 1, 2006, through 

April 17, 2006

5

4

Subtract line 4 from line 3 5

6 Enter the value of all your traditional, SEP, and SIMPLE IRAs as of

December 31, 2005, plus any outstanding rollovers. Subtract any

repayment of qualified Hurricane Katrina distributions. If the result is

zero or less, enter -0- (see page 6 of the instructions)

8

7

Enter the net amount you converted from traditional, SEP, and SIMPLE 

IRAs to Roth IRAs in 2005. Do not include amounts converted that

you later recharacterized (see page 8 of the instructions). Also enter

this amount on line 16 

9 9

10

Add lines 6, 7, and 8 

10

 .

11

Divide line 5 by line 9. Enter the result as a decimal rounded to at

least 3 places. If the result is 1.000 or more, enter “1.000”

11 Multiply line 8 by line 10. This is the nontaxable portion of the amount

you converted to Roth IRAs. Also enter this amount on line 17 

12

12

13

Multiply line 7 by line 10. This is the nontaxable portion of your

distributions that you did not convert to a Roth IRA 

13

14

15a

Subtract line 13 from line 3. This is your total basis in traditional IRAs for 2005 and earlier years

Cat. No. 63966F Form 8606 (2005)



In 2005, did you take a

distribution from traditional,

SEP, or SIMPLE IRAs, or

make a Roth IRA conversion?

No

Yes

Enter the amount from line 3 on

line 14. Do not complete the rest

of Part I.

Go to line 4.

Taxable amount. Subtract line 15b from line 15a. If more than zero, also include this amount on

Form 1040, line 15b; Form 1040A, line 11b; or Form 1040NR, line 16b





6

For Paperwork Reduction Act Notice, see page 8 of the instructions.

Part I Nondeductible Contributions to Traditional IRAs and Distributions From Traditional, SEP, and SIMPLE IRAs

Complete this part only if:

● You made nondeductible contributions to a traditional IRA for 2005,

● You took distributions from a traditional, SEP, or SIMPLE IRA in 2005 (other than a rollover, conversion,

recharacterization, or return of certain contributions) and you made nondeductible contributions to a traditional IRA

in 2005 or an earlier year, or

● You converted part, but not all, of your traditional, SEP, and SIMPLE IRAs to Roth IRAs in 2005 (excluding any portion 

you recharacterized) and you made nondeductible contributions to a traditional IRA in 2005 or an earlier year.

Enter your distributions from traditional, SEP, and SIMPLE IRAs in

2005. Do not include rollovers (other than repayments of qualified

Hurricane Katrina distributions), conversions to a Roth IRA, certain

returned contributions, or recharacterizations of traditional IRA

contributions (see page 6 of the instructions)

7

Add lines 11 and 12. This is the nontaxable portion of all your distributions 

14

8

15c

Note: You may be subject to an additional 10% tax on the amount on line 15c if you were under 

age 591⁄2 at the time of the distribution (see page 7 of the instructions).

(99)

2005

Subtract line 12 from line 7

Amount on line 15a attributable to qualified Hurricane Katrina distributions (see page 7 of the

instructions). Also enter this amount on Form 8915, line 13 

b

c

15a

15b

009

010

100

105

162

164

166

170

180

185

225

235

245

250

260

265

B-126

190

261

263
Draft as of

12/16/2005

Form 8606 (2005) Page 2

Under penalties of perjury, I declare that I have examined this form, including accompanying attachments, and to the best of my

knowledge and belief, it is true, correct, and complete. Sign Here Only if You

Are Filing This Form

by Itself and Not With

Your Tax Return  Your signature  Date

Part III

Complete this part if you converted part or all of your traditional, SEP, and SIMPLE IRAs to a Roth IRA in 2005 (excluding 

any portion you recharacterized).

17

18

If you completed Part I, enter the amount from line 11. Otherwise, enter your basis in the amount 

on line 16 (see page 8 of the instructions) 

16

19 Enter your total nonqualified distributions from Roth IRAs in 2005 including any qualified first-time

homebuyer distributions (see page 8 of the instructions)

20 Qualified first-time homebuyer expenses (see page 8 of the instructions). Do not enter more

than $10,000

21 Subtract line 20 from line 19. If zero or less, enter -0- and skip lines 22 through 25

22 Enter your basis in Roth IRA contributions (see page 9 of the instructions) 

19

Taxable amount. Subtract line 17 from line 16. Also include this amount on Form 1040,

line 15b; Form 1040A, line 11b; or Form 1040NR, line 16b 

Form 8606 (2005)

Caution: If your modified adjusted gross income is over $100,000 or you are married filing separately and you lived with 

your spouse at any time in 2005, you cannot convert any amount from traditional, SEP, or SIMPLE IRAs to Roth IRAs 

for 2005. If you erroneously made a conversion, you must recharacterize (correct) it (see page 7 of the instructions).

Part II

16 If you completed Part I, enter the amount from line 8. Otherwise, enter the net amount you

converted from traditional, SEP, and SIMPLE IRAs to Roth IRAs in 2005.Do not include amounts 

you later recharacterized back to traditional, SEP, or SIMPLE IRAs in 2005 or 2006 (see page 8 

of the instructions) 

17

18

Distributions From Roth IRAs

Complete this part only if you took a distribution from a Roth IRA in 2005. For this purpose, a distribution does not

include a rollover (other than repayments of qualified Hurricane Katrina distributions), recharacterization, or return of

certain contributions—see page 8 of the instructions.

25a Subtract line 24 from line 23. If zero or less, enter -0- and skip lines 25b and 25c 

20

21

25a

2005 Conversions From Traditional, SEP, or SIMPLE IRAs to Roth IRAs

22

24 Enter your basis in Roth IRA conversions (see page 9 of the instructions)

23 Subtract line 22 from line 21. If zero or less, enter -0- and skip lines 24 and 25. If more than zero, 

you may be subject to an additional tax (see page 9 of the instructions)

24

23

Taxable amount. Subtract line 25b from line 25a. If more than zero, also include this amount on 

Form 1040, line 15b; Form 1040A, line 11b; or Form 1040NR, line 16b 

b Amount on line 25a attributable to qualified Hurricane Katrina distributions (see page 9 of the

instructions). Also enter this amount on Form 8915, line 14 

c

Date Preparer’s SSN or PTIN Preparer’s

signature

Check if selfemployed

Firm’s name (or yours

if self-employed),

address, and ZIP code

EIN

Phone no.





Paid

Preparer’s

Use Only ( )

25b

25c

338

342

344

351

354

358

361

363

B-127

368

376

372

374
Draft as of

06/28/2005

Form

OMB No. 1545-XXXX Annual Statement for Low-Income Housing Credit

 File with owner’s federal income tax return.

(Rev. January 2006) Attachment Department of the Treasury

Internal Revenue Service

For Paperwork Reduction Act Notice, see instructions.

Name(s) shown on return Identifying number

1 Eligible basis of building 1

2 .

2 Low-income portion (smaller of unit fraction or floor space fraction) (if first year of the credit

period, see instructions)

3 Qualified basis of low-income building. Multiply line 1 by line 2 (see instructions for exceptions) 3

4 Part-year adjustment for disposition or acquisition during the tax year 4

5 Credit percentage 5 .

6 Multiply line 3 or line 4 by the percentage on line 5 6

7 Additions to qualified basis, if any 7

8 8

9 9 .

10 Multiply line 7 or line 8 by the percentage on line 9 10

11 Section 42(f)(3)(B) modification 11

12 Add lines 10 and 11 12

13 Credit for building before line 14 reduction. Subtract line 12 from line 6 13

14 Disallowed credit due to federal grants (see instructions) 14

15

15 Credit allowed for building for tax year. Subtract line 14 from line 13, but do not enter more than

the amount shown on Form 8609, Part I, line 1b

16 Taxpayer’s proportionate share of credit for the year (see instructions) 16

17

18

17 Adjustments for deferred first-year credit (see instructions)

Taxpayer’s credit. Combine lines 16 and 17. Enter here and in Part I of Form 8586

Sequence No. 36

Credit percentage. Enter one-third of the percentage on line 5

Cat No. 38841T

18

Form 8609-A (1-2006)

Part-year adjustment for disposition or acquisition during the tax year

B

A

C

Building identification number (BIN) 

This Form 8609-A is for (check the box)  a newly constructed or existing building 

section 42(e) rehabilitation expenditures

Do you have in your records the original Form 8609 (or a copy thereof) signed and issued by the housing credit

agency for the building in A?

If “No,” see the instructions and stop here—do not go to Part II.

Did the building in A qualify as a part of a qualified low-income housing project and meet the requirements of

section 42 as of the end of the tax year for which this form is being filed?

If “No,” see the instructions and stop here—do not go to Part II.

Was there a decrease in the qualified basis of the building in A for the tax year for which this form is being

filed?

If “Yes,” see the instructions. If “No,” and the entire credit has been claimed in prior tax years, stop here—do

not go to Part II.

D

E

Yes No

Part I

Part II

Compliance Information

Computation of Credit

8609-A

010

020

030

040

050 060

070 080

090 100

110

220

230

240

250

260

270

280

290

200

210

B-128

300

310

320

330

340

350

360

370
OMB No. 1545-1035 Recapture of Low-Income Housing Credit Form 8611

 Attach to your return. (Rev. December 2004)

Note: Complete a separate Form 8611 for each building to

which recapture applies.

Attachment

Sequence No. 90 Department of the Treasury

Internal Revenue Service

A Name(s) shown on return B Identifying number

C Address of building (as shown on Form 8609) D Building identification

number (BIN)

E Date placed in service (from

Form 8609)

Note: Skip lines 1–7 and go to line 8 if recapture is passed through from a flow-through entity (partnership, S corporation, estate,

or trust).

1 Enter total credits reported on Form 8586 in prior years for this building 1

2 Credits included on line 1 attributable to additions to qualified basis (see instructions) 2

3 Credits subject to recapture. Subtract line 2 from line 1 3

.

4 Credit recapture percentage (see instructions) 4

5 Accelerated portion of credit. Multiply line 3 by line 4 5

6

Percentage decrease in qualified basis. Express as a decimal amount carried out to at least 3 places

(see instructions)

6

7 Amount of accelerated portion recaptured (see instructions if prior recapture on building).

Multiply line 5 by line 6. Section 42(j)(5) partnerships, go to line 16. All other flow-through

entities (except electing large partnerships), enter the result here and enter each recipient’s

share in the appropriate box of Schedule K-1. Generally, flow-through entities other than

electing large partnerships will stop here. (Note: An estate or trust enters on line 8

only its share of recapture amount attributable to the credit amount reported on its

Form 8586.) 7

8 Enter recapture amount from flow-through entity (see Note above) 8

9 Enter the unused portion of the accelerated amount from line 7 (see instructions) 9

10 Net recapture. Subtract line 9 from line 7 or line 8. If less than zero, enter -0- 10

11 Enter interest on the line 10 recapture amount (see instructions) 11

12 Total amount subject to recapture. Add lines 10 and 11

15

Only Section 42(j)(5) partnerships need to complete lines 16 and 17.

16 Enter interest on the line 7 recapture amount (see instructions) 16

17 Total recapture. Add lines 7 and 16 (see instructions) 17

Cat. No. 63983Q Form 8611 (Rev. 12-2004)

F If building is financed in whole or part with tax-exempt bonds, see instructions and furnish: Date of issue

CUSIP number

Issuer’s name

Name of issue

(1)

(3)

(2)

(4)

.

For Paperwork Reduction Act Notice, see page 4.

13 Unused credits attributable to this building reduced by the accelerated portion included on

line 9 (see instructions)

14 Recapture tax. Subtract line 13 from line 12. If zero or less, enter -0-. Enter the result here

and on the appropriate line of your tax return (see instructions). If more than one

Form 8611 is filed, add the line 14 amounts from all forms and enter the total on the appropriate

line of your return. Electing large partnerships, see instructions

15 Carryforward of the low-income housing credit attributable to this building. Subtract

line 12 from line 13. If zero or less, enter -0- (see instructions)

12

13

14

003

020

030 040 050 060 070

080 090

100 110

120

130

140

150

160

170

180

190

200

210

220

230

240

250

B-129

215 "SECTION 42(J)(5)"

260

280

270
OMB No. 1545-0074 Tax for Children Under Age 14

With Investment Income of More Than $1,600 Form 8615

Department of the Treasury

Internal Revenue Service

Attachment

Sequence No. 33

 Attach only to the child’s Form 1040, Form 1040A, or Form 1040NR.

Child’s name shown on return Child’s social security number

Parent’s name (first, initial, and last). Caution: See instructions before completing. Parent’s social security number

Parent’s filing status (check one):

Child’s Net Investment Income

1 Enter the child’s investment income (see instructions) 1

If the child did not itemize deductions on Schedule A (Form 1040 or Form 1040NR), enter $1,600.

Otherwise, see instructions

2

2

Subtract line 2 from line 1. If zero or less, stop; do not complete the rest of this form but do

attach it to the child’s return

3

3

4

Enter the child’s taxable income from Form 1040, line 43; Form 1040A, line 27; or Form 1040NR, 

line 40

4

Enter the smaller of line 3 or line 4. If zero, stop; do not complete the rest of this form but do

attach it to the child’s return 

5

5

Tentative Tax Based on the Tax Rate of the Parent

Enter the parent’s taxable income from Form 1040, line 43; Form 1040A, line 27; Form 1040EZ, 

line 6; Form 1040NR, line 40; or Form 1040NR-EZ, line 14. If zero or less, enter -0-

6

6

Enter the total, if any, from Forms 8615, line 5, of all other children of the parent named

above. Do not include the amount from line 5 above

7

7

8 Add lines 5, 6, and 7 (see instructions). 8

9

Enter the tax on the amount on line 8 based on the parent’s filing status above (see instructions).

If the Qualified Dividends and Capital Gain Tax Worksheet, Schedule D Tax Worksheet, or

Schedule J (Form 1040) is used to figure the tax, check here 

9

10 Enter the parent’s tax from Form 1040, line 44; Form 1040A, line 28, minus any alternative minimum

tax; Form 1040EZ, line 10; Form 1040NR, line 41; or Form 1040NR-EZ, line 15. Do not include any

tax from Form 4972 or 8814. If the Qualified Dividends and Capital Gain Tax Worksheet, Schedule D 

Tax Worksheet, or Schedule J (Form 1040) was used to figure the tax, check here  10

Subtract line 10 from line 9 and enter the result. If line 7 is blank, also enter this amount on line

13 and go to Part III

11

11

12a Add lines 5 and 7 12a

b Divide line 5 by line 12a. Enter the result as a decimal (rounded to at least three places) 12b . 13 Multiply line 11 by line 12b 13

Child’s Tax—If lines 4 and 5 above are the same, enter -0- on line 15 and go to line 16.

14 Subtract line 5 from line 4 14

15

15 Enter the tax on the amount on line 14 based on the child’s filing status (see instructions). If the 

Qualified Dividends and Capital Gain Tax Worksheet, Schedule D Tax Worksheet, or

Schedule J (Form 1040) is used to figure the tax, check here 

16 Add lines 13 and 15 16

17

17 Enter the tax on the amount on line 4 based on the child’s filing status (see instructions). If the 

Qualified Dividends and Capital Gain Tax Worksheet, Schedule D Tax Worksheet, or

Schedule J (Form 1040) is used to figure the tax, check here 

18 Enter the larger of line 16 or line 17 here and on the child’s Form 1040, line 44; Form 1040A,

line 28; or Form 1040NR, line 41 18

For Paperwork Reduction Act Notice, see the instructions. Form 8615 (2005)

A B

C

Single

Cat. No. 64113U



Part III

Part I

Part II

(99)  See separate instructions.

Before you begin: If the child, the parent, or any of the parent’s other children under age 14 must use the Schedule D Tax

Worksheet or has income from farming or fishing, see Pub. 929, Tax Rules for Children and Dependents. It

explains how to figure the child’s tax using the Schedule D Tax Worksheet or Schedule J (Form 1040).

Married filing jointly Married filing separately Head of household Qualifying widow(er)

2005

010 020

040

045

050

055 "ESTIMATED"

070

080

090

100

110

115 "ESTIMATED"

120

128 "ESTIMATED"

130

140

143

160

163

180

190

200

210

220

230

233

250

260

270

280

290

B-130

060
Return by a Shareholder of a Passive Foreign

Investment Company or Qualified Electing Fund Form 8621

(Rev. December 2004)

Attachment

Sequence No. 69 Department of the Treasury

Internal Revenue Service  See separate instructions.

Name of shareholder Identifying number (see page 2 of instructions)

Number, street, and room or suite no. (If a P.O. box, see page 2 of instructions.)

City or town, state, and ZIP code or country

Check type of shareholder filing the return: Individual Corporation Partnership S Corporation Nongrantor Trust Estate

Name of passive foreign investment company (PFIC) or qualified electing fund (QEF) Employer identification number (if any)

Address (Enter number, street, city or town, and country.) Tax year of company or fund: calendar year 20 or other

tax year beginning , 20 and

ending , 20 .

Elections (See instructions.)

A

B

C

D

Income From a Qualified Electing Fund (QEF). All QEF shareholders complete lines 1a through 2c. If you are making

Election D, also complete lines 3a through 4c. (See page 5 of instructions.)

Enter your pro rata share of the ordinary earnings of the QEF 1a

Enter the portion of line 1a that is included in income under

section 551 or 951 or that may be excluded under section 1293(g) 1b

Subtract line 1b from line 1a. Enter this amount on your tax return as dividend income 1c

Enter your pro rata share of the total net capital gain of the QEF 2a

Enter the portion of line 2a that is included in income under

section 551 or 951 or that may be excluded under section 1293(g)

b

2b

Subtract line 2b from line 2a. This amount is a net long-term capital gain. Enter this amount

in Part II of the Schedule D used for your income tax return. (See instructions.)

c

2c

Add lines 1c and 2c 3a

2a

Enter the total amount of cash and the fair market value of other

property distributed or deemed distributed to you during the tax

year of the QEF. (See instructions.)

b

3b

Enter the portion of line 3a not already included in line 3b that is

attributable to shares in the QEF that you disposed of, pledged,

or otherwise transferred during the tax year

c

3c

Add lines 3b and 3c 3d

3e Subtract line 3d from line 3a, and enter the difference (if zero or less, enter amount in brackets)

Important: If line 3e is greater than zero, and no portion of line 1a or 2a is includible in income

under section 551 or 951, you may make Election D with respect to the amount on line 3e.

Enter the total tax for the tax year (See instructions.) 4a

3a

4b

Enter the total tax for the tax year determined without regard to

the amount entered on line 3e

b

Subtract line 4b from line 4a. This is the deferred tax, the time for payment of which is

extended by making Election D. See instructions

c

4c

For Paperwork Reduction Act Notice, see page 7 of separate instructions. Form 8621 (Rev. 12-2004)

Part I

Part II

E

1a

b

c

d

e

4a

Cat. No. 64174H

Election To Treat the PFIC as a QEF. I, a shareholder of a PFIC, elect to treat the PFIC as a QEF. Complete lines 1a through 2c of Part II.

Deemed Sale Election. I, a shareholder on the first day of a PFIC’s first tax year as a QEF, elect to recognize gain on the

deemed sale of my interest in the PFIC. Enter gain or loss on line 10f of Part IV.

Deemed Dividend Election. I, a shareholder on the first day of a PFIC’s first tax year as a QEF that is a controlled foreign

corporation (CFC), elect to treat an amount equal to my share of the post-1986 earnings and profits of the CFC as an excess

distribution. Enter this amount on line 10e of Part IV.

Election To Extend Time For Payment of Tax. I, a shareholder of a QEF, elect to extend the time for payment of tax on

the undistributed earnings and profits of the QEF until this election is terminated. Complete lines 3a through 4c of Part II to

calculate the tax that may be deferred.

Election To Recognize Gain on Deemed Sale of PFIC. I, a shareholder of a former PFIC or a PFIC to which section 1297(e) applies, elect to

treat as an excess distribution the gain recognized on the deemed sale of my interest in the PFIC, or, if I qualify, my share of the PFIC’s post-1986

earnings and profits deemed distributed, on the last day of its last tax year as a PFIC under section 1297(a). Enter gain on line 10f of Part IV.

OMB No. 1545-1002

Election To Mark-to-Market PFIC Stock. I, a shareholder of a PFIC, elect to mark-to-market the PFIC stock that is

marketable within the meaning of section 1296(e). Complete Part III.

F

Note: If any portion of line 1a or line 2a of Part II is includible under section 551 or 951, you may not make this election.

Also, see sections 1294(c) and 1294(f) and the related regulations for events that terminate this election.

Shareholder tax year: calendar year 20 or other tax year

beginning , 20 and ending , 20 .

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420 B-131
Form 8621 (Rev. 12-2004) Page 2

Distributions From and Dispositions of Stock of a Section 1291 Fund (See page 6 of instructions.)

Enter your total distributions from the section 1291 fund during the current tax year with respect to the

applicable stock. If the holding period of the stock began in the current tax year, see instructions

10a

Enter the total distributions (reduced by the portions of such distributions that were excess

distributions but not included in income under section 1291(a)(1)(B)) made by the fund with

respect to the applicable stock for each of the 3 years preceding the current tax year (or if

shorter, the portion of the shareholder’s holding period before the current tax year)

b

c Divide line 10b by 3. (See instructions if the number of preceding tax years is less than 3.)

d Multiply line 10c by 125% (1.25)

Subtract line 10d from line 10a. This amount, if more than zero, is the excess distribution with respect to

the applicable stock. If zero or less and you did not dispose of stock during the tax year, do not complete

the rest of Part IV. See instructions if you received more than one distribution during the current tax year.

Also, see instructions for rules for reporting a nonexcess distribution on your income tax return

e

Enter gain or loss from the disposition of stock of a section 1291 fund or former section 1291

fund. If a gain, complete line 11. If a loss, show it in brackets and do not complete line 11

f

Attach a statement for each distribution and disposition. Show your holding period for each

share of stock or block of shares held. Allocate the excess distribution to each day in your

holding period. Add all amounts that are allocated to days in each tax year.

11a

Enter the total of the amounts determined in line 11a that are allocable to the current tax year

and tax years before the foreign corporation became a PFIC (pre-PFIC tax years). Enter these

amounts on your income tax return as other income

b

10b

Enter the aggregate increases in tax (before credits) for each tax year in your holding period

(other than the current tax year and pre-PFIC years). (See instructions.)

c

11c

d Foreign tax credit. (See instructions.) 11d

Subtract line 11d from line 11c. Enter this amount on your income tax return as “additional

tax.” (See instructions.)

e

11e

Determine interest on each net increase in tax determined on line 11e using the rates and

methods of section 6621. Enter the aggregate amount of interest here. (See instructions.)

f

11f

Status of Prior Year Section 1294 Elections and Termination of Section 1294 Elections

Complete a separate column for each outstanding election. Complete lines 9 and 10 only if there is a

partial termination of the section 1294 election.

(i) (ii) (iii) (iv) (v) (vi)

1 Tax year of outstanding

election

Undistributed earnings to

which the election relates

2

3 Deferred tax

4 Interest accrued on deferred

tax (line 3) as of the filing date

5 Event terminating election

6 Earnings distributed or deemed

distributed during the tax year

Deferred tax due with this

return

7

Accrued interest due with

this return

8

Deferred tax outstanding after

partial termination of election

9

Interest accrued after partial

termination of election

10

Part IV

Part III

10a

10c

10d

10e

10f

11b

Complete a separate Part IV for each excess distribution (see instructions).

Part V

Gain or (Loss) From Mark-to-Market Election (See page 5 of instructions.)

5 Enter the fair market value of your PFIC stock at the end of the tax year 5

6 Enter your adjusted basis in the stock at the end of the tax year 6

Excess. Subtract line 6 from line 5. If a gain, stop here. Include this amount as ordinary income

on your tax return. If a loss, go to line 8

7

7

8 Enter any unreversed inclusions (as defined in section 1296(d)). See instructions. 8

9 Enter the smaller of line 7 or line 8. Include this amount as an ordinary loss on your tax return 9

Form 8621 (Rev. 12-2004)

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B-132
OMB No. 1545-0074 Allocation of Individual Income Tax

to the Virgin Islands Form 8689

Department of the Treasury

Internal Revenue Service  Attach to Form 1040. Attachment

Sequence No. 85

Name(s) shown on Form 1040 Your social security number

Income From the Virgin Islands

1 Wages, salaries, tips, etc. 1

2 Taxable interest 2

3 Ordinary dividends 3

4 Taxable refunds, credits, or offsets of local Virgin Islands taxes 4

5 Alimony received 5

6 Business income or (loss) 6

7 Capital gain or (loss) 7

8 8

9 9

Other gains or (losses)

10 10

IRA distributions (taxable amount)

11 11

Pensions and annuities (taxable amount)

12 12

Rental real estate, royalties, partnerships, S corporations, trusts, etc.

13 13

Farm income or (loss)

14 14

Unemployment compensation

15 15

Social security benefits (taxable amount)

16 16

Other income. List type and amount. 

Add lines 1 through 15. This is your total income 

Adjusted Gross Income From the Virgin Islands

17

Health savings account deduction

17

20

Penalty on early withdrawal of savings

20

21

IRA deduction

21

Student loan interest deduction

23 23

Tuition and fees deduction

24

Add lines 17 through 27

25

Subtract line 28 from line 16. This is your adjusted gross income 

26

25

Allocation of Tax to the Virgin Islands

Enter amount from Form 1040, line 63

27

29

Enter amount from Form 1040, line 38

30

Divide line 29 above by line 33. Enter the result as a decimal (rounded to at least 3 places). Do not enter more than 1.000.  .

31

Multiply line 32 by line 34. This is your tax allocated to the Virgin Islands

32

33

Payments of Income Tax to the Virgin Islands

Income tax withheld by the Virgin Islands

33

35

2005 estimated tax payments and amount applied from 2004 return

34

36

Amount paid with Form 4868 (extension request)

35

Add lines 36 through 38. These are your total payments 

36

38

Overpayment to the Virgin Islands. If line 39 is more than line 35, subtract line 35 from line 39

37

40

Amount of line 41 you want refunded to you 

38

Amount of line 41 you want applied to your 2006 estimated tax 

39

Amount you owe to the Virgin Islands. Subtract line 39 from line 35. Enter the amount that you are

paying here and on Form 1040, line 71. Next to line 71, enter “Form 8689” and the amount paid 

For Paperwork Reduction Act Notice, see back of form. Cat. No. 64603D Form 8689 (2005)

Part IV

Part I

Part II

Part III

Enter the total of the amounts from Form 1040, lines 58, 59, 62, 66a, and 68. Include any uncollected social security

and Medicare or tier 1 RRTA tax, tax on golden parachute payments, or excise tax on insider stock compensation

reported on line 63. Also include any amount from Form 5329, Parts III, IV, V, VI, VII, or VIII reported on line 60

28

30

Subtract line 31 from line 30

29

Self-employed health insurance deduction

41

24

32

37

43

41

42

31

34

19 19

Moving expenses

42

44

One-half of self-employment tax

Enter the smaller of line 35 or line 39. Also, include this amount in the total on Form 1040, line 71. On

the dotted line next to line 71, enter "Form 8689" and show this amount

43

44

28

26

39

27

18 Certain business expenses of reservists, performing artists, and fee-basis

government officials 18

22 Self-employed SEP, SIMPLE, and qualified plans 22

Educator expenses

40

2005

003

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Interest Computation Under the Look-Back

Method for Completed Long-Term Contracts Form 8697 OMB No. 1545-1031

(Rev. November 2002)

 See separate instructions. Department of the Treasury

Internal Revenue Service  Please print or type.

For the filing year beginning , and ending . See page 2 of the instructions.

Name Identifying number

Fill In Your Number, street, and apt., room, or suite no. If a P.O. box, see page 3 of the instructions. B Check applicable box to show type of taxpayer:

Address Only If

You Are Filing This

Form Separately

and Not With Your

Tax Return

Corporation S corporation

City or town, state, and ZIP code Individual Partnership

Estate or trust

C If you were an owner of an interest in a pass-through entity (such as a partnership or an S corporation) that holds one or more long-term contracts to which this

interest computation relates, enter the name and employer identification number of the entity. Attach a schedule if there is more than one such entity.

Name of entity Employer identification number

Date of each prior year to which interest

computation relates: Taxable income or loss for the prior years shown on tax

return (or as previously adjusted) before net operating loss

or capital loss carrybacks (other than carrybacks that must

be taken into account to properly compute interest under

section 460) (see page 3 of the instructions). If you were

required to file Form 8697 for an earlier year, enter adjusted

taxable income for the prior years from line 3, Form 8697,

for the most recent filing year that affects the prior years

1 (d)

Totals

(Add columns (a),

(b), and (c).)

(c)

Year ended

(b)

Year ended

(a)

Year ended

Adjustment to income to reflect the difference between:

(a) the amount of income required to be allocated for

post-February 1986 contracts completed or adjusted

during the tax year based on the actual contract price and

costs, and (b) the amount of income reported for such

contracts based on estimated contract price and costs.

See page 3 of the instructions and attach a schedule listing

each separate contract, unless you were an owner of an

interest in a pass-through entity reporting this amount from

Schedule K-1 or a similar statement

2

Adjusted taxable income for look-back purposes. Combine

lines 1 and 2

3

Income tax liability on line 3 amount using tax rates in effect

for the prior years (see page 3 of the instructions)

4

Income tax liability shown on return (or as previously

adjusted) for the prior years (see page 3 of the instructions).

If you were required to file Form 8697 for an earlier year,

enter the amount required to be reported on line 4, Form

8697, for the most recent filing year that affects the prior

years

5

Increase or decrease in tax for the prior years on which

interest is due (or is to be refunded). Subtract line 5 from

line 4.

6

Interest due on increase, if any, shown on line 6 (see

page 3 of the instructions)

7

Interest to be refunded on decrease, if any, shown on

line 6 (see page 3 of the instructions)

8

Net amount of interest to be refunded to you. If line 8, column (d), exceeds line 7, column (d), enter the excess. File

Form 8697 separately; do not attach it to your tax return (see page 3 of the instructions)

9

Net amount of interest you owe. If line 7, column (d), exceeds line 8, column (d), enter the excess. Attach

Form 8697 to your tax return. See page 4 of the instructions for where to include this amount on your return

10

For Privacy Act and Paperwork Reduction Act Notice, see page 5 of the instructions. Form 8697 (Rev. 11-2002)

Regular Method

A

Part I

Cat. No. 64598V

Attachment

Sequence No. 97

mo. yr. mo. yr. mo. yr.

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090

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Under penalties of perjury, I declare that I have examined this form, including accompanying schedules and statements, and to the best of my

knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer

Sign has any knowledge.

Here

Signature(s) Date

Date Preparer’s SSN or PTIN Preparer’s

signature Check if Paid self-employed 

Preparer’s

Use Only

Firm’s name (or yours

if self-employed), address, and ZIP code

EIN

Phone no. ()

Form 8697 (Rev. 11-2002) Page 2

Simplified Marginal Impact Method

Date of each prior year to which interest

1 Adjustment to regular taxable income to reflect the computation relates:

difference between: (a) the amount of such income required

to be allocated for post-February 1986 contracts

completed or adjusted during the tax year based on actual

contract price and costs, and (b) the amount of such

income reported for such contracts based on estimated

contract price and costs. See page 4 of the instructions

and attach a schedule listing each separate contract,

unless you were an owner of an interest in a pass-through

entity reporting this amount from Schedule K-1 or a similar

statement

2 Increase or decrease in regular tax for prior years. Multiply

line 1 in each column by the applicable regular tax rate (see

page 4 of the instructions)

3 Adjustment to alternative minimum taxable income to

reflect the difference between: (a) the amount of such

income required to be allocated for post-February 1986

contracts completed or adjusted during the tax year based

on actual contract price and costs, and (b) the amount of

such income reported for such contracts based on

estimated contract price and costs. See page 4 of the

instructions and attach a schedule listing each separate

contract, unless you were an owner of an interest in a

pass-through entity reporting this amount from Schedule

K-1 or a similar statement

4 Increase or decrease in alternative minimum tax (AMT) for

prior years. Multiply line 3 in each column by the applicable

AMT rate (see page 4 of the instructions)

5 Enter the larger of line 2 or line 4. See page 4 of the

instructions if either amount is negative

Pass-through entities: Skip line 6 and enter on line 7 the

amount from line 5.

6 Overpayment ceiling. For each column in which line 5 is a

negative number, enter your total tax liability for the prior

year, as adjusted for past applications of the look-back

method and after net operating loss, capital loss, net

section 1256 contracts loss, and credit carryovers and

carrybacks to that year. For each column in which line 5 is

a positive number, leave line 6 blank and enter on line 7

the amount from line 5

7 Increase or decrease in tax for the prior years on which

interest is due (or is to be refunded). Enter the amount from

line 5 or line 6, whichever is smaller. Treat both numbers

as positive when making this comparison, but enter the

amount as a negative number

8 Interest due on increase, if any, shown on line 7 (see page

4 of the instructions)

9 Interest to be refunded on decrease, if any, shown on

line 7 (see page 4 of the instructions)

10 Net amount of interest to be refunded to you. If line 9, column (d), exceeds line 8, column (d), enter the excess. File

Form 8697 separately; do not attach it to your tax return (see page 4 of the instructions)

11 Net amount of interest you owe. If line 8, column (d), exceeds line 9, column (d), enter the excess. Attach

Form 8697 to your tax return. See page 4 of the instructions for where to include this amount on your return

(d)

Totals

(Add columns (a),

(b), and (c).)

(a)

Year ended

Note: For prior years beginning before 1987, skip lines 3

and 4 and enter on line 5 the amount from line 2.

mo. yr.

(b)

Year ended

mo. yr.

(c)

Year ended

mo. yr.

Part II









Signature(s) Complete this section only if this form is being filed separately.

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B-135

617
Draft as of

09/02/2005

OMB No. 1545-1073

Form 8801

Department of the Treasury

Internal Revenue Service

Attachment

 Attach to Form 1040, 1040NR, or 1041. Sequence No. 74

Name(s) shown on return Identifying number

Net Minimum Tax on Exclusion Items

1 Combine lines 1, 6, and 10 of your 2004 Form 6251. Estates and trusts, see instructions 1

2 Enter adjustments and preferences treated as exclusion items (see instructions) 2

3 ( ) 3 Minimum tax credit net operating loss deduction (see instructions)

Combine lines 1, 2, and 3. If zero or less, enter -0- here and on line 15 and go to Part II. If more

than $191,000 and you were married filing separately for 2004, see instructions

4

4

5

Enter: $58,000 if married filing jointly or qualifying widow(er) for 2004; $40,250 if single or head

of household for 2004; or $29,000 if married filing separately for 2004. Estates and trusts, enter

$22,500

5

6

Enter: $150,000 if married filing jointly or qualifying widow(er) for 2004; $112,500 if single or head

of household for 2004; or $75,000 if married filing separately for 2004. Estates and trusts, enter

$75,000

6

7 Subtract line 6 from line 4. If zero or less, enter -0- here and on line 8 and go to line 9 7

8 Multiply line 7 by 25% (.25) 8

9

9 Subtract line 8 from line 5. If zero or less, enter -0-. If this form is for a child under age 14, see

instructions

10

Subtract line 9 from line 4. If zero or less, enter -0- here and on line 15 and go to Part II. Form

1040NR filers, see instructions

10

11

11 ● If for 2004 you reported capital gain distributions directly on Form 1040, line 13; you reported

qualified dividends on Form 1040, line 9b (Form 1041, line 2b(2)); or you had a gain on both lines

15 and 16 of Schedule D (Form 1040) (lines 14a and 15, column (2), of Schedule D (Form 1041)),

complete Part III of Form 8801 and enter the amount from line 46 here.

Minimum tax foreign tax credit on exclusion items (see instructions) 12

13

14

Tentative minimum tax on exclusion items. Subtract line 12 from line 11

14

15

Enter the amount from your 2004 Form 6251, line 34, or 2004 Form 1041, Schedule I, line 55

15 Net minimum tax on exclusion items. Subtract line 14 from line 13. If zero or less, enter -0-

16 16

Minimum Tax Credit and Carryforward to 2006

Enter the amount from your 2004 Form 6251, line 35, or 2004 Form 1041, Schedule I, line 56

17 17

18

Enter the amount from line 15 above

18

19

Subtract line 17 from line 16. If less than zero, enter as a negative amount

19

20

2004 minimum tax credit carryforward. Enter the amount from your 2004 Form 8801, line 26

20 Enter the total of your 2004 unallowed nonconventional source fuel credit and 2004 unallowed

qualified electric vehicle credit (see instructions)

21 21

22

Combine lines 18, 19, and 20. If zero or less, stop here and see instructions

22

23

Enter your 2005 regular income tax liability minus allowable credits (see instructions)

23

24 24

Enter the amount from your 2005 Form 6251, line 33, or 2005 Form 1041, Schedule I, line 54

25

Subtract line 23 from line 22. If zero or less, enter -0-

25

26

Minimum tax credit. Enter the smaller of line 21 or line 24. Also enter this amount on your 2005

Form 1040, line 55; Form 1040NR, line 50; or Form 1041, Schedule G, line 2d

26

Minimum tax credit carryforward to 2006. Subtract line 25 from line 21. Keep a record of this

amount because you may use it in future years

Cat. No. 10002S

Part II

Part I

Credit for Prior Year Minimum Tax—

Individuals, Estates, and Trusts

For Paperwork Reduction Act Notice, see page 6. Form 8801 (2005)

(99)

 See instructions on pages 3 and 4.

● All others: If line 10 is $175,000 or less ($87,500 or less if married filing separately for

2004), multiply line 10 by 26% (.26). Otherwise, multiply line 10 by 28% (.28) and subtract

$3,500 ($1,750 if married filing separately for 2004) from the result.

12

13



2005

020

030

040

050

060

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B-136
Draft as of

09/02/2005

Tax Computation Using Maximum Capital Gains Rates

27 Enter the amount from Form 8801, line 10 27

28

Enter the amount from line 6 of your 2004 Qualified Dividends and

Capital Gain Tax Worksheet, the amount from line 13 of your 2004

Schedule D Tax Worksheet, or the amount from line 22 of the 2004

Schedule D (Form 1041), whichever appies.*

28

29

Enter the amount from line 19 of your 2004 Schedule D (Form 1040),

or line 14b, column (2), of the 2004 Schedule D (Form 1041)

29

30

Add lines 28 and 29, and enter the smaller of that result or the amount

from line 10 of your 2004 Schedule D Tax Worksheet

30

31

32

Enter the smaller of line 27 or line 30

32

33

Subtract line 31 from line 27

33

34

If line 32 is $175,000 or less ($87,500 or less if married filing separately for 2004), multiply line

32 by 26% (.26). Otherwise, multiply line 32 by 28% (.28) and subtract $3,500 ($1,750 if married

filing separately for 2004) from the result 

34

Enter:

● $58,100 if married filing jointly or qualifying widow(er) for 2004,

● $29,050 if single or married filing separately for 2004,

● $38,900 if head of household for 2004, or

● $1,950 for an estate or trust

37 Enter the smaller of line 27 or line 28 37

38

Form 8801 (2005) Page 2

Part III

39

40

Multiply line 38 by 5% (.05) 

Subtract line 38 from line 37

Subtract line 37 from line 31

Multiply line 42 by 25% (.25) 

Add lines 33, 39, 41, and 43

40

41

Caution: If you did not complete the 2004 Qualified Dividends and Capital Gain Tax Worksheet,

the 2004 Schedule D Tax Worksheet, or Part V of the 2004 Schedule D (Form 1041), see the

instructions before completing this part.

If line 29 is zero or blank, skip lines 42 and 43 and go to line 44. Otherwise, go to line 42.

Form 8801 (2005)

Enter the smaller of line 36 or line 37

* The 2004 Qualified Dividends and Capital Gain Tax Worksheet is on page 34 of the 2004 Instructions for Form 1040. The 2004 Schedule D Tax Worksheet is on

page D-9 of the 2004 Instructions for Schedule D (Form 1040) (page 37 of the 2004 Instructions for Form 1041).

38

If line 27 is $175,000 or less ($87,500 or less if married filing separately), multiply line 27 by 26%

(.26). Otherwise, multiply line 27 by 28% (.28) and subtract $3,500 ($1,750 if married filing

separately) from the result

Enter the smaller of line 44 or line 45 here and on line 11 46

31

39

Multiply line 40 by 15% (.15) 

44

42

43

45

41

42

43

44

46

45

35 Enter the amount from line 7 of your 2004 Qualified Dividends and Capital

Gain Tax Worksheet, the amount from line 14 of your 2004 Schedule D Tax

Worksheet, or the amount from line 23 of the 2004 Schedule D (Form 1041),

whichever applies. If you did not complete either worksheet or Part V of the

2004 Schedule D (Form 1041), enter -0- 35

36 Subtract line 35 from line 34. If zero or less, enter -0- 36

If you figured your 2004 tax using the 2004 Qualified Dividends

and Capital Gain Tax Worksheet, skip line 29 and enter the amount

from line 28 on line 30. Otherwise, go to line 29.

300

310

320

330

350

360

370

380

385

387

390

400

430

440

524

430

545

B-137

527

610

600

550
Yes. Subtract $11,000 from the amount on line 4a. Enter the result

OMB No. 1545-0074

Additional Child Tax Credit Form 8812

Complete and attach to Form 1040 or Form 1040A. Department of the Treasury

Internal Revenue Service

Attachment

Sequence No. 47

Name(s) shown on return Your social security number

For Paperwork Reduction Act Notice, see back of form. Cat. No. 10644E Form 8812 (2005)

3

2

4a

6

Withheld social security and Medicare taxes from Form(s) W-2, boxes 4 and

6. If married filing jointly, include your spouse’s amounts with yours. If you

worked for a railroad, see instructions on back

Add lines 7 and 8

1

Enter the total of the amounts from Form 1040, lines

27 and 59, plus any uncollected social security and

Medicare or tier 1 RRTA taxes included on line 63.

Enter -0-.

Enter the total of the amounts from Form 1040, lines

66a and 67.

Enter the total of the amount from Form 1040A, line

41a, plus any excess social security and tier 1 RRTA

taxes withheld that you entered to the left of line 43

(see instructions on back).

Enter the amount from line 1 of your Child Tax Credit Worksheet on page 42 of the Form 1040 instructions

or page 39 of the Form 1040A instructions. If you used Pub. 972, enter the amount from line 8 of the

worksheet on page 4 of the publication

Enter the amount from Form 1040, line 52, or Form 1040A, line 33

Subtract line 2 from line 1. If zero, stop; you cannot take this credit

8

9



6

1040A filers:

1040 filers:

1040 filers:

1040A filers:

1

2

13

1040 .

1040A . . . . . . . . . Enter this amount on

Form 1040, line 68, or

Form 1040A, line 42.





8812

1040

1040A

. . . . . . . . . .

3

Earned income (see instructions on back). If your main home was in the

Hurricane Katrina disaster area on August 25, 2005, and you are electing to

use your 2004 earned income, check here 

5 Is the amount on line 4a more than $11,000?

No. Leave line 5 blank and enter -0- on line 6.

4a

5

Multiply the amount on line 5 by 15% (.15) and enter the result

7

Next. Do you have three or more qualifying children?

No. If line 6 is zero, stop; you cannot take this credit. Otherwise, skip Part II and enter the

smaller of line 3 or line 6 on line 13.

Yes.

7

8

9

10

10

11 Subtract line 10 from line 9. If zero or less, enter -0- 11

12 Enter the larger of line 6 or line 11 12

Next, enter the smaller of line 3 or line 12 on line 13.

13 This is your additional child tax credit

Part III

Part I

Part II

All Filers

Certain Filers Who Have Three or More Qualifying Children

Additional Child Tax Credit

If line 6 is equal to or more than line 3, skip Part II and enter the amount from line 3 on

line 13. Otherwise, go to line 7.

(99)

4b

Nontaxable combat pay (see instructions on

back)

b

2005

008

012

016

021

025

035 038

045

058

054

075

085

095

105

110

B-138

115

140

023

019
OMB No. 1545-0074 Parents’ Election To Report

Child’s Interest and Dividends Form 8814

 See instructions. Department of the Treasury

Internal Revenue Service

Attachment

 Attach to parents’ Form 1040 or Form 1040NR. Sequence No. 40

Name(s) shown on your return Your social security number

Child’s name (first, initial, and last) Child’s social security number

If more than one Form 8814 is attached, check here 

Child’s Interest and Dividends To Report on Your Return

Enter your child’s taxable interest. If this amount is different from the amounts shown on the

child’s Forms 1099-INT and 1099-OID, see the instructions

1a

1a

b Enter your child’s tax-exempt interest. Do not include this

amount on line 1a 1b

2 Enter your child’s ordinary dividends, including any Alaska Permanent Fund dividends. If your

child received any ordinary dividends as a nominee, see the instructions

Enter your child’s capital gain distributions. If your child received any capital gain distributions

as a nominee, see the instructions

Add lines 1a, 2, and 3. If the total is $1,600 or less, skip lines 5 and 6 and go to line 7. If the

total is $8,000 or more, do not file this form. Your child must file his or her own return to report

the income

3

1,600 00

4

Base amount

4

5

Subtract line 5 from line 4. See the instructions for where to report this amount. Go to line 7

below  6

Tax on the First $1,600 of Child’s Interest and Dividends

Amount not taxed 800 00

9

7 7

Subtract line 7 from line 4. If the result is zero or less, enter -0-

No. Enter $80 here and see the Note below.

Tax. Is the amount on line 8 less than $800?

8 8

Yes. Multiply line 8 by 10% (.10). Enter the result here and see the Note below.

Note. If you checked the box on line C above, see the instructions. Otherwise, include the amount from line 9 in the tax you enter

on Form 1040, line 44, or Form 1040NR, line 41. Be sure to check box a on Form 1040, line 44, or Form 1040NR, line 41.

For Paperwork Reduction Act Notice, see page 3. Cat. No. 10750J Form 8814 (2005)



A B

C

3

6

2

5

Part I

Part II

9

Caution. The federal income tax on your child’s income, including qualified dividends and capital gain distributions, may be less

if you file a separate tax return for the child instead of making this election. This is because you cannot take certain tax benefits

that your child could take on his or her own return. For details, see Tax benefits you may not take on page 2.

2005

010

015

020

030

*040"TAX-EXEMPT INTEREST" "STM nn" +050 *060 "STM nn" +070 +090 

*080 "ACCRUED INTEREST" "ABP ADJUSTMENT"" OID ADJUSTMENT" "STM nn"

100

110

120 "ND" 130 135

141 "ND" 146 151

170

180 "CGD" 190 195 200

210

220

B-139

212

216
Exclusion of Interest From Series EE and I OMB No. 1545-0074

U.S. Savings Bonds Issued After 1989 Form 8815

(For Filers With Qualified Higher Education Expenses)

 Attach to Form 1040 or Form 1040A.

Department of the Treasury

Internal Revenue Service Attachment

Sequence No. 57

Name(s) shown on return Your social security number

(a)

Name of person (you, your spouse, or your dependent) who

was enrolled at or attended an eligible educational institution

1 (b)

Name and address of eligible educational institution

If you need more space, attach a statement.

Enter the total qualified higher education expenses you paid in 2005 for the person(s) listed in

column (a) of line 1. See the instructions to find out which expenses qualify

2

2

Enter the total of any nontaxable educational benefits (such as nontaxable scholarship or

fellowship grants) received for 2005 for the person(s) listed in column (a) of line 1 (see instructions)

3

3

4 Subtract line 3 from line 2. If zero or less, stop. You cannot take the exclusion 4

5 Enter the total proceeds (principal and interest) from all series EE and I U.S. savings bonds

issued after 1989 that you cashed during 2005 5

6 Enter the interest included on line 5 (see instructions) 6

If line 4 is equal to or more than line 5, enter “1.000.” If line 4 is less than line 5, divide line 4

by line 5. Enter the result as a decimal (rounded to at least three places)

7

7  .

8 Multiply line 6 by line 7 8

9 Enter your modified adjusted gross income (see instructions) 9

Note: If line 9 is $76,200 or more if single or head of household, or

$121,850 or more if married filing jointly or qualifying widow(er), stop.

You cannot take the exclusion.

10

Enter: $61,200 if single or head of household; $91,850 if married filing

jointly or qualifying widow(er)

10

Subtract line 10 from line 9. If zero or less, skip line 12, enter -0- on

line 13, and go to line 14

11

11

Divide line 11 by: $15,000 if single or head of household; $30,000 if married filing jointly or

qualifying widow(er). Enter the result as a decimal (rounded to at least three places)

12

12  .

13 Multiply line 8 by line 12 13

14 Excludable savings bond interest. Subtract line 13 from line 8. Enter the result here and on

Schedule B (Form 1040), line 3, or Schedule 1 (Form 1040A), line 3, whichever applies  14

Cat. No. 10822S Form 8815 (2005)

Purpose of Form

1. You cashed qualified U.S. savings bonds in 2005 that were

issued after 1989.

2. You paid qualified higher education expenses in 2005 for

yourself, your spouse, or your dependents.

3. Your filing status is any status except married filing separately.

4. Your modified AGI (adjusted gross income) is less than: $76,200

if single or head of household; $121,850 if married filing jointly or

qualifying widow(er). See the instructions for line 9 to figure your

modified AGI.

U.S. Savings Bonds That Qualify for Exclusion

Who May Take the Exclusion

If you cashed series EE or I U.S. savings bonds in 2005 that were

issued after 1989, you may be able to exclude from your income

part or all of the interest on those bonds. Use this form to figure the

amount of any interest you may exclude.

You may take the exclusion if all four of the following apply.

To qualify for the exclusion, the bonds must be series EE or I U.S.

savings bonds issued after 1989 in your name, or, if you are married,

they may be issued in your name and your spouse’s name. Also, you

must have been age 24 or older before the bonds were issued. A

bond bought by a parent and issued in the name of his or her child

under age 24 does not qualify for the exclusion by the parent or

child.

Section references are to the Internal Revenue Code.

General Instructions

For Paperwork Reduction Act Notice, see back of form.

Recordkeeping Requirements

● A written record of each post-1989 series EE or I bond that you

cash. Your record must include the serial number, issue date, face

value, and total redemption proceeds (principal and interest) of each

bond. You may use Form 8818, Optional Form To Record

Redemption of Series EE and I U.S. Savings Bonds Issued After

1989.

● Bills, receipts, canceled checks, or other documents showing you

paid qualified higher education expenses in 2005.

Keep the following records to verify interest you exclude.

(99)

2005

*010 "STM nn" +020

*+030 "NONE" or "STM nn" +040

050 060

070 "NONE" 080

090 100

110 "NONE" 120

170

180

190

200

210

220

230

240

250

"61200"

or "91850"

260

270

280

290

B-140
OMB No. 1545-1505 8820 Orphan Drug Credit Form

 Attach to your tax return. Attachment

Sequence No. 103 Department of the Treasury

Internal Revenue Service

Name(s) shown on return Identifying number

Current Year Credit

1 1

2 2

3

4

3

4

Form 8820 (2005)

Part I

Allowable Credit (See Who must file Form 3800 to find out if you complete Part II or file Form 3800.)

● Individuals. Enter the amount from Form 1040, line 44

5

Corporations. Enter the amount from Form 1120, Schedule J, line 3; Form 1120-A,

Part I, line 1; or the applicable line of your return

●

●

8a 8a

b 8b

Foreign tax credit

Possessions tax credit (Form 5735, line 17 or 27)

Other specified credits (see instructions)

Nonconventional source fuel credit (Form 8907, line 23)

Add lines 8a through 8e 8f

9

9 Net income tax. Subtract line 8f from line 7. If zero, skip lines 10 through 13 and enter -0- on

line 14

6 Alternative minimum tax:

● Individuals. Enter the amount from Form 6251, line 35

● Corporations. Enter the amount from Form 4626, line 14 6

● Estates and trusts. Enter the amount from Form 1041, Schedule I, line 56

10

Tentative minimum tax (see instructions):

● Individuals. Enter the amount from Form 6251, line 33

10

● Corporations. Enter the amount from Form 4626, line 12

● Estates and trusts. Enter the amount from Form 1041,

Schedule I, line 54

11 Enter 25% (.25) of the excess, if any, of line 10 over $25,000 (see

instructions)

13

Subtract line 13 from line 9. If zero or less, enter -0-

13

14

Credit allowed for the current year. Enter the smaller of line 4 or line 14 here and on Form

1040, line 55; Form 1120, Schedule J, line 6d; Form 1120-A, Part I, line 2; Form 1041, Schedule

G, line 2c; or the applicable line of your return. If line 14 is smaller than line 4, see instructions 15

Part II



5 Regular tax before credits:

7 Add lines 5 and 6 7

12

Enter the greater of line 11 or line 12

11

12

Cat. No. 11208S

Qualified clinical testing expenses paid or incurred during the tax year

Current year credit. Multiply line 1 by 50% (.50) (see instructions)

Pass-through orphan drug credits from an S corporation, partnership, estate, or trust

Current year credit. Add lines 2 and 3

General Instructions

Purpose of Form

Who Must File

An individual, estate, trust, organization, or

corporation that elects to claim an orphan

drug credit, or any S corporation,

partnership, estate, or trust that allocates

the credit to its shareholders, partners, or

beneficiaries must complete this form and

attach it to its income tax return.

Use Form 8820 to claim the orphan drug

credit. The credit is 50% of qualified

clinical testing expenses paid or incurred

during the tax year. See section 45C and

Regulations section 1.28-1 for details.

Definitions

Qualified clinical testing expenses.

Generally, qualified clinical testing

expenses are amounts paid or incurred by

the taxpayer that would be described as

qualified research expenses under section

41, with two modifications:

● In sections 41(b)(2) and (3), “clinical

testing” is substituted for “qualified

research” and

Section references are to the Internal

Revenue Code unless otherwise noted.

For Paperwork Reduction Act Notice, see page 2.

d

e

8d

Estates and trusts. Enter the sum of the amounts from Form 1041, Schedule G, lines 1a

and 1b, or the amount from the applicable line of your return

Net regular tax. Subtract line 8f from line 5. If zero or less, enter -0-

15

14



8e

f

c 8c

Credits from Form 1040, lines 48 through 54

2005

020

030

040

050

060

070

080

090

105

170

180

190

200

210

245

230

240

250

260

270

B-141

045
OMB No. 1545-1190 Like-Kind Exchanges

Form 8824

(and section 1043 conflict-of-interest sales)

Department of the Treasury

Internal Revenue Service  Attach to your tax return. Attachment

Sequence No. 109

Name(s) shown on tax return Identifying number

Information on the Like-Kind Exchange

1 Description of like-kind property given up 

2 Description of like-kind property received 

3 Date like-kind property given up was originally acquired (month, day, year) 3 / /

4 Date you actually transferred your property to other party (month, day, year) 4 / /

5 / /

Date like-kind property you received was identified by written notice to another party (month,

day, year). See instructions for 45-day written notice requirement

5

6 Date you actually received the like-kind property from other party (month, day, year). See instructions 6 / /

7 Was the exchange of the property given up or received made with a related party, either directly or indirectly

(such as through an intermediary)? See instructions. If “Yes,” complete Part II. If “No,” go to Part III

8 Name of related party Related party’s identifying number

Address (no., street, and apt., room, or suite no., city or town, state, and ZIP code)

Relationship to you

During this tax year (and before the date that is 2 years after the last transfer of property that was part of the

exchange), did the related party directly or indirectly (such as through an intermediary) sell or dispose of any

part of the like-kind property received from you in the exchange?

9

During this tax year (and before the date that is 2 years after the last transfer of property that was part of the

exchange), did you sell or dispose of any part of the like-kind property you received?

10

If both lines 9 and 10 are “No” and this is the year of the exchange, go to Part III. If both lines 9 and 10 are “No” and this is not the

year of the exchange, stop here. If either line 9 or line 10 is “Yes,” complete Part III and report on this year’s tax return the deferred

gain or (loss) from line 24 unless one of the exceptions on line 11 applies.

11 If one of the exceptions below applies to the disposition, check the applicable box:

The disposition was after the death of either of the related parties.

The disposition was an involuntary conversion, and the threat of conversion occurred after the exchange.

You can establish to the satisfaction of the IRS that neither the exchange nor the disposition had tax avoidance as its

principal purpose. If this box is checked, attach an explanation (see instructions).

For Paperwork Reduction Act Notice, see page 5. Cat. No. 12311A Form 8824 (2005)

Part I

Yes No

Yes No

Note: If the property described on line 1 or line 2 is real or personal property located outside the United States, indicate the country.

a

b

c

Part II

Yes No

2005

Related Party Exchange Information

*020 "STM nn"

*030 "STM nn"

040

050

060

070

100

110 115 120

140 150 160

180 185

190 195

200

210

215

@217 "STM nn"

B-142

080
Form 8824 (2005) Page 2

Deferral of Gain From Section 1043 Conflict-of-Interest Sales

Description of divested property 

Description of replacement property 

Date divested property was sold (month, day, year) 29 / /

Sales price of divested property (see instructions) 30

26

31

27

Basis of divested property

Realized gain. Subtract line 31 from line 30

28

33

29

Cost of replacement property purchased within 60 days after date

of sale

30

34

31

Ordinary income under recapture rules. Enter here and on Form 4797, line 10 (see instructions)

Basis of replacement property. Subtract line 37 from line 33

32

35

Note: This part is to be used only by officers or employees of the executive branch of the Federal Government for reporting

nonrecognition of gain under section 1043 on the sale of property to comply with the conflict-of-interest requirements. This part

can be used only if the cost of the replacement property is more than the basis of the divested property.

Name(s) shown on tax return. Do not enter name and social security number if shown on other side. Your social security number

33

34

35

36

37

38

Subtract line 33 from line 30. If zero or less, enter -0-

Subtract line 35 from line 34. If zero or less, enter -0-. If more than zero, enter here and on

Schedule D or Form 4797 (see instructions)

Deferred gain. Subtract the sum of lines 35 and 36 from line 32

36

Part IV

Form 8824 (2005)

Enter the number from the upper right corner of your certificate of divestiture. (Do not attach a

copy of your certificate. Keep the certificate with your records.) 

37

38

32

–

Caution: If you transferred and received (a) more than one group of like-kind properties or (b) cash or other (not like-kind) property,

see Reporting of multi-asset exchanges in the instructions.

Note: Complete lines 12 through 14 only if you gave up property that was not like-kind. Otherwise, go to line 15.

12 Fair market value (FMV) of other property given up 12

13 Adjusted basis of other property given up 13

Gain or (loss) recognized on other property given up. Subtract line 13 from line 12. Report the

gain or (loss) in the same manner as if the exchange had been a sale

14

14

15 Cash received, FMV of other property received, plus net liabilities assumed by other party, reduced

(but not below zero) by any exchange expenses you incurred (see instructions) 15

16 FMV of like-kind property you received 16

17 Add lines 15 and 16 17

Adjusted basis of like-kind property you gave up, net amounts paid to other party, plus any

exchange expenses not used on line 15 (see instructions)

18

18

19 Realized gain or (loss). Subtract line 18 from line 17 19

20 Enter the smaller of line 15 or line 19, but not less than zero 20

21 Ordinary income under recapture rules. Enter here and on Form 4797, line 16 (see instructions) 21

Basis of like-kind property received. Subtract line 15 from the sum of lines 18 and 23

22

22

Realized Gain or (Loss), Recognized Gain, and Basis of Like-Kind Property Received

23

24 Deferred gain or (loss). Subtract line 23 from line 19. If a related party exchange, see instructions

Subtract line 21 from line 20. If zero or less, enter -0-. If more than zero, enter here and on Schedule

D or Form 4797, unless the installment method applies (see instructions)

Recognized gain. Add lines 21 and 22

25

23

24

25

Part III

Caution: If the property given up was used previously or partly as a home, see Property used

as home in the instructions.

*390 "STM nn"

380

400 "STM nn"

410

420

430

450

440

460

470

480

490

500

B-143

360

230

240

350

@345 "STM nn" 340

330

320

310

@305 "STM nn" 300

290

280

270

250

260
OMB No. 1545-1205 8826 Disabled Access Credit

Form

 Attach to your tax return.

Attachment

Sequence No. 86 Department of the Treasury

Internal Revenue Service

Name(s) shown on return Identifying number

Current Year Credit

1 Total eligible access expenditures (see instructions) 1

2 Minimum amount 2 $ 250 00

3 Subtract line 2 from line 1. If zero or less, enter -0- 3

4 Maximum amount 4 $10,000 00

5 Enter the smaller of line 3 or line 4 5

6 Multiply line 5 by 50% (.50) 6

Disabled access credits from

pass-through entities:

7 If you are a— Then enter the total of the current year disabled access credits from—

a Shareholder Schedule K-1 (Form 1120S), Box 13, Code F, G, or L

b Partner Schedule K-1 (Form 1065), Box 15, Code F, G, or L

7

8 Current year credit. Add lines 6 and 7, but do not enter more than $5,000 8

Part I



Part II Allowable Credit (See Who must file Form 3800 to find out if you complete Part II or file Form 3800.)

For Paperwork Reduction Act Notice, see page 2. Cat. No. 12774N Form 8826 (2005)

● Individuals. Enter the amount from Form 1040, line 44

9

Corporations. Enter the amount from Form 1120, Schedule J, line 3; Form 1120-A,

Part I, line 1; or the amount from the applicable line of your return

●

●

12a 12a

b Credits from Form 1040, lines 48 through 54 12b

12d

Foreign tax credit

d

e 12e

Possessions tax credit (Form 5735, line 17 or 27)

f

Nonconventional source fuel credit (Form 8907, line 23)

Other specified credits (see instructions)

Add lines 12a through 12e 12f

13 Net income tax. Subtract line 12f from line 11. If zero, skip lines 14 through 17 and enter -0- on line 18 13

10 Alternative minimum tax:

● Individuals. Enter the amount from Form 6251, line 35

● Corporations. Enter the amount from Form 4626, line 14 10

● Estates and trusts. Enter the amount from Form 1041, Schedule I, line 56

14

Tentative minimum tax (see instructions):

● Individuals. Enter the amount from Form 6251, line 33

14

● Corporations. Enter the amount from Form 4626, line 12

● Estates and trusts. Enter the amount from Form 1041,

Schedule I, line 54

15 Enter 25% (.25) of the excess, if any, of line 14 over $25,000 (see

instructions)

17

Subtract line 17 from line 13. If zero or less, enter -0-

17

18

Credit allowed for the current year. Enter the smaller of line 8 or line 18 here and on Form

1040, line 55; Form 1120, Schedule J, line 6d; Form 1120-A, Part I, line 2; Form 1041, Schedule

G, line 2c; or the applicable line of your return. If line 18 is smaller than line 8, see instructions 19



c 12c

9 Regular tax before credits:

11 Add lines 9 and 10 11

16

Enter the greater of line 15 or line 16

15

16

Estates and trusts. Enter the sum of the amounts from Form 1041, Schedule G, lines 1a

and 1b, or the amount from the applicable line of your return

Net regular tax. Subtract line 12f from line 9. If zero or less, enter -0-

19

18



2005

@025 "STM nn" 020

030

040

050

060

070

080

090

100

110

125

190

200

210

220

230

265

250

260

270

B-144

280

290
Form

Department of the Treasury

Internal Revenue Service

Recapture of Federal Mortgage Subsidy

 Attach to Form 1040.  See separate instructions.

OMB No. 1545-0074

Name(s) Social security number (as shown on page 1 of your tax return)

1

2

Mortgage loan from the proceeds of a tax-exempt bond

Mortgage credit certificate

Note. If neither box applies, you are not subject to recapture tax on the sale or other disposition of your home. Do not

complete this form.

3

State

4

5

Month

Note. If the date of closing of the loan was before January 1, 1991, recapture tax does not apply. Do not complete this form.

If you (1) checked the box on line 2b (mortgage credit certificate), (2) refinanced your home, and (3) received a reissued

mortgage credit certificate, see Refinancing your home on page 1 of the instructions.

Date of sale or other disposition of your interest in the home

Number of years and full months between original closing date (line 5) and date of sale or disposition (line 6):

Years

Computation of Recapture Tax

Sales price of your interest in the home sold or disposed of (see instructions)

Expenses of sale. Include sales commissions, advertising, legal fees, etc.

Adjusted basis of your interest in the home sold or disposed of (see instructions)

Multiply line 13 by 50% (.50)

Modified adjusted gross income (see instructions)

Adjusted qualifying income (see instructions)

Subtract line 16 from line 15. If zero or less, stop here and attach this form to your Form 1040.

You do not owe recapture tax

Income percentage. If the amount on line 17 is $5,000 or more, enter “100.” Otherwise, divide

the amount on line 17 by $5,000 and enter the result as a percentage. Round to the nearest

whole percentage

Federally subsidized amount (see instructions)

Multiply line 19 by the percentage on line 20

Recapture amount. Multiply line 21 by the percentage on line 18

Tax. Enter the smaller of line 14 or line 22. Also, include this amount on the line for total tax

on Form 1040. For details, see the Instructions for Form 1040

8828

Part I Description of Home Subject to Federally Subsidized Debt

Part II

Address of property (number and street, city or town, state, and ZIP code)

Check the box that describes the type of federal subsidy you had on the loan for your home.

Name of the bond or certificate issuer

Name and address of original lending institution

Date of closing of the original loan

6

7

Political subdivision (city, county, etc.) Agency, if any

Day Year

Month Year Day

Full months

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

Amount realized. Subtract line 10 from line 9

Gain or (loss) from sale or disposition. Subtract line 12 from line 11. If a loss, stop here and

attach this form to your Form 1040. You do not owe recapture tax

Holding period percentage (see instructions)

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

Cat. No. 13049F Form 8828 (Rev. 12-2005)

%

%

For Paperwork Reduction Act Notice, see page 2 of separate instructions.

Attachment

Sequence No. 64

a

b

Date of full repayment of the original loan including a refinancing other than one for which a replacement mortgage credit

certificate was issued (see instructions)

8

Month Year Day

(Rev. December 2005)

010 "NONE"

020

030

040

050 060 070

080 090

100

110

120 130

135

140

150

160

170

180

190

200

210

220

230

240

250

260

270

280

B-145
Expenses for Business Use of Your Home

Part of Your Home Used for Business

1 Area used regularly and exclusively for business, regularly for daycare, or for storage of inventory

or product samples (see instructions)

2 Total area of home

3 Divide line 1 by line 2. Enter the result as a percentage

● For daycare facilities not used exclusively for business, also complete lines 4–6.

● All others, skip lines 4–6 and enter the amount from line 3 on line 7.

4 Multiply days used for daycare during year by hours used per day

5 Total hours available for use during the year (365 days  24 hours) (see instructions)

6 Divide line 4 by line 5. Enter the result as a decimal amount

7 Business percentage. For daycare facilities not used exclusively for business, multiply line 6 by

line 3 (enter the result as a percentage). All others, enter the amount from line 3 

Figure Your Allowable Deduction

8 Enter the amount from Schedule C, line 29, plus any net gain or (loss) derived from the business use of

your home and shown on Schedule D or Form 4797. If more than one place of business, see instructions

9 Casualty losses (see instructions)

10 Deductible mortgage interest (see instructions)

11 Real estate taxes (see instructions)

12 Add lines 9, 10, and 11

13 Multiply line 12, column (b) by line 7

14 Add line 12, column (a) and line 13

15 Subtract line 14 from line 8. If zero or less, enter -0-

16

17 Insurance

18 Repairs and maintenance

 File only with Schedule C (Form 1040). Use a separate Form 8829 for each

home you used for business during the year.

 See separate instructions.

OMB No. 1545-0074

Department of the Treasury

Internal Revenue Service

Attachment

Sequence No. 66

Form 8829

Name(s) of proprietor(s)

(a) Direct expenses (b) Indirect expenses

19 Utilities

20 Other expenses (see instructions)

21 Add lines 16 through 20

22 Multiply line 21, column (b) by line 7

23 Carryover of operating expenses from 2004 Form 8829, line 41

24 Add line 21 in column (a), line 22, and line 23

25 Allowable operating expenses. Enter the smaller of line 15 or line 24

26 Limit on excess casualty losses and depreciation. Subtract line 25 from line 15

27 Excess casualty losses (see instructions)

28 Depreciation of your home from Part III below

29 Carryover of excess casualty losses and depreciation from 2004 Form 8829, line 42

30 Add lines 27 through 29

31 Allowable excess casualty losses and depreciation. Enter the smaller of line 26 or line 30

32 Add lines 14, 25, and 31

33 Casualty loss portion, if any, from lines 14 and 31. Carry amount to Form 4684, Section B

34 Allowable expenses for business use of your home. Subtract line 33 from line 32. Enter here

and on Schedule C, line 30. If your home was used for more than one business, see instructions 

35 Enter the smaller of your home’s adjusted basis or its fair market value (see instructions)

36 Value of land included on line 35

37 Basis of building. Subtract line 36 from line 35

38 Business basis of building. Multiply line 37 by line 7

Depreciation of Your Home

39 Depreciation percentage (see instructions)

40 Depreciation allowable (see instructions). Multiply line 38 by line 39. Enter here and on line 28 above

41 Operating expenses. Subtract line 25 from line 24. If less than zero, enter -0-

42 Excess casualty losses and depreciation. Subtract line 31 from line 30. If less than zero, enter -0-

Carryover of Unallowed Expenses to 2006

For Paperwork Reduction Act Notice, see page 4 of separate instructions. Cat. No. 13232M Form 8829 (2005)

1

2

3

4

5

6

7

24

25

26

30

31

32

33

34

35

36

37

38

39

40

41

42

27

28

29

22

23

8

9

10

11

12

13

14

15

16

17

18

19

20

21

hr.

8,760

.

%

Part IV

Part I

Part II

Your social security number

%

%

Part III

See instructions for columns (a) and (b) before

completing lines 9–20.

(99)

hr.

Excess mortgage interest (see instructions)

2005

010 020

030

040

050

060

065

070

080

090

100 110

120 130

140 150

160 170

180

190

200

210 220

230 240

250 260

270 280

290 300

310 320

330

340

350

360

370

380

390

400

410

420

430

440

450

460

470

480

490

500

510

520

530

B-146

@085 "STM nn"

@465 "STM nn"

@515 "STM nn"
OMB No. 1545-1282 Enhanced Oil Recovery Credit

Form 8830

 Attach to your tax return. Attachment

Sequence No. 78 Department of the Treasury

Internal Revenue Service

Name(s) shown on return Identifying number

Current Year Credit 

1 Qualified enhanced oil recovery costs (see instructions) 1

2 Multiply line 1 by 15% (.15) 2

3

4

Enhanced oil recovery credits

from pass-through entities:

3 If you are a— Then enter the total of the current year credits from—

a Shareholder Schedule K-1 (Form 1120S), Box 13, code F, G, or U

b Partner Schedule K-1 (Form 1065), Box 15, code F, G, or U

4

Form 8830 (2005)

Part I



Current year credit. Add lines 2 and 3

Cat. No. 13059B

Section references are to the Internal

Revenue Code unless otherwise noted.

Use Form 8830 to claim the enhanced oil

recovery credit.

The credit generally is 15% of qualified

costs for the year, but is reduced when the

reference price per barrel exceeds the

base value of $28 (as adjusted by inflation).

For 2005, there is no reduction of the

credit.

General Instructions

An owner of an operating mineral

interest may claim or elect not to claim this

credit any time within 3 years from the due

date (excluding extensions) of its return on

either its original or an amended return.

This credit is part of the general business

credit.

Purpose of Form

Amount of Credit

For Paperwork Reduction Act Notice, see page 2.

Allowable Credit (See Who must file Form 3800 to find out if you complete Part II or file Form 3800.)

● Individuals. Enter the amount from Form 1040, line 44

5

Corporations. Enter the amount from Form 1120, Schedule J, line 3; Form 1120-A,

Part I, line 1; or the amount from the applicable line of your return

●

●

8a 8a

Credits from Form 1040, lines 48 through 54 8b

Foreign tax credit

Possessions tax credit (Form 5735, line 17 or 27)

Nonconventional source fuel credit (Form 8907, line 23)

Other specified credits (see instructions)

Add lines 8a through 8e 8f

9 Net income tax. Subtract line 8f from line 7. If zero, skip lines 10 through 13 and enter -0- on line 14 9

6 Alternative minimum tax:

● Individuals. Enter the amount from Form 6251, line 35

● Corporations. Enter the amount from Form 4626, line 14 6

● Estates and trusts. Enter the amount from Form 1041, Schedule I, line 56

10

Tentative minimum tax (see instructions):

● Individuals. Enter the amount from Form 6251, line 33

11

● Corporations. Enter the amount from Form 4626, line 12

● Estates and trusts. Enter the amount from Form 1041,

Schedule I, line 54

11 Enter 25% (.25) of the excess, if any, of line 10 over $25,000 (see

instructions)

13

Subtract line 13 from line 9. If zero or less, enter -0-

13

14

Credit allowed for the current year. Enter the smaller of line 4 or line 14 here and on Form

1040, line 55; Form 1120, Schedule J, line 6d; Form 1120-A, Part I, line 2; Form 1041, Schedule

G, line 2c; or the applicable line of your return. If line 14 is smaller than line 4, see instructions 15

Part II



5 Regular tax before credits:

7 Add lines 5 and 6 7

12

Enter the greater of line 11 or line 12

12

c

d

e

8c

8d

Estates and trusts. Enter the sum of the amounts from Form 1041, Schedule G, lines 1a

and 1b, or the amount from the applicable line of your return

Net regular tax. Subtract line 8f from line 5. If zero or less, enter -0-

15

14



8e

f

10

2005

2. Any intangible drilling and

development costs—

b. For which the taxpayer may make an

election under section 263(c). For an

integrated oil company, this includes

intangible drilling costs required to be

amortized under section 291(b).

Definitions

Qualified enhanced oil recovery costs

means:

a. That is an integral part of a qualified

enhanced oil recovery project and

b. For which depreciation (or

amortization) is allowable.

1. Any amount paid or incurred during

the tax year for tangible property—

a. That are paid or incurred in

connection with a qualified enhanced oil

recovery project and

3. Any qualified tertiary injectant

expenses (as defined in section 193(b))

paid or incurred in connection with a

qualified enhanced oil recovery project for

b

020

030

040

050

060

070

080

090

105

170

180

190

200

210

245

230

240

250

260

270

B-147
Form 8833 Treaty-Based Return Position Disclosure

Under Section 6114 or 7701(b) OMB No. 1545-1354

(Rev. December 2000)

Department of the Treasury

Internal Revenue Service

Name U.S. taxpayer identifying number

Cat. No. 14895L Form 8833 (Rev. 12-2000)

Address in country of residence Address in the United States

Check this box if the taxpayer is a U.S. citizen or resident or is incorporated in the United States 

1

a

Article(s)

List the Internal Revenue Code provision(s) overruled or

modified by the treaty-based return position

Name, identifying number (if available to the taxpayer), and

address in the United States of the payor of the income (if

fixed or determinable annual or periodical). See instructions.

List the provision(s) of the limitation on benefits article (if any) in the treaty that the taxpayer relies on to prevent application

of that article 

Explain the treaty-based return position taken. Include a brief summary of the facts on which it is based. Also, list the nature

and amount (or a reasonable estimate) of gross receipts, each separate gross payment, each separate gross income item,

or other item (as applicable) for which the treaty benefit is claimed

Enter the specific treaty position relied on:

Treaty country

b

2

3

4

5

Attach a separate Form 8833 for each treaty-based return position taken. Failure to disclose a treaty-based return position may

result in a penalty of $1,000 ($10,000 in the case of a C corporation) (see section 6712).

Check one or both of the following boxes as applicable:

● The taxpayer is disclosing a treaty-based return position as required by section 6114 

● The taxpayer is a dual-resident taxpayer and is disclosing a treaty-based return position as required by 

Regulations section 301.7701(b)-7 

For Paperwork Reduction Act Notice, see back of form.

 Attach to your tax return.

180

190

*200 "STM nn"

210 220

*280 "STM nn"

290

300

310

320

330

340

350

360

370

380

390

400

410

420

430

440

450

460

470

480

490

500

510

520

530

540

550

560

230 240 250

260 270

B-148

020

100

030 040 050 060 070 080 090

110 120 130 140

010

150

160

170
Form 8834

Department of the Treasury

Internal Revenue Service

Qualified Electric Vehicle Credit OMB No. 1545-1374

Attachment

Sequence No. 111

 Attach to your tax return.

Part I

Part II

Name(s) shown on return Identifying number

Tentative Credit

Cost of vehicle

Section 179 expense deduction (see instructions)

Subtract line 3 from line 2

For a vehicle placed in service before 2006, multiply

line 4 by 10% (.10). For a vehicle placed in service in

2006, multiply line 4 by 2.5% (.025) (see instructions).

Maximum credit per vehicle. For a vehicle placed in

service before 2006, enter $4,000. For a vehicle placed

in service in 2006, enter $1,000 (see instructions).

Enter the smaller of line 5 or line 6

Add columns (a) through (c) on line 7

Passive activity credits included on line 10 (see instructions)

Subtract line 11 from line 10

Passive activity credits allowed for 2005 (see instructions)

Tentative qualified electric vehicle credit. Add lines 12 and 13 

Allowable Credit

Regular tax before credits.

● Individuals. Enter the amount from Form 1040, line 44.

● Corporations. Enter the amount from Form 1120, Schedule J, line 3.

● Other filers. Enter the regular tax before credits from your return.

Credits that reduce regular tax before the qualified electric vehicle credit:

Credits from Form 1040, lines 48 through 54

Foreign tax credit

Nonconventional source fuel credit (Form 8907, line 23)

Add lines 16a through 16d

Net regular tax. Subtract line 16e from line 15. If zero or less, do not file this form; you cannot

claim this credit

Tentative minimum tax (see instructions).

● Individuals. Enter the amount from Form 6251, line 33.

● Corporations. Enter the amount from Form 4626, line 12.

● Estates and trusts. Enter the amount from Form 1041, Schedule I, line 54.

Subtract line 18 from line 17. If zero or less, do not file this form; you cannot claim this credit

Qualified electric vehicle credit. Enter the smaller of line 14 or 19 here and on Form 1040, line

55; Form 1120, Schedule J, line 6c; Form 1041, Schedule G, line 2b; or the appropriate line of

your return. If line 19 is smaller than line 14, see instructions 

2

3

4

5

6

7

10

11

12

13

14

15

a

b

c

16

17

18

19

2

3

4

5

6

10

11

12

13



15

16a

16b

16e

17

18

19

20

(a) (b) (c)

Cat. No. 14953G Form 8834 (2005)

Possessions tax credit (Form 5735, line 17 or 27)

If you are a: Then enter the total electric vehicle credits from:

Shareholder Schedule K-1 (Form 1120S), box 13, code F, G, or U

8

9 Qualified electric vehicle credits from pass-through entities:

Add lines 8 and 9

9

8



 See instructions on back.

Partner Schedule K-1 (Form 1065), box 15, code F, G, or U

For Paperwork Reduction Act Notice, see back of form.



Use a separate column for each vehicle. If you need more columns,

use additional Forms 8834 and include the total on line 8.

d

e

16c

16d

1 Enter date vehicle placed in service (MM/DD/YYYY) 1 // // //

14

20

7

2005

020

030

040

050

060

070

080

090

100

110

120

130

140

150

170

190

200

210

220

230

240

250

265

330

340

350

360

370

380

390

B-149

015 065 115

160

055 105 155

180
Draft as of

10/24/2005

Form

Department of the Treasury

Internal Revenue Service

Renewable Electricity, Refined Coal,

and Indian Coal Production Credit

OMB No. 1545-1362

 Attach to your tax return. Attachment

Sequence No. 95

Current Year Credit

1 Kilowatt-hours produced and sold (see instructions) 

2 Phaseout adjustment (see instructions)

3

4

5

6

7

Credit before reduction. Subtract line 2 from line 1

Reduction for government grants, subsidized financing, and other credits:

8

Total of government grants, proceeds of tax-exempt government obligations, subsidized energy 

financing, and any other credits allowed for the project for this and all prior tax years

9

Total of additions to the capital account for the project for this and all prior tax years

10

Divide line 4 by line 5. Show as a decimal carried to at least 4 places

11

Multiply line 3 by line 6

12

Subtract line 7 from line 3

13

Section A credits

from pass-through

entities:

14

Current year credit. Add lines 8 and 9

Part I

0.019



For Paperwork Reduction Act Notice, see instructions. Cat. No. 14954R Form 8835 (2005)

8835



Name(s) shown on return Identifying number

1

2

3

4

5

6

7

8

9

10

11

12

13

$

Part II Allowable Credit (See Who must file Form 3800 to find out if you complete Part II or file Form 3800.)

15

a 14a

b Credits from Form 1040, lines 48 through 54 14b

Foreign tax credit

Possessions tax credit (Form 5735, line 17 or 27)

Nonconventional source fuel credit (Form 8907, line 23)

Other specified credits (see instructions)

Add lines 14a through 14e

21

Net income tax. Subtract line 14f from line 13. If zero, skip lines 16 through 19 and enter -0-

on line 20

16

Alternative minimum tax (see instructions)

19 19

Tentative minimum tax (see instructions)

16

20

Enter 25% (.25) of the excess, if any, of line 16 over $25,000

(see instructions)

Subtract line 19 from line 15. If zero or less, enter -0-

Credit allowed for the current year. Enter the smaller of line 10 or line 20. Report the total of 

this amount and the amount from Section B, line 41, on Form 1040, line 55; Form 1120, Schedule 

J, line 6d; Form 1120-A, Part I, line 2; Form 1041, Schedule G, line 2c; or the applicable line of 

your return. If line 20 is smaller than line 10, see instructions 

15

Regular tax before credits (see instructions)

17

Add lines 11 and 12

20

21

Enter the greater of line 17 or line 18

17

18

c

d

e

14c

14d

Net regular tax. Subtract line 14f from line 11. If zero or less, enter -0-

14e

f

2005

Section A. Electricity produced at qualified facilities placed in service prior to October 23, 2004

14f

18

Current Year Credit

1 Kilowatt-hours produced and sold (see instructions) 

2

3

Kilowatt-hours produced and sold after December 31, 2004

Add lines 1 and 2

Part I

 0.019 1

2

3

Section B. Electricity and refined coal produced at qualified facilities placed in service after October 22, 2004 

and Indian coal produced at facilities placed in service after August 8, 2005

Electricity produced at qualified facilities using wind, closed-loop biomass not modified

for co-fire purposes, geothermal, and solar

Electricity produced at qualified facilities using open-loop biomass, small irrigation power, 

landfill gas, trash combustion, and hydropower

(see instructions)  .0095

If you are a— Then enter the credit(s) from—

a Shareholder Schedule K-1 (Form 1120S), box 13, code F, G, or U

b Partner Schedule K-1 (Form 1065), box 15, code F, G, or U

c Beneficiary Schedule K-1 (Form 1041), box 13, code H 

.

d Patron Written statement from cooperative

4

5

Phaseout adjustment (see instructions)

Subtract line 4 from line 3

4

5

$ 

015 "FY"

020 030

@035 "STM nn"

@055 "STM nn" 040 045 050

130

140

150

160

170

180

190

210

220

230

240

255

320

330

340

350

360

380

395

390

400

410

420

B-150

200

560

530

570

590 600

620

580

520

610
Draft as of

10/24/2005

6

7

8

24

31

Tons produced and sold (see instructions)

32

Phaseout adjustment (see instructions)

33

Subtract line 7 from line 6

If you are a— Then enter the credit(s) from—

a Shareholder Schedule K-1 (Form 1120S), box 13, code F, G, or U

b Partner Schedule K-1 (Form 1065), box 15, code F, G, or U

c Beneficiary Schedule K-1 (Form 1041), box 13, code H

34

Add lines 15, 22, and 23

6

7

8

24

31

32

33



Part II Allowable Credit

35

a 34a

b Credits from Form 1040, lines 48 through 54 34b

Foreign tax credit

Possessions tax credit (Form 5735, line 17 or 27)

Nonconventional source fuel credit (Form 8907, line 23)

Other specified credits (see instructions)

Add lines 34a through 34e

41

Net income tax. Subtract line 34f from line 33. If zero, skip lines 36 through 39 and enter-0- on line 40

36

Alternative minimum tax (see instructions)

36

40

Enter 25% (.25) of the excess, if any, of line 36 over $25,000 (see instructions)

Subtract line 39 from line 38. If zero or less, enter -0-

Credit allowed for the current year. Enter the smaller of line 30 or line 40. Report this amount and the amount

from Section A, line 21 (if any) on Form 1040, line 55; Form 1120, Schedule J, line 6d; Form 1120-A, Part I, line 2;

Form 1041, Schedule G, line 2c; or the applicable line of your return. If line 41 is smaller than line 30, see instructions

35

Regular tax before credits (see instructions)

37

Add lines 31 and 32

40

41

37

c

d

e

34c

34d

Net regular tax. Subtract line 34f from line 31. If zero or less, enter -0-

34e

f 34f

Form 8835 (2005) Page 2

10 Credit before reduction. Add lines 5, 8, and 9

Reduction for government grants, subsidized financing, and other credits:

11 Total of government grants, proceeds of tax-exempt government obligations, subsidized energy

financing, and any other credits allowed for the project for this and all prior tax years

12 Total of additions to the capital account for the project for this and all prior tax years

13 Divide line 11 by line 12. Show as a decimal carried to at least 4 places

14 Multiply line 12 by the lesser of 1⁄2 or line 13

15 Subtract line 14 from line 10

23 Section B credits

from pass-through

entities:

10

11

12

13

14

15

Refined coal produced at a qualified refined coal production facility

 $5.481

$ 

Electricity produced at qualified closed-loop biomass facilities modified to co-fire with

coal, other biomass, or both

16 Thermal content of closed-loop biomass used in the facilities

17 Thermal content of all fuels used in the facilities 

18 Divide line 16 by line 17. Show as a decimal carried to at least two places

16

17

18

19 Kilowatt-hours produced and sold (see instructions)  0.019 19

20 Multiply line 19 by line 18 20

21 Phaseout adjustment (see instructions) $  21

22 Subtract line 21 from line 20 22

23

25 Renewable electricity, refined coal, and Indian coal production credit included on line 24 from

passive activities (see instructions) 25

26 Subtract line 25 from line 24 26

27 Renewable electricity, refined coal, and Indian coal production credit allowed for 2005 from a

passive activity (see instructions) 27

29 Carryback of renewable electricity, refined coal, and Indian coal production credit from 2006

(see instructions)

30 Current year credit. Add lines 26 through 29 (Caution. If you also have a credit from Form

6478, see instructions.)

38 Subtract line 37 from line 35. If zero or less, enter -0- 38

39 General business credit (see instructions) 39

.

.

Form 8835 (2005)

28 Carryforward of renewable electricity and refined coal production credit to 2005 (see instructions)

28

29

30

9 Tons produced and sold (see instructions)  $1.50 9

d Patron Written statement from cooperative

Indian Coal produced at a qualified Indian coal production facility

1245

1255

954 957

900 910

920 930 940

950

960

1000

1010

1020

1030

1040

1100

1110

1120

1130 1140

1150

1100 1170 1180

1190

1200

1210

1220

1230

1240

1243

1250

1257

1310

1320

1260

1340

1350

1360

1370

1380

1390

1400

1410

1420

1440

1450

1430

B-151

1300

1330
OMB No. 1545-0074 Qualified Adoption Expenses Form 8839

 Attach to Form 1040 or 1040A.

Department of the Treasury

Internal Revenue Service

Attachment

Sequence No. 38  See separate instructions.

Name(s) shown on return Your social security number

Information About Your Eligible Child or Children—You must complete this part. See page 2 of the

instructions for details, including what to do if you need more space.

(b)

Child’s year

of birth

(c)

born before

1988 and

was disabled

1

(a)

Child’s name

Adoption Credit

2

Did you file Form 8839 for a prior year

for the same child?

Maximum credit per child

3

3

Enter the smaller of line 4 or line 5

4

5

Add the amounts on line 6. If zero, skip lines 8 through 11 and enter -0- on line 12 7

10 

Subtract line 11 from line 7

9

For Paperwork Reduction Act Notice, see page 6 of the instructions. Form 8839 (2005)

Before you begin: See Definitions on page 1 of the instructions.

Cat. No. 22843L

Part I

Part II

2

.

(d)

a child

with special

needs

(f)

Child’s

identifying number

First Last

Is line 8 more than $159,450?

6

9

7

Divide line 9 by $40,000. Enter the result as a decimal (rounded to at least three places). Do

not enter more than “1.000”

Multiply line 7 by line 10

8

4

Check if child was—

(e)

a

foreign

child

Child

1

Child

2

Caution: If the child was a foreign child, see Special rules in the instructions for line 1, column (e), that begin on page 2, before

you complete Part II or Part III. If you received employer-provided adoption benefits, complete Part III on the back next.

10

Child 1 Child 2

Modified adjusted gross income (see page 4 of the instructions) 8

11

Subtract line 3 from line 2

12

13 Credit carryforward from prior years (line 23 of your Credit Carryforward Worksheet on

page 4 of the 2004 Form 8839 instructions)

14 Add lines 12 and 13 14

13

11

12

No. Enter -0-.

Yes. See page 4 of the instructions

for the amount to enter. 

No. Skip lines 9 and 10, and enter -0- on line 11.

Yes. Subtract $159,450 from line 8

Adoption credit. Enter the smaller of line 14 or line 17 here and on Form 1040, line 53, or

Form 1040A, line 34. If line 17 is smaller than line 14, you may have a credit carryforward

(see page 4 of the instructions)

15 Enter the amount from Form 1040, line 46, or Form 1040A, line 28

18

18

$10,630 $10,630

1040 filers: Enter the total of the amounts from Form

1040, lines 47 through 52, plus any mortgage

interest credit from Form 8396, line 11.

5

6

16

1040A filers: Enter the total of the amounts from Form

1040A, lines 29 through 33.

17 Subtract line 16 from line 15

15

16 

17

00 00

Caution: Your qualified adoption expenses

may not be equal to the adoption expenses

you paid in 2005.

2005

Before you begin: If you are filing Form 1040 and claiming the mortgage interest credit (for holders of qualified mortgage

credit certificates issued by state or local governmental units or agencies), complete Form 8396, Mortgage Interest Credit.

Qualified adoption expenses (see page 4

of the instructions)

B-152

010

020

030

040 049 060 070

080

090 100

110

120 129 140 150 160

170 200

171 201

173 203 174 204

177 207

180 210

190 220

230

240

250

260

270

280

284

289

291

293

295

297

255

257
Form 8839 (2005) Page 2

Employer-Provided Adoption Benefits

Add the amounts on line 22

26

20

Modified adjusted gross income

(from the worksheet on page 6 of

the instructions)

Is line 26 more than $159,450?

Excluded benefits. Subtract line 29 from line 25 30

31

Part III

27

Printed on recycled paper

Employer-provided adoption benefits

you received in 2005. This amount

should be shown in box 12 of your

2005 Form(s) W-2 with code T

Did you receive employer-provided

adoption benefits for a prior year for

the same child?

Divide line 27 by $40,000. Enter the result as a decimal (rounded

to at least three places). Do not enter more than “1.000”

25

Multiply line 25 by line 28

26

Taxable benefits. Is line 30 more than line 23?

28

29

28  .

21

22

Enter the smaller of line 21 or line 22.

But if the child was a child with special

needs and the adoption became final in

2005, enter the amount from line 21

24

29

27

You may be able to claim the adoption credit in Part II on the front of this form if either of the following applies.

23

24

22

20

Child 1 Child 2

25

Add the amounts on line 24. If zero, skip lines 26 through 29, enter

-0- on line 30, and go to line 31

23

No. Enter -0-.

Yes. See page 4 of the instructions

for the amount to enter.

Subtract line 20 from line 19

19

21



Maximum exclusion per child 19

Form 8839 (2005)

No. Skip lines 27 and 28, and

enter -0- on line 29.

Yes. Subtract $159,450 from

line 26

30

31

$10,630 $10,630 00 00

No.

Yes.

● The total adoption expenses you paid in 2005 were not fully reimbursed by your employer and the adoption

became final in 2005 or earlier.

● You adopted a child with special needs and the adoption became final in 2005.

Subtract line 30 from line 23. Also, include this amount, if more than zero, on

line 7 of Form 1040 or 1040A. On the line next to line 7, enter “AB.”

Subtract line 23 from line 30. Enter the result as a negative number. Reduce

the total you would enter on line 7 of Form 1040 or 1040A by the amount on

Form 8839, line 31, and enter the result on line 7 of Form 1040 or 1040A. On

the line next to line 7, enter “SNE.”

TIP



B-153

310 330

311 331

313 333 314 334

317 337

320 340

350

360 370

380

390

400

393

395

410

420

440

450

323 "PYAB"

326

343 "PYAB"

346

442

445
OMB No. 1545-1444

Form 8844 Empowerment Zone and Renewal

Community Employment Credit

Department of the Treasury

Internal Revenue Service  Attach to your tax return. Attachment

Sequence No. 99

Name(s) shown on return Identifying number

Current Year Credit

1 Enter the total qualified wages paid or incurred during calendar year 2005 only (see instructions)

2 2

If you are a— Then enter the total of the current year credits from—

Schedule K-1 (Form 1120S), box 13, code F, G, or M

Schedule K-1 (Form 1065), box 15, code F, G, or M

Schedule K-1 (Form 1041), box 13, code K

Written statement from cooperative

a Shareholder

b Partner

c Beneficiary

d Patron

5

5

6 6

7

9

Part I



Cat. No. 16145S

3

4

3

4

Add lines 1a and 1b. You must subtract this amount from your deduction for salaries and wages

Form 8844

credits from

pass-through

entities:

Add lines 2 and 3

Empowerment zone and renewal community employment credit included on line 4 from passive

activities (see instructions)

Subtract line 5 from line 4

Passive activity credit allowed for 2005 (see instructions)

Carryback of empowerment zone and renewal community employment credit from 2006 (see instructions)

Current year credit. Add lines 6 through 9. (S corporations, partnerships, estates, trusts, and

cooperatives, see instructions.)

10

10

9

7

For Paperwork Reduction Act Notice, see page 4. Form 8844 (2005)

8 Carryforward of empowerment zone and renewal community employment credit to 2005 8

Part II Allowable Credit

● Individuals. Enter the amount from Form 1040, line 44

11 Corporations. Enter the amount from Form 1120, Schedule J, line 3; Form 1120-A,

Part I, line 1; or the applicable line of your return

●

●

14a 14a

b Credits from Form 1040, lines 48 through 54 14b

14d

Foreign tax credit

d

e 14e

Possessions tax credit (Form 5735, line 17 or 27)

f

Nonconventional source fuel credit (Form 8907, line 23)

Other specified credits (see instructions)

Add lines 14a through 14e 14f

Net income tax. Subtract line 14f from line 13. If zero, skip lines 16 through 22 and enter -0- on line 23 15

Alternative minimum tax:

12

Tentative minimum tax (see instructions)

16

11

Enter 25% (.25) of the excess, if any, of line 16 over $25,000 (see instructions)

13

20

c 14c

Regular tax before credits:

13

12

Enter the greater of line 18 or line 19

18

19

Estates and trusts. Enter the sum of the amounts from Form 1041, Schedule G, lines 1a and

1b, or the amount from the applicable line of your return

Net regular tax. Subtract line 14f from line 11. If zero or less, enter -0-

15



16

Multiply line 17 by 75% (.75)

17

18

19

20

17

a Qualified empowerment zone wages

b Qualified renewal community wages

1a

1b

$ X 20% (.20)

$ X 15% (.15)

Subtract line 20 from line 15. If zero or less, enter -0-

24

21

General business credit (see instructions)

Subtract line 22 from line 21

21

22

23

24

22

23

Credit allowed for the current year. Enter the smaller of line 10 or line 23 here and on Form 1040, line 55; Form

1120, Schedule J, line 6d; Form 1120-A, Part I, line 2; Form 1041, Schedule G, line 2c; or the applicable line of your

return. If line 23 is smaller than line 10, see instructions

Add lines 11 and 12

Individuals. Enter the amount from Form 6251, line 35

Corporations. Enter the amount from Form 4626, line 14

Estates and trusts. Enter the amount from Form 1041, Schedule I, line 56

●

●

● 

2005

020

030

040

050

060

070

080

090

100

110 120

130

140

150

160

250

260

270

280

315

325

310

320

330

340

350

360

370

B-154

027

015

025

175

240
OMB No. 1545-1417

Form 8845 Indian Employment Credit

Department of the Treasury

Internal Revenue Service  Attach to your tax return.

Attachment

Sequence No. 113

Name(s) as shown on return Identifying number

Current Year Credit

1 Total of qualified wages and qualified employee health insurance costs paid or incurred during

the tax year 1

Calendar year 1993 qualified wages and qualified employee health insurance costs (see

instructions). If none, enter -0-

2

2

If you are a— Then enter the total of the current year credit(s) from—

Schedule K-1 (Form 1120S), box 13, code F, G, or U

Schedule K-1 (Form 1065), box 15, code F, G, or U

Schedule K-1 (Form 1041), box 13, code L

Written statement from cooperative

a Shareholder

b Partner

c Beneficiary

d Patron

Indian employment

credits from

pass-through entities:

5

5

Current year credit. Add lines 4 and 5. (S corporations, partnerships, estates, trusts, and

cooperatives, see instructions.)

6

6

Form 8845 (2005)

Part I



Cat. No. 16146D

3

4

3 Incremental increase. Subtract line 2 from line 1

4 Multiply line 3 by 20% (.20) (see instructions)

For Paperwork Reduction Act Notice, see instructions.

Part II Allowable Credit (See Who must file Form 3800 to find out if you complete Part II or file Form 3800.)

● Individuals. Enter the amount from Form 1040, line 44

7

Corporations. Enter the amount from Form 1120, Schedule J, line 3; Form 1120-A, 

Part I, line 1; or the applicable line of your return

●

●

10a 10a

b Credits from Form 1040, lines 48 through 54 10b

Foreign tax credit

Possessions tax credit (Form 5735, line 17 or 27)

Nonconventional source fuel credit (Form 8907, line 23)

Other specified credits (see instructions)

Add lines 10a through 10e 10f

11

11 Net income tax. Subtract line 10f from line 9. If zero, skip lines 12 through 15 and enter -0- on

line 16

8 Alternative minimum tax:

● Individuals. Enter the amount from Form 6251, line 35

● Corporations. Enter the amount from Form 4626, line 14

● Estates and trusts. Enter the amount from Form 1041, Schedule I, line 56

14 Tentative minimum tax (see instructions):

● Individuals. Enter the amount from Form 6251, line 33

12

● Corporations. Enter the amount from Form 4626, line 12

● Estates and trusts. Enter the amount from Form 1041,

Schedule I, line 54

12

Enter 25% (.25) of the excess, if any, of line 12 over $25,000 (see instructions)

15

Subtract line 15 from line 11. If zero or less, enter -0-

15

16

Credit allowed for the current year. Enter the smaller of line 6 or line 16 here and on Form

1040, line 55; Form 1120, Schedule J, line 6d; Form 1120-A, Part I, line 2; Form 1041, Schedule

G, line 2c; or the applicable line of your return. If line 16 is smaller than line 6, see instructions 17



7 Regular tax before credits:

9 Add lines 7 and 8 9

13

Enter the greater of line 13 or line 14

13

 14

c

d

e

10c

10d

Estates and trusts. Enter the sum of the amounts from Form 1041, Schedule G, lines 1a

and 1b, or the amount from the applicable line of your return

Net regular tax. Subtract line 10f from line 7. If zero or less, enter -0-

17

16



10e

f

8

2005

020

030

040

050

060

070

080

090

100

110

125

190

200

210

220

230

265

250

260

270

B-155

280

290

065
OMB No. 1545-1414 Credit for Employer Social Security and Medicare Taxes

Paid on Certain Employee Tips Form 8846

 Attach to your tax return.

Department of the Treasury

Internal Revenue Service

Attachment

Sequence No. 98

Name(s) shown on return Identifying number

Current Year Credit

1

1

2 2

4

4

5

6

Allowable Credit (See Who must file Form 3800 to find out if you complete Part II or file Form 3800.)

Form 8846 (2005)

Part I

Part II

Tips received by employees for services on which you paid or incurred employer social security

and Medicare taxes during the tax year (see instructions)

3

Form 8846 credits from

pass-through entities:

6 Current year credit. Add lines 4 and 5

3

Cat. No. 16148Z

Tips not subject to the credit provisions (see instructions)

Creditable tips. Subtract line 2 from line 1

Multiply line 3 by 7.65% (.0765). If you had any tipped employees whose wages (including tips)

exceeded $90,000, see instructions and check here 

a

b

Shareholder

Partner

If you are a—

5

Then enter the Form 8846 credits from—

Schedule K-1 (Form 1065) box 15, code F, G, or P

Schedule K-1 (Form 1120S) box 13, code F, G, or P 

Note. Claim this credit only for social security and Medicare taxes paid by a food or beverage establishment where tipping is

customary for providing food or beverages. See the instructions for line 1.

For Paperwork Reduction Act Notice, see instructions.

● Individuals. Enter the amount from Form 1040, line 44

7

Corporations. Enter the amount from Form 1120, Schedule J, line 3; Form 1120-A,

Part I, line 1; or the applicable line of your return

●

●

10a 10a

b Credits from Form 1040, lines 48 through 54 10b

10d

Foreign tax credit

d

e 10e

Possessions tax credit (Form 5735, line 17 or 27)

f

Nonconventional source fuel credit (Form 8907, line 23)

Other specified credits (see instructions)

Add lines 10a through 10e 10f

11

11 Net income tax. Subtract line 10f from line 9. If zero, skip lines 12 through 15 and enter -0- on

line 16

8 Alternative minimum tax:

● Individuals. Enter the amount from Form 6251, line 35

● Corporations. Enter the amount from Form 4626, line 14 8

● Estates and trusts. Enter the amount from Form 1041, Schedule I, line 56

14 Tentative minimum tax (see instructions):

● Individuals. Enter the amount from Form 6251, line 33

12

● Corporations. Enter the amount from Form 4626, line 12

● Estates and trusts. Enter the amount from Form 1041,

Schedule I, line 54

12

Enter 25% (.25) of the excess, if any, of line 12 over $25,000 (see

instructions)

15

Subtract line 15 from line 11. If zero or less, enter -0-

15

16

Credit allowed for the current year. Enter the smaller of line 6 or line 16 here and on Form

1040, line 55; Form 1120, Schedule J, line 6d; Form 1120-A, Part I, line 2; Form 1041, Schedule

G, line 2c; or the applicable line of your return. If line 16 is smaller than line 6, see instructions 17



c 10c

7 Regular tax before credits:

9 Add lines 7 and 8 9

13

Enter the greater of line 13 or line 14

13

 14

Estates and trusts. Enter the sum of the amounts from Form 1041, Schedule G, lines 1a

and 1b, or the amount from the applicable line of your return

Net regular tax. Subtract line 10f from line 7. If zero or less, enter -0-

17

16



2005

020

030

040

@065 "STM nn" 050 060

070

080

090

100

110

120

200

210

220

230

240

275

260

270

280

290

300

B-156

135
OMB No. 1545-1416 Credit for Contributions to Selected Community

Development Corporations Form 8847

 Attach to your tax return.

Attachment

Sequence No. 100 Department of the Treasury

Internal Revenue Service

Name(s) shown on return Identifying number

Current Year Credit

1

1 Total qualified community development corporation (CDC) contributions from Part I of

Schedules A (Form 8847)

3

4

CDC credits from passthrough entities:3 If you are a— Then enter the total of the current year CDC credit(s) from—

a Shareholder Schedule K-1 (Form 1120S), box 13, code U

b Partner Schedule K-1 (Form 1065), box 15, code U

4

Form 8847 (2005)

Part I

Cat. No. 16149K

Current year credit. Add lines 2 and 3

2 Multiply line 1 by 5% (.05) 2



(99)

For Paperwork Reduction Act Notice, see back of form.

Allowable Credit (See Who must file Form 3800 to find out if you complete Part II or file Form 3800.)

● Individuals. Enter the amount from Form 1040, line 44

5

Corporations. Enter the amount from Form 1120, Schedule J, line 3; Form 1120-A,

Part I, line 1; or the applicable line of your return

●

●

8a 8a

b Credits from Form 1040, lines 48 through 54 8b

8d

Foreign tax credit

d

e 8e

Possessions tax credit (Form 5735, line 17 or 27)

Nonconventional source fuel credit (Form 8907, line 23)

Other specified credits (see instructions)

Add lines 8a through 8e 8f

9

9 Net income tax. Subtract line 8f from line 7. If zero, skip lines 10 through 13 and enter -0- on

line 14

6 Alternative minimum tax:

● Individuals. Enter the amount from Form 6251, line 35

● Corporations. Enter the amount from Form 4626, line 14 6

● Estates and trusts. Enter the amount from Form 1041, Schedule I, line 56

12 Tentative minimum tax (see instructions):

● Individuals. Enter the amount from Form 6251, line 33

10

● Corporations. Enter the amount from Form 4626, line 12

● Estates and trusts. Enter the amount from Form 1041,

Schedule I, line 54

10

Enter 25% (.25) of the excess, if any, of line 10 over $25,000 (see

instructions)

13

Subtract line 13 from line 9. If zero or less, enter -0-

13

14

Credit allowed for the current year. Enter the smaller of line 4 or line 14 here and on Form

1040, line 55; Form 1120, Schedule J, line 6d; Form 1120-A, Part I, line 2; Form 1041, Schedule

G, line 2c; or the applicable line of your return. If line 14 is smaller than line 4, see instructions 15

Part II



c 8c

5 Regular tax before credits:

7 Add lines 5 and 6 7

11

Enter the greater of line 11 or line 12

11

 12

Estates and trusts. Enter the sum of the amounts from Form 1041, Schedule G, lines 1a

and 1b, or the amount from the applicable line of your return

Net regular tax. Subtract line 8f from line 5. If zero or less, enter -0-

15

14



2005

f

020

030

040

050

060

070

080

090

105

170

180

190

200

210

245

230

240

250

260

270

B-157
OMB No. 1545-0074 Archer MSAs and

Long-Term Care Insurance Contracts Form 8853

Department of the Treasury

Internal Revenue Service  Attach to Form 1040.

Name(s) shown on Form 1040

Cat. No. 24091H Form 8853 (2005)

Archer MSA contributions you made for 2005, including those made from January 1, 2006, through

April 17, 2006, that were for 2005. Do not include rollovers (see page 4 of the instructions)

Archer MSA Distributions

8a Total distributions you and your spouse received in 2005 from all Archer MSAs (see page 4 of

the instructions)

Unreimbursed qualified medical expenses (see page 4 of the instructions)

c

11a

Taxable Archer MSA distributions. Subtract line 9 from line 8c. If zero or less, enter -0-. Also

include this amount in the total on Form 1040, line 21. On the dotted line next to line 21, enter

“MSA” and the amount 10

Limitation from the worksheet on page 3 of the instructions

Compensation (see page 3 of the instructions) from the employer maintaining the high deductible

health plan. (If self-employed, enter your earned income from the trade or business under which

the high deductible health plan was established.) 

Archer MSA deduction. Enter the smallest of line 4, 5, or 6. Also include this amount in the

total on Form 1040, line 36. On the dotted line next to line 36, enter “MSA” and the amount

6

7

5

7

8a

8b

Attachment

Sequence No. 39

Caution: If line 4 is more than line 7, you may have to pay an additional tax (see page 4 of the instructions).

b

Section A. Archer MSAs. If you have only a Medicare Advantage MSA, skip Section A and complete Section B.

For Paperwork Reduction Act Notice, see page 8 of the instructions.

4

5

6

 See separate instructions.

If any of the distributions included on line 10 meet any of the Exceptions to the Additional

15% Tax (see page 4 of the instructions), check here 

Additional 15% tax (see page 4 of the instructions). Enter 15% (.15) of the distributions included

on line 10 that are subject to the additional 15% tax. Also include this amount in the total on

Form 1040, line 63. On the dotted line next to line 63, enter “MSA” and the amount

4

If you are filing jointly and both you and your spouse have high deductible health plans with self-only

coverage, complete a separate Part II for each spouse (see page 2 of the instructions).

Archer MSA Contributions and Deductions. See page 2 of the instructions before completing this part.

Distributions included on line 8a that you rolled over to another Archer MSA or a health savings account.

Also include any excess contributions (and the earnings on those excess contributions) included on

line 8a that were withdrawn by the due date of your return (see page 4 of the instructions)

Subtract line 8b from line 8a 8c

9 9

10

b

11b

Social security number of MSA

account holder. If both spouses

have MSAs, see page 1 of the instructions 

3 Total employer contributions to your Archer MSA(s) for 2005

Section B. Medicare Advantage MSA Distributions. If you are filing jointly and both you and your spouse received

distributions in 2005 from a Medicare Advantage MSA, complete a separate Section B for each spouse

(see page 5 of the instructions).

Total distributions you received in 2005 from all Medicare Advantage MSAs (see page 5 of the

instructions)

Unreimbursed qualified medical expenses (see page 5 of the instructions)

Taxable Medicare Advantage MSA distributions. Subtract line 13 from line 12. If zero or less,

enter -0-. Also include this amount in the total on Form 1040, line 21. On the dotted line next

to line 21, enter “Med MSA” and the amount

Additional 50% tax (see page 5 of the instructions). Also include this amount in the total on

Form 1040, line 63. On the dotted line next to line 63, enter “Med MSA” and the amount

If any of the distributions included on line 14 meet any of the Exceptions to the Additional

50% Tax (see page 5 of the instructions), check here 

12

13

14

15a

b

12

13

14

15b

3

(99)

Part I

1a Did you or your employer make contributions to your Archer MSA for 2005?

b

c

2a

b

c

If “Yes,” were you uninsured when the MSA was established (see page 2 of the instructions)?

If line 1a is “Yes,” indicate coverage under high deductible health plan: Self-Only or Family

If “Yes,” was your spouse uninsured when the MSA was established (see page 2 of the instructions)?

If line 2a is “Yes,” indicate coverage under high deductible health plan: Self-Only or Family

If married, did your spouse or spouse’s employer make contributions to your spouse’s Archer MSA for 2005?

1a

1b

2a

2b

Part II

Part III

Yes No

General Information. See page 2 of the instructions.

2005

003

019 020

030 040

050 060

070 080

090 100 110 120

160

170

180

190

200

210

220

230

240

250

260

270

272

274

276

278

279

B-158

@017 "STM nn"
23

19

21

28

Section C. Long-Term Care (LTC) Insurance Contracts. See Filing Requirements for Section C on page 6 of

the instructions before completing this section.

16a Name of insured 

In 2004, did anyone other than you receive payments on a per diem or other periodic basis under a qualified

LTC insurance contract covering the insured or receive accelerated death benefits under a life insurance

policy covering the insured?

Was the insured a terminally ill individual? Yes No

17

Gross LTC payments received on a per diem or other periodic basis. Enter the total of the amounts

from box 1 of all Forms 1099-LTC you received with respect to the insured on which the “Per

diem” box in box 3 is checked

18

Accelerated death benefits received on a per diem or other periodic basis. Do not include any

amounts you received because the insured was terminally ill (see page 7 of the instructions)

19

Add lines 20 and 21

Note: If you checked “Yes” on line 17 above, see Multiple Payees

on page 7 of the instructions before completing lines 23 through 27.

20

Multiply $230 by the number of days in the LTC period

21

Costs incurred for qualified LTC services provided for the insured

during the LTC period (see page 7 of the instructions)

22

Enter the larger of line 23 or line 24

23

Reimbursements for qualified LTC services provided for the insured

during the LTC period

24

Per diem limitation. Subtract line 26 from line 25

Taxable payments. Subtract line 27 from line 22. If zero or less, enter -0-. Also include this

amount in the total on Form 1040, line 21. On the dotted line next to line 21, enter “LTC” and

the amount

Form 8853 (2004) Page 2

Yes No

22

24

26

Name of policyholder (as shown on Form 1040)

Note: If “Yes” and the only payments you received in 2004 were accelerated death benefits that were paid

to you because the insured was terminally ill, skip lines 19 through 27 and enter -0- on line 28.

b Social security number of insured 

25

Enter the part of the amount on line 19 that is from qualified LTC insurance contracts 20

Caution: If you received any reimbursements from LTC contracts

issued before August 1, 1996, see page 7 of the instructions.

Social security number

of policyholder 

27

Attachment Sequence No. 39

Caution: Do not use lines 20 through 28 to figure the taxable amount of benefits paid under an

LTC insurance contract that is not a qualified LTC insurance contract. Instead, if the benefits

are not excludable from your income (for example, if the benefits are not paid for personal injuries

or sickness through accident or health insurance), report the amount not excludable as income

on Form 1040, line 21.

25

26

27

28

Form 8853 (2004)

If more than one Section C is attached, check here  290

300 295 310

320 330

340 350

360

370

380

390

400

410

420

430

440

450

B-159

288 289
OMB No. 1545-1567 8854 Initial and Annual Expatriation Information Statement Form

 See separate instructions.  Please print or type.

Department of the Treasury

Internal Revenue Service

Name

Part I General Information. All filers must complete Part I. See instructions.

Date of birth (mo., day, yr.) Tax Year

Attachment

Sequence No. 112

Identifying number (see instructions) 

a

1

2

3

4

5

b

c

Mailing address and telephone number where you can be reached after expatriation

Address of principal foreign residence (if different from 2)

Country of tax residence (if different from 3)

Date of notification of expatriating act, termination of residency, or claim of treaty benefits. Check the box that applies

and enter the appropriate date.

Citizen. Date notification given to Department of State (see instructions).

Long-term resident. Date notification given to Homeland Security (see instructions).

Long-term resident with dual residency in a treaty country. Date commencing to be treated, for tax purposes, as a

resident of the treaty country .

For Paperwork Reduction Act Notice, see separate instructions. Cat. No. 24126N Form 8854 (Rev. 5-2005)

6 Enter your U.S. income tax liability (after foreign tax credits) for the 5 tax years ending before the date of expatriation.

Part II Initial Expatriation or Termination Information Statement

1st Year

Before Expatriation

$

2nd Year

Before Expatriation

$

3rd Year

Before Expatriation

$

4th Year

Before Expatriation

$

5th Year

Before Expatriation

$

11

10

7

8

9

Enter your net worth on the date of your expatriation for tax purposes

Yes

Did you become at birth a U.S. citizen and a citizen of another country, and do you continue to be

a citizen of that other country?

Do you have substantial contacts with the United States? (see instructions)

Are you a minor described in section 877(c)(3)? (see instructions)

Yes No

Yes

No

No

Yes No

Do you certify under penalty of perjury that you have complied with all of your tax obligations for

the 5 preceding tax years? (see instructions)

$

 Section references on this form are to the Internal Revenue Code.

(Rev. May 2005)

Initial or Annual Information Statement. Check the box that applies.

Initial Information Statement. Complete Parts I and II and Schedules A and B. Skip Part III (see instructions).

Annual Information Statement. Complete Parts I and III and Schedules A and B. Skip Part II (see instructions).

030 040

050

060

070 080 090 100 110 120

130

140 150 160 170 180

190

210

230

240

260 270 280 290 300

310

010

020

200

220

240

320

350

330

370

340

360

380 390

B160
Number of days you were physically present in the United States during the current year. If you were

present in the United States more than 60 days, skip line 14

Were you physically present in the United States for more than 30 days but not more than 60 days

during the tax year?

13

14

Yes No

Were you performing services for an unrelated employer?

If you checked “Yes” to line 14a, are you a citizen or resident, fully liable for income tax, in the

country in which you were born, your spouse was born, or either of your parents were born?

a

b

Yes No

Yes No

Form 8854 (Rev. 5-2005) Page 2

Form 8854 (Rev. 5-2005)

Under penalties of perjury, I declare that I have examined this form, including accompanying schedules and statements, and to the best

of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than filer) is based on all information of which

preparer has any knowledge.

Your signature

Preparer’s signature

Date

Date

Sign

Here

12

Do not complete this part if:

Part III Annual Information Reporting under Section 6039G

List all countries (other than the United States) of which you are a citizen.

Name of country

How you became a citizen

a

b

c

●

●

● You checked “Yes” to line 10, and you checked “Yes” to line 11.

You checked “Yes” to line 8 and “No” to line 9, and you checked “Yes” to line 11, or

Your average annual net income tax liability for years 1-5 (line 6) was $124,000 or less and your net worth on

line 7 was under $2,000,000, and you checked “Yes” to line 11, or

Date you became a citizen

410 440 470

420 450 480

430 460 490

500

510 520

530 540

550 560

B161
Provide the name, address and EIN, if any, of

any such company

Form 8854 (Rev. 5-2005) Page 3

Assets

1

2

3

4

5

6

7

8

9

10

11

12

13

21

22

23

24

25

Cash, including bank deposits

Marketable stock and securities issued by

U.S. companies

Marketable stock and securities issued by

foreign companies

Nonmarketable stock and securities issued by

U.S. companies

Nonmarketable stock and securities issued by

foreign companies

Pensions from services performed in the

United States

Partnership interests (see instructions)

Assets held by trusts you own under

sections 671–679 (see instructions)

Intangibles used in the United States

Real property located in the United States

Business property located in the United

States

Other assets (see instructions)

Total assets. Add lines 1 through 5 and lines

6 through 19. Do not include amounts on line

5a in this total

Installment obligations

Other liabilities (see instructions)

Total liabilities. Add lines 21 through 23

Net worth. Subtract line 24 from line 20,

column (a)

Liabilities

(a) Fair Market

Value (FMV)

(b) U.S. adjusted

basis

(c) Gain or (Loss).

Subtract column (b)

from column (a)

Mortgages, etc.

Schedule A

Pensions from services performed outside

the United States

Beneficial interests in nongrantor trusts

(see instructions)

14 Loans to foreign persons

15

16

Amount

● If this is an initial information statement, list in U.S. dollars the fair market value (column (a)) and the U.S. adjusted basis (column

(b)) of your assets and liabilities as of the date of your expatriation for tax purposes.

● If this is an annual information statement, list in U.S. dollars the fair market value (column (a)) and the U.S. adjusted basis

(column (b)) of your assets and liabilities as of the end of the tax year for which you are filing this form.

● If you are a former U.S. long-term resident (LTR), it may benefit you to complete column (d). Only former LTRs should do so.

For more details, see the separate instructions.

17

18

19

20

Intangibles used outside the United States

Loans to U.S. persons

Real property located outside the United

States

Business property located outside the

United States

(d) FMV on beginning

date of U.S. residency

(optional, for LTRs only)

Form 8854 (Rev. 5-2005)

Separately state stock issued by foreign

companies that would be controlled foreign

corporations if you were still a U.S. citizen or

permanent resident (see instructions)

b

a

Balance Sheet

600 1230 1420 1610

610 1240 1430 1620

620 1250 1440 1630

630 1260 1450 1640

640

*650 "STM nn" +660 +670

1650

*+690 "STM nn"

+700 +710 +730 +740 +750 +770

780 1280 1470 1660

790 1290 1480 1670

800 1490 1680

870 1500 1690

940

1010 1320 1510 1710

1020

1340 1530 1720 1030

1350 1540 1730

1050 1360 1550 1740

1060 1370 1560 1750

1070 1380 1570 1760

1080 1390 1580 1770

1090 1400 1590 1780

1150 1420 1600 1790

1160

*1190 "STM nn" +1200

1210

1220

*580 "STM nn" *590 "STM nn"

*+720 "STM nn" *+760 "STM nn"

*810 "STM nn" +820 *+830 "STM nn" +840 +850

1040

*880 "STM nn" +890 *+900 "STM nn" +910 +920 

1710

+930

+860

+680

120

1460

1330

1310

1300

1270

1180

1170

*1100 "STM nn" +1110 +1120 +1130 +1140

*+970 "STM nn" +980 +990 +1000

*950 "STM nn" +960 *

B162
1 U.S. source gross income not effectively connected with the conduct of a U.S. trade or business.

Gross income that is effectively connected with the conduct of a U.S. trade or business

3

5

Income from the performance of services in the United States

4

5

Property (other than stock or debt obligations) located in the United

States

6

7

Stock issued by a U.S. domestic corporation

6

7

8

9

Debt obligations of U.S. persons or of the United States, a state or

political subdivision thereof, or the District of Columbia

8

1a

9

Gains on certain exchanges of property that would ordinarily not be recognized (see instructions)

Form 8854 (Rev. 5-2005) Page 4

Interest

Dividends

Royalties

Pension distributions

Other

Total, add lines a through e

Gains from the sale or exchange of:

Total, add lines a through c

2

a

b

c

d

e

f

a

b

c

d

1f

1e

1d

1c

1b

3

4a

4b

4c

4d

2

Income or gain derived from certain foreign corporations to the extent of your share of earnings

and profits earned or accumulated before the date of expatriation (see instructions)

Income received or accrued by certain foreign corporations (see instructions)

Add lines 1f, 2, 3, 4d, 5, 6, and 7

Gross income from all other sources

Total, add lines 8 and 9 10

Form 8854 (Rev. 5-2005)

Schedule B Income Statement

10

● If this is an initial information statement, provide income information for that portion of the year that ends on the

date of your expatriation for tax purposes.

● If this is an annual information statement, provide income information for the tax year for which you are filing the

form.

1810

1820

1830

1840

1850

1880

1890

1900

1910

1920

1930

1940

1950

1960

1970

1980

1990

2000

*1860 "STM nn" +1870

B163
OMB No. 1545-0074 District of Columbia First-Time

Homebuyer Credit Form 8859

 Attach to Form 1040. Department of the Treasury

Internal Revenue Service

Attachment

Sequence No. 106

Name(s) shown on Form 1040 Your social security number

General Information

1

1

2

4

4

5

6

Form 8859 (2005)

Part I

Part II

Enter $5,000 ($2,500 if married filing separately). If the purchase price of the home was less than

$5,000, enter the purchase price (one-half of the purchase price if married filing separately). If

someone other than a spouse also held an interest in the home, enter only your share of the

$5,000 (or, if smaller, your share of the purchase price) (see instructions)

3

6

Cat. No. 24779G

Is line 2 more than $70,000 ($110,000 if married filing jointly)?

Divide line 3 by $20,000 and enter the result as a decimal (rounded to at least three places).

Do not enter more than “1.000”

5

8

9

Enter your modified adjusted gross income (see instructions) 2

10 10

Multiply line 1 by line 4

8

For Paperwork Reduction Act Notice, see back of form.

Tentative Credit

A

BCD

Address of home qualifying for the credit (if different from the address shown on Form 1040)

Information from

settlement statement

or deed

Lot number Square number Settlement or closing date 

No.

Yes.

× .

Subtract line 5 from line 1. This is your tentative credit

Part III Credit Carryforward From 2004

Enter the amount from Form 1040, line 46

Enter the total of the amounts from Form 1040, lines 47 through 53, plus any mortgage interest

credit from Form 8396, line 11

Subtract line 9 from line 8. If zero or less, enter -0- here and on line 11 and go to line 12

Current year credit. If you completed Part II, enter the smaller of line 6 or line 10. If you

completed Part III, enter the smaller of line 7 or line 10. Also include this amount on Form 1040,

line 54, and check box b on that line

Credit carryforward to 2006. Subtract line 11 from line 6 or line 7, whichever applies

9

Skip lines 3 through 5 and enter the amount from line 1 on line 6.

Subtract $70,000 ($110,000 if married filing jointly) from the

amount on line 2 3

Note: Do not complete Parts I and II if you only have a credit carryforward from 2004.

Part IV Tax Liability Limit

7 Enter the amount from line 12 of your 2004 Form 8859 7

12

11

12

11

2005

020 030 040 050

060 070 080

090

100

130

140

150

160

170

180

190

200

230

240

B-164
2a

OMB No. 1545-1606

Form 8860 Qualified Zone Academy Bond Credit

Department of the Treasury

Internal Revenue Service

 Attach to your tax return.

Name Employer identification number

Current Year Credit

1

4

4

Current year credit. Add line 2a and all amounts on line 1, column (e). Caution. Holders of bonds,

see the instructions for how and when to report the credit amount as interest income

5

Allowable Credit

Form 8860 (2005)

Part I

Part II

Cat. No. 24804G

6

7a

Alternative minimum tax:

7b

7e

7f

Other specified credits (see instructions)

7h

General business credit (see instructions)

Credit for prior year minimum tax

Add lines 7a through 7g

5

8 Net income tax. Subtract line 7h from line 6

Credit allowed for the current year. Enter the smaller of line 3 or line 8 here and on Form

1040, line 55; Form 1120, Schedule J, line 6f; Form 1041, Schedule G, line 3; or the applicable

line of your return. Caution. If line 9 is smaller than line 3, you generally should deduct the

unallowed credit in figuring your taxable income for this tax year. Because this deduction will

affect the allowable credit, refigure the unallowed credit until it equals the deduction. However,

you may be able to deduct the unallowed credit attributable to bonds sold after September 25,

2000, in the next tax year (see instructions)

Add line 4 and line 5

7d

Regular tax before credits:

9

9

Foreign tax credit

7c

For Paperwork Reduction Act Notice, see instructions.

3

3

6

7a

b

8

(b)

Month and year

bond issued

(c)

Outstanding principal

amount of bond

(d)

Credit rate

(e)

Credit ((c) x (d))

c

d

e

f

g

(a)

Bond issuer’s name, city

or town, and state

Attachment

Sequence No.133

2a Qualified zone academy bond credit from Schedule K-1 (Form 1120S), box 13, code U

b Enter the S corporation’s employer identification number (EIN) –

Possessions tax credit (Form 5735, line 17 or 27)

Nonconventional source fuel credit (Form 8907, line 23)

h

7g



 ● Corporations. Enter the amount from Form 1120, Schedule J, line 3, or the applicable

line of your return

● Estates and trusts. Enter the sum of the amounts from Form 1041, Schedule G, lines

1a and 1b, or the amount from the applicable line of your return

● Individuals. Enter the amount from Form 1040, line 44

● Individuals. Enter the amount from Form 6251, line 35

● Corporations. Enter the amount from Form 4626, line 14

● Estates and trusts. Enter the amount from Form 1041, Schedule I, line 56

Note: S corporations—stop here—do not complete Part II (see instructions).

Credits from Form 1040, lines 48 through 54

2005

*020 "STM nn"

+030 +040 +050 +060 *+070

"STM nn"

+080

090

100 110 120 130 140 150

160

170 180

190 200 210 220

230

240 250

260 270 280 290

360 300

310 320

330 340 350

*370 "STM nn"

+380

390

400

410

420

430

445

520

530

540

550

560

570

580

590

B-165
OMB No. 1545-1569

Form 8861 Welfare-to-Work Credit

Department of the Treasury

Internal Revenue Service  Attach to your tax return. Attachment

Sequence No. 107

Name(s) shown on return Identifying number

Current Year Credit

1 Enter on the applicable line below the qualified first- or second-year wages paid or incurred

during the tax year and multiply by the percentage shown for services of employees who began

work for you before January 1, 2006, and are certified as long-term family assistance recipients.

Members of a controlled group, see instructions.

1a

If you are a— Then enter the total of the credits from—

Schedule K-1 (Form 1120S), box 13, code F, G, or K

Schedule K-1 (Form 1065), box 15, code F, G, or K

Schedule K-1 (Form 1041), box 13, code G

Written statement from cooperative

a Shareholder

b Partner

c Beneficiary

d Patron

Welfare-to-work

credits from

pass-through

entities:

3

3

Current year credit. Add lines 2 and 3. (S corporations, partnerships, estates, trusts, cooperatives,

regulated investment companies, and real estate investment trusts, see instructions.)

4

4

Form 8861 (2005)

Part I



Cat. No. 24858E

Add lines 1a and 1b. You must subtract this amount from your deduction for salaries and wages

For Paperwork Reduction Act Notice, see instructions.

2 2

b

a Qualified first-year wages $

Qualified second-year wages $

35% (.35)

50% (.50) 1b

Allowable Credit (See Who must file Form 3800 to find out if you complete Part II or file Form 3800.)

● Individuals. Enter the amount from Form 1040, line 44

5

Corporations. Enter the amount from Form 1120, Schedule J, line 3; Form 1120-A,

Part I, line 1; or the applicable line of your return

●

●

8a 8a

b Credits from Form 1040, lines 48 through 54 8b

Foreign tax credit

Possessions tax credit (Form 5735, line 17 or 27)

Nonconventional source fuel credit (Form 8907, line 23)

Other specified credits (see instructions)

Add lines 8a through 8e 8f

9 Net income tax. Subtract line 8f from line 7. If zero, skip lines 10 through 13 and enter -0- on line 14 9

6 Alternative minimum tax:

● Individuals. Enter the amount from Form 6251, line 35

● Corporations. Enter the amount from Form 4626, line 14 6

● Estates and trusts. Enter the amount from Form 1041, Schedule I, line 56

12 Tentative minimum tax (see instructions):

● Individuals. Enter the amount from Form 6251, line 33

10

● Corporations. Enter the amount from Form 4626, line 12

● Estates and trusts. Enter the amount from Form 1041,

Schedule I, line 54

10

Enter 25% (.25) of the excess, if any, of line 10 over $25,000 (see instructions)

13

Subtract line 13 from line 9. If zero or less, enter -0-

13

14

Credit allowed for the current year. Enter the smaller of line 4 or line 14 here and on Form

1040, line 55; Form 1120, Schedule J, line 6d; Form 1120-A, Part I, line 2; Form 1041, Schedule

G, line 2c; or the applicable line of your return. If line 14 is smaller than line 4, see instructions 15

Part II



5 Regular tax before credits:

7 Add lines 5 and 6 7

11

Enter the greater of line 11 or line 12

11

 12

c

d

e

8c

8d

Estates and trusts. Enter the sum of the amounts from Form 1041, Schedule G, lines 1a

and 1b, or the amount from the applicable line of your return

Net regular tax. Subtract line 8f from line 5. If zero or less, enter -0-

15

14



8e

f

2005

020 030

040 050

060

@065 "STM nn" @067 "STM nn"

070

075 080

090

100

110

120

135

200

210

220

230

240

275

260

270

280

290

300

B-166
8862 OMB No. 1545-0074

Information To Claim Earned Income Credit

After Disallowance

Department of the Treasury

Internal Revenue Service

Attachment

 Attach to your tax return. Sequence No. 43A

For Paperwork Reduction Act Notice, see back of form. Cat. No. 25145E Form 8862 (Rev. 12-2005)

 See instructions on back.

Name(s) shown on return Your social security number

(Rev. December 2005)

Form

Part I All Filers

1

Yes

Enter the year for which you are filing this form (for example, 2005) 

If the only reason your EIC was reduced or disallowed in the earlier year was because you incorrectly

reported your earned income or investment income, check “Yes.” Otherwise, check “No” 

2

No

Filers Without a Qualifying Child

3

Part II

Caution. If you checked “Yes,” stop. Do not fill in the rest of this form. But you must attach it to your tax return to take

the EIC. If you checked “No,” continue.

Could you (or your spouse if filing jointly) be claimed as a qualifying child of another person for the

year shown on line 1? 

Part III Filers With a Qualifying Child or Children

b

a Other person living with child 1:

Before you begin: See your tax return instructions or Pub. 596, Earned Income Credit (EIC), for the year for which you are

filing this form to make sure you can take the earned income credit (EIC) and to find out who is a

qualifying child.



Do not file this form if you are taking the EIC without a qualifying child and the only reason your EIC

was reduced or disallowed in the earlier year was because it was determined that a child listed on

Schedule EIC was not your qualifying child.



 If you have a qualifying child, complete Schedule EIC before you fill in this form.

Yes No

Caution. If you checked “Yes,” stop. You cannot take the EIC. If you checked “No,” continue.

4 Enter the number of days during the year shown on line 1 that you lived in the United States 

Caution. If you entered less than 183 (184 if the year on line 1 is 2004), stop. You cannot take the EIC. See the instructions.

5 If married filing a joint return, enter the number of days during the year shown on line 1 that your spouse

lived in the United States 

Caution. If you entered less than 183 (184 if the year on line 1 is 2004), stop. You cannot take the EIC. See the instructions.

Note. Child 1 and Child 2 are the same children you listed as Child 1 and Child 2 on Schedule EIC for the year shown on line 1 above.

6 Enter the number of days each child lived with you in the United States during the year shown on line 1 above:

a Child 1  Child 2 

Caution. If you entered less than 183 for either child (184 if the year on line 1 is 2004), you cannot take the EIC based on

that child, unless the special rule for a child who was born or died during the year shown on line 1 applies. See the

instructions.

If your child was born or died during the year shown on line 1, enter the month and day the child was born and/or died.

Otherwise, skip this line.

7

a Child 1  (1) Month and day of birth (MM/DD) 

b

Enter the address where you and the child lived together during the year shown on line 1. If you lived with the child at more

than one address during the year, attach a list of the addresses where you lived:

8

a Child 1  Number and street

City or town, state, and ZIP code

b Child 2  If same as shown for child 1, check this box.  Otherwise, enter below:

Number and street

Name

9 Did any other person (except your spouse, if filing jointly, and your dependents under age 19) live with

child 1 or child 2 for more than half the year shown on line 1? 

If “Yes,” enter that person’s name and relationship to the child below. If more than one other person

lived with the child for more than half the year, attach a list of each person’s name and relationship to

the child:

Relationship to child 1

Other person living with child 2:

Name

Relationship to child 2

If same as shown for child 1, check this box.  Otherwise, enter below:

Caution. The IRS may ask you to provide additional information to verify your eligibility to claim the EIC.

Child 2  (1) Month and day of birth (MM/DD) 

(2) Month and day of death (MM/DD) 

(2) Month and day of death (MM/DD) 

/

/

/

/

Yes No

City or town, state, and ZIP code

b

010 "2005"

020 030

042

062 072

092

133

082 084

B-167

052

150

310 330 350

380 400 420

290 300

390 410 430

012 014

094

246

250 255 260 265 270

370

320 340 360

137 141 144 145 147
OMB No. 1545-0074 Education Credits

Form 8863

 See instructions. Department of the Treasury

Internal Revenue Service

Attachment

Sequence No. 50

Name(s) shown on return Your social security number

Hope Credit. Caution: You cannot take the Hope credit for more than 2 tax years for the same student.

1

2

Lifetime Learning Credit

Form 8863 (2005)

Part I

Part II

2

(a) Student’s name

(as shown on page 1

of your tax return)

Cat. No. 25379M

Tentative Hope credit. Add the amounts on line 1, column (f). If you are taking the lifetime

learning credit for another student, go to Part II; otherwise, go to Part III 

7

Add the amounts on line 3, column (c), and enter the total

8

8

Enter the smaller of line 4 or $10,000

9

Subtract line 9 from line 8. If zero or less, stop; you cannot take

any education credits

9

11

15

3

10

10

14

For Paperwork Reduction Act Notice, see page 3.

(f) Enter one-half

of the amount in

column (e)

(e) Add

column (c) and

column (d)

(d) Enter the

smaller of the

amount in

column (c) or

$1,000

(c) Qualified

expenses (see

instructions). Do

not enter more

than $2,000 for

each student.

Caution: You

cannot take the

Hope credit and

the lifetime learning

credit for the same

student in the

same year.

(a) Student’s name (as shown on page 1

of your tax return)

First name Last name

(c) Qualified

expenses (see

instructions)

Tentative lifetime learning credit. Multiply line 5 by 20% (.20) and go to Part III 

4

5

6

4

5

6

Part III Allowable Education Credits

7 Tentative education credits. Add lines 2 and 6

Enter: $107,000 if married filing jointly; $53,000 if single, head of

household, or qualifying widow(er)

Enter the amount from Form 1040, line 38*, or Form 1040A, line 22

If line 10 is equal to or more than line 11, enter the amount from line 7 on line 13 and

go to line 14. If line 10 is less than line 11, divide line 10 by line 11. Enter the result as

a decimal (rounded to at least three places)

12

13 Multiply line 7 by line 12 

14 Enter the amount from Form 1040, line 46, or Form 1040A, line 28 

17

Subtract line 15 from line 14. If zero or less, stop; you cannot take any education

credits 

Education credits. Enter the smaller of line 13 or line 16 here and on Form 1040,

line 50, or Form 1040A, line 31 

13

12 .

(Hope and Lifetime Learning Credits)

(b) Student’s

social security

number (as

shown on page 1

of your tax return)

(b) Student’s social security

number (as shown on page

1 of your tax return)

Enter: $20,000 if married filing jointly; $10,000 if single, head of

household, or qualifying widow(er) 11

* If you are filing Form 2555, 2555-EZ, or 4563, or you are excluding income from Puerto Rico, see Pub. 970 for the amount to enter.

 Attach to Form 1040 or Form 1040A.

Last name

First name

Caution: You cannot take both an education credit and the tuition and fees deduction (Form 1040, line 34, or Form 1040A, 

line 19) for the same student in the same year.

16

17

15

16

Enter the total, if any, of your credits from Form 1040, lines 47 through 49, or Form

1040A, lines 29 and 30

(99)

2005

+020 +030 +035 *+040 +050 +060 +070

080

090 100 105 110 120 130 140

150

160 170 175 180 190 200 210

240

*250 "STM nn" +260 +270 +275 +280

290 300 310 315 320

330 340 350 355 360

450

460

470

480

490

500

510

515

520

529

540

550

560

590

B-168

*010 "STM nn"
Draft as of

11/10/2005

OMB No. 1545-1924

Form 8864

Department of the Treasury

Internal Revenue Service

Attachment

Sequence No. 141

Name(s) shown on return Identifying number

(b)

Rate

(c)

Column (a) x Column (b)

(a)

Number of Gallons

Sold or Used

Type of Fuel

1

Agri-biodiesel 2 $1.00

4

4

2

Biodiesel (other than agri-biodiesel) included in a biodiesel 

mixture

5 Agri-biodiesel included in a biodiesel mixture 5

8

9

10

8

9

Biodiesel and renewable diesel fuels credit(s) from a partnership, S corporation, estate, trust, or 

cooperative (see instructions)

Current year credit. Add lines 8 and 9. (S corporations, partnerships, estates, and trusts, see

instructions.) 10

B 1 $ .50 iodiesel (other than agri-biodiesel)

Biodiesel and Renewable Diesel Fuels Credit

 Attach to your tax return.

$ .50

$1.00

Allowable Credit (See Who must file Form 3800 to find out if you complete the lines below or file Form 3800.)

For Paperwork Reduction Act Notice, see page 4. Cat. No. 25778F Form 8864 (2005)

● Individuals. Enter the amount from Form 1040, line 44

11

Corporations. Enter the amount from Form 1120, Schedule J, line 3; Form 1120-A,

Part I, line 1; or the applicable line of your return

●

●

14a 14a

b Credits from Form 1040, lines 48 through 54 14b

14d

Foreign tax credit

d

f

Possessions tax credit (Form 5735, line 17 or 27)

Nonconventional source fuel credit (Form 8907, line 23)

Other specified credits (see instructions) 

Add l 14f ines 14a through 14e 

Net income tax. Subtract line 14f from line 13. If zero, skip lines 16 through 19 and enter -0- on line 20 15

12 Alternative minimum tax:

12

15

16 Net regular tax. Subtract line 14f from line 11. If zero or less, enter -0- 16

18 Tentative minimum tax (see instructions)

Subtract line 19 from line 15. If zero or less, enter -0-

19 19

Credit allowed for the current year. Enter the smaller of line 10 or line 20 here and on Form

1040, line 55; Form 1120, Schedule J, line 6d; Form 1120-A, Part I, line 2; Form 1041, Schedule 

G, line 2c; or the applicable line of your return. If line 20 is smaller than line 10, see instructions 21

c 14c

11 Regular tax before credits:

13 Add lines 11 and 12 13

17

Enter the greater of line 17 or line 18

17

18

Estates and trusts. Enter the sum of the amounts from Form 1041, Schedule G, lines 1a

and 1b, or the amount from the applicable line of your return

Enter 25% (.25) of the excess, if any, of line 16 over $25,000 (see instructions)

20 20



21

e 14e

Part I

Part II

Current Year Credit

Individuals. Enter the amount from Form 6251, line 35

Corporations. Enter the amount from Form 4626, line 14 

Estates and trusts. Enter the amount from Form 1041, Schedule I, line 56 

●

●

● 

Caution: You cannot claim any amounts on Form 8864 that you claimed (or will claim) on Schedule C (Form 720), Form 8849,

or Form 4136.

Add lines 1 through 7. Include this amount in your income for 2005 (see instructions) 

Claimant has a certificate from the producer or importer of biodiesel or renewable diesel reported on lines 1 through 6 below and, if

applicable, claimant also has a statement from the reseller. Claimant has no reason to believe that the information in the certificate or

statement is false. Claimant may need to attach a copy of the certificate and statement. See Certification on page 2.

2005

3 Renewable diesel sold or used after December 31, 2005 3 $1.00

6

6

Renewable diesel included in a renewable diesel mixture

sold or used after December 31, 2005 

7

7 Qualified agri-biodiesel production (gallons sold)

(cooperatives, see instructions for election) 

$1.00

$ .10

020 030

040 050

052 054

060 070

080 090

092 094

096 098

100

110

120

200

210

220

230

240

250

260

270

280

290

300

310

320

330

340

350

@125 "STM nn"

@008 "STM nn"

B169
Draft as of

06/23/2005

Return of U.S. Persons With Respect to OMB No. 1545-1668 8865 Certain Foreign Partnerships Form

Department of the Treasury Information furnished for the foreign partnership’s tax year

Internal Revenue Service

Name of person filing this return Filer’s identifying number

Filer’s address (if you are not filing this form with your tax return) A Category of filer (see Categories of Filers in the instructions and check applicable box(es)):

1234

Filer’s tax year beginning , 20 , and ending , 20

F1 Name and address of foreign partnership 2 EIN (if any)

3 Country under whose laws organized

Principal business

activity

Principal business 7

activity code number

Principal place 6

of business

Date of 5

organization

1

G Provide the following information for the foreign partnership’s tax year:

Name, address, and identifying number of agent (if any) in the 2 Check if the foreign partnership must file:

United States

Name and address of person(s) with custody of the books and

records of the foreign partnership, and the location of such books

and records, if different

Name and address of foreign partnership’s agent in country of 4

organization, if any

3

For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions. Form 8865 (2005)

 Attach to your tax return. See separate instructions.

(4) Check applicable box(es) (1) Name (2) Address (3) Identifying number

Category 1 Category 2

E Information about certain other partners (see instructions)

Cat. No. 25852A

4

Service Center where Form 1065 or 1065-B is filed:

8a Functional currency

D If filer is a member of a consolidated group but not the parent, enter the following information about the parent:

Name EIN

Form 1042 Form 1065 or 1065-B Form 8804

5 Were any special allocations made by the foreign partnership?  Yes No

Enter the number of Forms 8858, Information Return of U.S. Persons With Respect To Foreign Disregarded Entities,

attached to this return (see instructions). 

6

Address

C Filer’s share of liabilities: Nonrecourse $ Qualified nonrecourse financing $ Other $

7 How is this partnership classified under the law of the country in which it is organized? 

Constructive owner

B

Sign Here

Only If You

Are Filing

This Form

Separately

and Not With

Your Tax

Return

Paid Preparer

Sign and

Complete

Only If Form

is Filed

Separately.

Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my

knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than general partner or limited liability company member) is

based on all information of which preparer has any knowledge.

Signature of general partner or limited liability company member Date

Preparer’s

signature

Check if

self-employed 

Preparer’s SSN or PTIN

Firm’s name (or

yours if self-employed),

address, and ZIP code

EIN 

Phone no. ( )









Date

Attachment

Sequence No. 118

Did the partnership own any separate units within the meaning of Regulations section 1.1503-2(c)(3) or (4)? 

Does this partnership meet both of the following requirements?

● The partnership’s total receipts for the tax year were less than $250,000 and

● The value of the partnership’s total assets at the end of the tax year was less than $600,000.

If “Yes,” do not complete Schedules L, M-1, and M-2.

8

9

Yes No

Yes No  

beginning , 2005, and ending , 20

Exchange rate

(see instr.)

8b

2005

010 020

080 090 100 110

120 130

140 150 160

170

180

190 200 210

220

*230 or STMnn +240 *+250 +260 +270 +280 +290 +300 +310

590

600 605

610 615

620 625 630 635 640

650

660

670 680 690 700 710 712

@715

720

730

740

750 760 770 775

780 790 800

810

820

830

840 850 860 865

870

880

890

900 910 920 925 930

940 950

960

970

@995 STMnn 980 990

1000 1010

@1029 "STM nn"

B-170

320

410

330 340 350 360

420 430 440 450

370

460

380

470

390

480

400

490

@965 "STM nn"
Draft as of

06/23/2005

Total income (loss). Combine lines 3 through 7

Bad debts

Form 8865 (2005) Page 2

Certain Partners of Foreign Partnership (see instructions)

Name Address Identifying number (if any)

Caution. Include only trade or business income and expenses on lines 1a through 22 below. See the instructions for more information.

1a

b

1a Gross receipts or sales

Less returns and allowances 1b 1c

2 Cost of goods sold 2

3 Gross profit. Subtract line 2 from line 1c 3

4 Ordinary income (loss) from other partnerships, estates, and trusts (attach statement) 4

Income

5 5

7

Net farm profit (loss) (attach Schedule F (Form 1040))

7

8

Other income (loss) (attach statement)

8

9 Salaries and wages (other than to partners) (less employment credits)

11

10 Guaranteed payments to partners

12

Rent 

12

13

Interest

14 Taxes and licenses 14

13

16a Depreciation (if required, attach Form 4562) 16a

b Less depreciation reported elsewhere on return 16b

Depletion (Do not deduct oil and gas depletion.) 17

15

18

21

Other deductions (attach statement)

Deductions (see instructions for limitations)

Total deductions. Add the amounts shown in the far right column for lines 9 through 20

20

Ordinary business income (loss) from trade or business activities. Subtract line 21 from line 8

17

22

10

9

Affiliation Schedule. List all partnerships (foreign or domestic) in which the foreign partnership

owns a direct interest or indirectly owns a 10% interest.

EIN

(if any) Name Address

6 Net gain (loss) from Form 4797, Part II, line 17 (attach Form 4797) 6

11 Repairs and maintenance

Retirement plans, etc.

19 Employee benefit programs

20

21

22

15

18

19

Schedule A-2

Check if

foreign

person

Check if

foreign

partnership

Total ordinary

income or loss

Does the partnership have any other foreign person as a direct partner? Yes No

Constructive Ownership of Partnership Interest. Check the boxes that apply to the filer. If you

check box b, enter the name, address, and U.S. taxpayer identifying number (if any) of the

person(s) whose interest you constructively own. See instructions.

Name Address Identifying number (if any)

Schedule A

Check if

direct

partner

Schedule A-1

a Owns a direct interest b Owns a constructive interest

Check if

foreign

person

Schedule B Income Statement—Trade or Business Income

Form 8865 (2005)

16c

1040 1045

*1050 or STMnn +1060

*+1070 or STMnn +1080 +1090

+1100 +1110 +1120

1130 1210 1290 1370 1140 1220 1300 1380 1180 1260 1340 1420

1190 1200

1150 1160 1170 1230 1240 1250 

1310 1320 1330 1390 1400 1410 1430 1440

1270 1280

1350 1360

*1450 or STMnn +1460 +1500 +1510

*+1470 or STMnn +1480 +1490

1520 1590 1660 1730 1530 1600 1670 1740 1570 1640 1710 1780

1580

1650

1540 1550 1560 1610 1620 1630 

1680 1690 1700 1750 1760 1770

1720

1790

*1820 or STMnn +1830 +1870 +1880 +1890

*+1840 or STMnn +1850 +1860

1900 1980 2060 2140 1910 1990 2070 2150

1950 1960 1970

2040 2050

1920 1930 1940 2000 2010 2020 

2080 2090 2100 2160 2170 2180

2120 2130

2200 2210

1800 1810

2030

2110

2190

@2225 STMnn 2220

2230 2240

2250

2260

2270 @2275"STM nn"

2280

2290

@2305"STM nn" 2300

2310

2320

2330

2340

2350

2360

2370

@2385"STM nn" 2380

2390

2400 2405

2410

2420

2430

@2445 STMnn 2440

2450

2460

B @2465 STMnn -171
Draft as of

06/23/2005

Form 8865 (2005) Page 3

Short-Term Capital Gains and Losses—Assets Held One Year or Less

(c) Date sold

(month, day, year)

(b) Date acquired

(month, day, year)

(d) Sales price

(see instructions)

(e) Cost or other basis

(see instructions)

(a) Description of property

(e.g., 100 shares

of “Z” Co.)

1

2 Short-term capital gain from installment sales from Form 6252, line 26 or 37

4 Partnership’s share of net short-term capital gain (loss), including specially allocated short-term capital

gains (losses), from other partnerships, estates, and trusts

5

Long-Term Capital Gains and Losses—Assets Held More Than One Year

6

7 Long-term capital gain from installment sales from Form 6252, line 26 or 37

Partnership’s share of net long-term capital gain (loss), including specially allocated long-term capital

gains (losses), from other partnerships, estates, and trusts

9

10 Capital gain distributions

Part I

Part II

3

4

5

8

9

10

2

3 Short-term capital gain (loss) from like-kind exchanges from Form 8824

8 Long-term capital gain (loss) from like-kind exchanges from Form 8824

7

(c) Date sold

(month, day, year)

(b) Date acquired

(month, day, year)

(d) Sales price

(see instructions)

(e) Cost or other basis

(see instructions)

(a) Description of property

(e.g., 100 shares

of “Z” Co.)

(f) Gain or (loss)

Subtract (e) from (d)

Net short-term capital gain or (loss). Combine lines 1 through 4 in column (f). Enter here and on

Form 8865, Schedule K, line 8 or 11

Net long-term capital gain or (loss). Combine lines 6 through 10 in column (f). Enter here and on

Form 8865, Schedule K, line 9a or 11

11

11

Schedule D Capital Gains and Losses

Form 8865 (2005)

(f) Gain or (loss)

Subtract (e) from (d)

*2480 STCGL +2490 +2500 +2510 +2520 +2530

2540 2550 2560 2570 2580 2590

2600 2610 2620 2630 2640 2650

2660 2670 2680 2690 2700 2710

2720

2730

2740

2750

*2760 LTCGL +2770 +2780 +2790 +2800 +2810

2830 2840 2850 2860 2870 2880

2900 2910 2920 2930 2940 2950

3040

3060

3080

3100

@3135 STMnn

B-172

3130

2970 2980 2990 3000 3010 3020
Draft as of

06/23/2005

Form 8865 (2005) Page 4

Partners’ Distributive Share Items

1 Ordinary business income (loss) (page 2, line 22) 1

2 Net rental real estate income (loss) (attach Form 8825) 2

3a Other gross rental income (loss) 3a

b Expenses from other rental activities (attach statement) 3b

c Other net rental income (loss). Subtract line 3b from line 3a 3c

4 Guaranteed payments

Interest income

4

Royalties

Income (Loss)

5 5

6

7

Other income (loss) (see instructions) Type 

7

8 8

9a

Section 179 deduction (attach Form 4562)

9a

10 10

Deductions

11

12

Low-income housing credit (section 42(j)(5))

Credits &

Credit

Recapture

13b

c Qualified rehabilitation expenditures (rental real estate) (attach Form 3468)

13d

d Other rental real estate credits (see instructions) Type 

13c(2)

e Other rental credits (see instructions) Type 

13a

12

14a Net earnings (loss) from self-employment 14a

b Gross farming or fishing income 14b

SelfEmployment

c Gross nonfarm income 14c

17a

16b

b

16c

Post-1986 depreciation adjustment

c

d

Depletion (other than oil and gas)

f

Alternative

Minimum Tax

(AMT) Items

Other AMT items (attach statement)

16a Name of country or U.S. possession 

Foreign gross income sourced at partnership level

c

Deductions allocated and apportioned at partner level

d e

Deductions allocated and apportioned at partnership level to foreign source income

f

Foreign Transactions

18a 18

Other Information

Schedule K

Adjusted gain or loss

19a

20a

Other tax-exempt income

Nondeductible expenses

b Gross income from all sources

Form 8865 (2005)

g

Passive 

Total amount

h 16h

Net short-term capital gain (loss)

Dividends: a Ordinary dividends

Net long-term capital gain (loss)

6a

b

Net section 1231 gain (loss) (attach Form 4797)

b Qualified dividends

c

Collectibles (28%) gain (loss)

Unrecaptured section 1250 gain (attach statement)

6b

9c

9b

b

c

d

Contributions

Investment interest expense

Section 59(e)(2) expenditures: (1) Type 

Other deductions (see instructions) Type 

(2) Amount 

13a

15a

b Low-income housing credit (other)

f

15b

15c

15d

15e

15a

15f

Listed categories (attach statement)  General limitation 

Interest expense  Other 

16f

ij k Passive  Listed categories (attach statement)  General limitation  16k

Oil, gas, and geothermal properties—gross income

e Oil, gas, and geothermal properties—deductions

17a

17b

17c

17d

17e

17f

l

m

Total foreign taxes (check one): 

Reduction in taxes available for credit (attach statement)

16l

16m

b

c

Tax-exempt interest income

b Distributions of other property

Distributions of cash and marketable securities

b Investment expenses

Investment income

c Other items and amounts (attach statement)

18b

18c

19

19b

20a

20b

11

Paid Accrued

Gross income sourced at partner level

Other credits and credit recapture (see instructions) Type 

n Other foreign tax information (attach statement)

3150

3160

3170

3180 @3185 STMnn

3190

3200

3216

3210

3220

3230

3240

3270

3280

@3265 STMnn

3290

@3305 STMnn 3300

3320

3352

+3340 @3345 STMnn

@3355 STMnn 3350

3360

@3395 STMnn 3390

@3415 "STM nn"

@3405 "STM nn 3400

+3470

3540

@3525 STMnn

3560

3520

3530

3550

@3545 STMnn

B-173

3370

3380

3570

3690

3680

3670

3660 3630 3640

3620

3610

3600

3580 3590

3700

3710

3720

3730

3740

3750

3746

3760

3770

3780

3196

3250

3260

@3285 "STM nn" 3282

*3330 "STM nn"

3410

*3430 "STM nn" +3440

*3460 "STM nn"

*3490 "STM nn" @3505 STMnn +3500

@3565 STMnn

@3615 STMnn

3650

@3665 STMnn

@3667 STMnn

@3685 STMnn

@3705 STMnn

@3715 STMnn

@3725 STMnn

@3755 STMnn

@3765 STMnn

@3785 STMnn

@3789 STMnn
Draft as of

06/23/2005

Form 8865 (2005) Page 5

Balance Sheets per Books. (Not required if Item G9, page 1, is answered "Yes.")

Beginning of tax year End of tax year

Assets (a) (b) (c) (d)

1 Cash

2a Trade notes and accounts receivable

b Less allowance for bad debts

3 Inventories

4 U.S. government obligations

5 Tax-exempt securities

6 Other current assets (attach statement)

7 Mortgage and real estate loans

8 Other investments (attach statement)

9a Buildings and other depreciable assets

b Less accumulated depreciation

10a Depletable assets

b Less accumulated depletion

11 Land (net of any amortization)

12a Intangible assets (amortizable only)

b Less accumulated amortization

13 Other assets (attach statement)

14 Total assets

Liabilities and Capital

15 Accounts payable

16 Mortgages, notes, bonds payable in less than 1 year

17 Other current liabilities (attach statement)

18 All nonrecourse loans

19 Mortgages, notes, bonds payable in 1 year or more

20 Other liabilities (attach statement)

21 Partners’ capital accounts

22 Total liabilities and capital

Schedule L

Form 8865 (2005)

3800

3820

3810

3840

4040

3850

3880

4070

3900

3830

3860 3670

3890

3990

3910

3930

4090

3950

4120

4010

3970

4050

3920

3940

3960

3980

4140

4110

4160

4030

B-174

4000

4020

4060

4080 4100

4220

4170

4200

4180

4150

4130

4190

4210

4230

4240 4250

4260 4270

4280 4290

4300 4310

4320 4330

4340 4350

4360 4370

4380 4390

@3995 "STM nn"

@4215 "STM nn"

@4295 "STM nn"

@4355 "STM nn"

@4395 "STM nn"
Draft as of

06/23/2005

Form 8865 (2005) Page 6

Analysis of Partners’ Capital Accounts. (Not required if Item G9, page 1, is answered “Yes.”)

1 6 Distributions:

Net income (loss) per books

2

Other increases (itemize):

3

Property

7 Other decreases (itemize):

8 Add lines 6 and 7

5

9 Balance at end of year. Subtract

line 8 from line 5

4

Balance Sheets for Interest Allocation

1 Total U.S. assets

2 Total foreign assets:

Listed categories (attach statement)

Passive income category

General limitation income category

(a)

Beginning of

tax year

(b)

End of

tax year

Reconciliation of Income (Loss) per Books With Income (Loss) per Return. (Not required if Item G9, page

1, is answered “Yes.”)

a

Net income (loss) per books

Income included on Schedule K,

lines 1, 2, 3c, 5, 6a, 7, 8, 9a, 10,

and 11 not recorded on books

this year (itemize):

b

Schedule M-1

2

1

c

Guaranteed payments (other

than health insurance)

Expenses recorded on books

this year not included on

Schedule K, lines 1 through 13d,

and 16l (itemize):

Depreciation $

Travel and entertainment $

Add lines 1 through 4

3

4

a

b

5

Income recorded on books this

year not included on Schedule K,

lines 1 through 11 (itemize):

6

a Tax-exempt interest $

Deductions included on Schedule

K, lines 1 through 13d, and 16l not

charged against book income this

year (itemize):

a Depreciation $

Add lines 6 and 7

Income (loss). Subtract line 8

from line 5

7

8

9

Schedule M-2

Schedule M

Form 8865 (2005)

Capital contributed:

a

b

a Cash

b

Add lines 1 through 4

Cash

Property

Balance at beginning of year

4420 4430

4440 4450

@4475 STMnn 4460 4470

4480 4490

4500

@4515 STMnn 4510

4520

4530

4540 @4545 STMnn

4550

4560

4570

4580 @4585 STMnn

4590

4600

4610 @4615 STMnn

4620

4630

4640

4650

4660

4670

4680

4675

@4685 STMnn 4690

4700

4710

4720

@4725 STMnn 4730

4740

4750

@4755 STMnn @4757 STMnn

B-175
Draft as of

06/23/2005

Important: Complete a separate Form 8865 and Schedule N for each controlled foreign partnership. Enter the totals for each type of

transaction that occurred between the foreign partnership and the persons listed in columns (a) through (d).

(b) Any domestic

corporation or partnership

controlling or controlled

by the U.S. person filing

this return

Transactions

of

foreign partnership

(a) U.S. person

filing this return

(d) Any U.S. person with a

10% or more direct interest

in the controlled foreign

partnership (other than the

U.S. person filing this return)

(c) Any other foreign

corporation or partnership

controlling or controlled

by the U.S. person filing

this return

1 Sales of inventory

2 Sales of property rights

(patents, trademarks, etc.)

Compensation received for

technical, managerial,

engineering, construction,

or like services

3

4 Commissions received

5 Rents, royalties, and

license fees received

6 Distributions received

7 Interest received

8

Purchases of inventory

Purchases of tangible

property other than

inventory

10

11

Purchases of property

rights (patents,

trademarks, etc.)

Compensation paid for

technical, managerial,

engineering, construction,

or like services

12

13

14 Commissions paid

Rents, royalties, and

license fees paid

Distributions paid

15

16

Interest paid

18

9

17

19 Add lines 10 through 18

Add lines 1 through 8

Amounts loaned (enter the

maximum loan balance

during the year)—see

instructions

Amounts borrowed (enter

the maximum loan

balance during the year)

—see instructions

Printed on recycled paper

Other

Other

20

21

Form 8865 (2005) Page 7

Schedule N Transactions Between Controlled Foreign Partnership and Partners or Other Related Entities

Form 8865 (2005)

4780 4790 4800 4810

4820 4830 4840 4850

4860 4870 4880 4890

4900 4910 4920 4930

4940 4950 4960 4970

4980 4990 5000 5010

5020 5030 5040 5050

5060 5070 5080 5090

5100 5110 5120 5130

5140 5150 5160 5170

5180 5190 5200 5210

5220 5230 5240 5250

5260 5270 5280 5290

5300 5310 5320 5330

5340 5350 5360 5370

5380 5390 5400 5410

5420 5430 5440 5450

5460 5470 5480 5490

5500 5510 5520 5530

5540 5550 5560 5570

5580 5590 5600 5610

@5615 STMnn

B-176
Draft as of

08/31/2005

OMB No. 1545-1668

year beginning , 2005

, 20

Schedule K-1

(Form 8865)

Information About the Partnership

Partner’s Share of Income, Deductions,

Credits, etc.

Department of the Treasury

Internal Revenue Service

2005

ending

Part III

Part I

Part II

A Partnership’s employer identification number

B Partnership’s name, address, city, state, and ZIP code

Information About the Partner

C Partner’s identifying number

D Partner’s name, address, city, state, and ZIP code

E Partner’s share of profit, loss, capital, and deductions:

Beginning Ending

Profit %

Loss

Capital

F Partner’s capital account analysis:

Beginning capital account

Capital contributed during the year

Current year increase (decrease)

Withdrawals & distributions

Ending capital account

Tax basis GAAP Section 704(b) book

Other (explain)

%

% %

% %

$

$

$

$

$

( )

Final K-1 Amended K-1

Partner’s Share of Current Year Income,

Deductions, Credits, and Other Items

1 Ordinary business income (loss)

2 Net rental real estate income (loss)

15 Credits & credit recapture

4 Guaranteed payments

5 16 Foreign transactions

12 Section 179 deduction

18 Tax-exempt income and

nondeductible expenses

13 Other deductions

Cat. No. 28396B Schedule K-1 (Form 8865) 2005

 See back of form and separate instructions.

Interest income

6a Ordinary dividends

6b Qualified dividends

7 Royalties

8 Net short-term capital gain (loss)

9a Net long-term capital gain (loss)

9b Collectibles (28%) gain (loss)

10 Net section 1231 gain (loss)

11 Other income (loss)

14 Self-employment earnings (loss)

9c Unrecaptured section 1250 gain 17 Alternative minimum tax 

(AMT) items

19 Distributions

20 Other information

For Privacy Act and Paperwork Reduction Act Notice, see Instructions for Form 8865.

3 Other net rental income (loss)

Deductions % %

For IRS Use Only

*See attached statement for additional information.

For calendar year 2005, or tax

010

020

100

110 120 130 140 150 160 170 180 190

300

310 320 330 340 350 360 370 380 390

800

810

830

870

820

880

840

900

860

500

850

650

680

520

540

890

560

600

610

620

630

640

910

920

1110

1510

660

1530

1550

1710

1730

1190

1750

1220

1770

1790

1310

1810

1330

2130

1370

2150

1390

2310

2330

2350

2370

1350

B-177

510

530

550

570

670

2110

1170

1150

1130

1440

1460

1910

1930

1950

2210

2230

2390

1480 2410

1830

1570

1970

@685 "STM nn"

799 *

@805 "STM nn"

@815 "STM nn"

809 *

849 *

@825 "STM nn"

@835 "STM nn"

859 *

869 *

879 *

849 *

839 *

829 *

@845 "STM nn"

@855 "STM nn"

@865 "STM nn"

@875 "STM nn"

@885 "STM nn"

@895 "STM nn"

@905 "STM nn"

@915 "STM nn"

@925 "STM nn"

@1195 "STM nn"

@1197 "STM nn"

889 *

899 *

909 *

919 *

1100

1120

1140

1160

1180

1219 *

1225 "STM nn"

1300

1320

1340

1360

1380

@1395 "STM nn"

@1397 "STM nn"

1430

1450

1470

@1485 "STM nn"

1500

1520

1540

1560

@1575 "STM nn"

@1577 "STM nn"

1690

1700

1720

1740

1760

1780

1800

1820

@1835 "STM nn"

@1837 "STM nn"

1900

1920

1940

1960

@1977 "STM nn"

@1975 "STM nn"

2100

2120

2140

@2155 "STM nn"

2200

2220

@2235 "STM nn"

2300

2320

2340

2360

2380

2400

@2415 "STM nn"

@2417 "STM nn"

@2500 "STM nn"
Draft as of

06/21/2005

SCHEDULE O Transfer of Property to a Foreign Partnership OMB No. 1545-1668

(Form 8865)

Department of the Treasury

Internal Revenue Service  Attach to Form 8865. See Instructions for Form 8865.

Name of transferor Filer’s identifying number

(b)

Number of

items

transferred

Type of

property

(a)

Date of

transfer

(d)

Cost or other

basis

(e)

Section 704(c)

allocation

method

(c)

Fair market

value on date

of transfer

Marketable

securities

Inventory

Tangible

property

used in trade

or business

Intangible

property

Other

property

For Paperwork Reduction Act Notice, see the Instructions for Form 8865. Cat. No. 25909U Schedule O (Form 8865) 2005

Printed on recycled paper

Transfers Reportable Under Section 6038B

(f)

Gain

recognized on

transfer

(g)

Percentage interest

in partnership after

transfer

Name of foreign partnership

Supplemental Information Required To Be Reported (see instructions):

(c)

Date of

disposition

(a)

Type of

property

(b)

Date of

original

transfer

(e)

Gain

recognized by

partnership

(f)

Depreciation

recapture

recognized

by partnership

(d)

Manner of

disposition

Dispositions Reportable Under Section 6038B

(g)

Gain allocated

to partner

(h)

Depreciation

recapture allocated

to partner

(under section 6038B)

Is any transfer reported on this schedule subject to gain recognition under section 904(f)(3) or

section 904(f)(5)(F)?  Yes No

Part III

Part I

Part II

Cash

2005

010

*060 STMnn

020

030 040 050

+070 +080 +090 +100 +110 +120 +125

130 140 150 160 170 180 190 195

200 210 220 230 240 250 260 265

270 280 290 300 310 320 330 335

*340 STMnn +350 +360 +370 +380 +390 +400 +405

410 420 430 440 450 460 470 475

480 490 500 510 520 530 540 545

550 560 570 580 590 600 610 615

*620 STMnn +630 +640 +650 +660 +670 +680 +685

690 700 710 720 730 740 750 755

760 770 780 790 800 810 820 825

830 840 850 860 870 890 900 905

*910 STMnn +920 +930 +940 +950 +960 +970 +975

980 990 1000 1010 1020 1030 1040 1045

1050 1060 1070 1080 1090 1100 1110 1115

1120 1130 1140 1150 1160 1170 1180 1185

*1190 STMnn +1200 +1210 +1220 +1230 +1240 +1250 +1255

1260 1270 1280 1290 1300 1310 1320 1325

1330 1340 1350 1360 1370 1380 1390 1395

1400 1410 1420 1430 1440 1450 1460 1465

@1470 STMnn

1480 @1485 1490 @1495 1500 1510 1520 1530 1540 1550 @1555

1560 @1565 1570 @1575 1580 1590 1600 1610 1620 1630 @1635

1640 @1645 1650 @1655 1660 1670 1680 1690 1700 1710 @1715

1720 @1725 1730 @1735 1740 1750 1760 1770 1780 1790 @1795

@1797 STMnn

@1813 STMnn 1800 1810

@1815 STMnn

B-178

055
Draft as of

06/21/2005

SCHEDULE P Acquisitions, Dispositions, and Changes of Interests

(Form 8865) in a Foreign Partnership

OMB No. 1545-1668

Department of the Treasury

Internal Revenue Service  Attach To Form 8865. See Instructions for Form 8865.

Name of person filing Form 8865 Filer’s identifying number

Acquisitions

For Paperwork Reduction Act Notice, see the Instructions for Form 8865. Cat. No. 25943Q Schedule P (Form 8865) 2005

Part I

Part II

(under section 6046A)

(e)

% of interest

before acquisition

(b)

Date of acquisition

(a)

Name, address, and identifying number of

person from whom your interest was acquired

Printed on recycled paper

Dispositions

Part III Change in Proportional Interest

Part IV

(c)

FMV of

interest acquired

(d)

Basis in

interest acquired

(f)

% of interest

after acquisition

(a)

Description of change

Name of foreign partnership

Supplemental Information Required To Be Reported (see instructions)

(e)

% of interest

before disposition

(b)

Date of disposition

(c)

FMV of

interest disposed

(d)

Basis in

interest disposed

(f)

% of interest

after disposition

(a)

Name, address, and identifying number of

person who acquired your interest

(e)

% of interest

before change

(b)

Date of change

(c)

FMV of

interest

(d)

Basis in

interest

(f)

% of interest

after change

2005

010

020

*030 +040 *+050

+060 +070 +080

+090 +100 +110 *+120 +125 +130 +135

140 150 160

170 180 190

200 210 220 230 235 240 245

250 260 270

280 290 300

310 320 330 340 345 350 355

*360 +370 *+380

+390 +400 +410

+420 +430 +440 *+450 +455 +460 +465

470 480 490

500 510 520

530 540 550 560 565 570 575

580 590 600

610 620 630

640 650 660 670 675 680 685

*690 STMnn +700 +710 *+720 STMnn *+730 +735 +740 +745

750 760 770 780 790 795 800 805

810 820 830 840 850 855 860 865

@870 STMnn

B-179
Interest Computation Under the Look-Back Method for

Property Depreciated Under the Income Forecast Method Form 8866 OMB No. 1545-1622

(Rev. November 2002)

 See separate instructions. Department of the Treasury

Internal Revenue Service  Please print or type.

For the recomputation year beginning , and ending . See instructions.

Name Identifying number

Fill In Your Number, street, and apt., room, or suite no. If a P.O. box, see instructions. B Check applicable box to show type of taxpayer:

Address Only If

You Are Filing This

Form Separately

and Not With Your

Tax Return

Corporation S corporation

City or town, state, and ZIP code. If a foreign address, see instructions. Individual Partnership

Estate or trust

C If you were an owner of an interest in a pass-through entity (such as a partnership or an S corporation) that depreciated one or more properties to which this interest

computation relates, enter the name and employer identification number of the entity. Attach a schedule if there is more than one such entity.

Name of entity Employer identification number

Date of each prior year to which interest

computation relates: Taxable income (or loss) for the prior years shown on tax

return (or as previously adjusted) before net operating loss

or capital loss carrybacks (other than carrybacks that must

be taken into account to properly compute interest under

section 167(g)) (see instructions). If you were required to

file Form 8866 for an earlier year, enter adjusted taxable

income for the prior years from Form 8866, line 3, for the

most recent recomputation year that affects the prior years

1 (d)

Totals

(Add columns (a),

(b), and (c).)

(c)

Year ended

(b)

Year ended

(a)

Year ended

Adjustment to taxable income for the difference between:

(a) the depreciation deducted under the income forecast

method based on estimated future income and

(b) depreciation allowable under the income forecast

method based on actual income earned for periods before

the end of the recomputation year and estimated future

income to be earned after the recomputation year.

See instructions and attach a schedule listing each

separate property, unless you were an owner of an interest

in a pass-through entity reporting this amount from

Schedule K-1 or a similar statement

2

Adjusted taxable income for look-back purposes. Combine

lines 1 and 2

3

Income tax liability on line 3 amount using tax rates in effect

for the prior years (see instructions)

4

Income tax liability shown on return (or as previously

adjusted) for the prior years (see instructions). If you were

required to file Form 8866 for an earlier year, enter the amount

required to be reported on Form 8866, line 4, for the most

recent recomputation year that affects the prior years

5

Increase (or decrease) in tax for the prior years on which

interest is due (or is to be refunded). Subtract line 5 from

line 4. (Pass-through entities: See instructions.)

6

Interest due on increase, if any, shown on line 6 (see

instructions)

7

Interest to be refunded on decrease, if any, shown on

line 6 (see instructions)

8

Net amount of interest to be refunded to you. If line 8, column (d), exceeds line 7, column (d), enter the excess. File

Form 8866 separately; do not attach it to your tax return (see instructions)

9

Net amount of interest you owe. If line 7, column (d), exceeds line 8, column (d), enter the excess. Attach

Form 8866 to your tax return. See instructions for where to include this amount on your return

10

A

Attachment

Sequence No. 108

mo. yr. mo. yr. mo. yr.

Under penalties of perjury, I declare that I have examined this form, including accompanying schedules and statements, and to the best of my

knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer

has any knowledge. Sign

Here

Signature(s) Date

Date Preparer’s SSN or PTIN Preparer’s

signature Check if Pa self-employed  id

Preparer’s

Use Only Firm’s name (or yours

if self-employed) address, and ZIP code

EIN 

Phone no. 









For Privacy Act and Paperwork Reduction Act Notice, see instructions. Cat. No. 26036C Form 8866 (11-2002)

Pass-through entities: Skip lines 1, 3, 4, and 5.

Signatures. Complete this section only if this form is being filed separately and not with the tax return.

080

010 020

090

100

110

120

130

140 @145 "STM nn" or blank 150

160

170

180

@185 STMnn

190

200

210

220

230

240

250

260

@275 STMnn

270

280

290

300

310

320

330

340

350

@365 STMnn

360

370

380

390

400

410

420

430

440

450

460

B-180

@235 STMnn

@245 STMnn

@325 STMnn

@335 STMnn

@415 STMnn

@425 STMnn
Draft as of

10/06/2005

OMB No. 1545-1722

Form 8873 Extraterritorial Income Exclusion

 See separate instructions. Department of the Treasury

Internal Revenue Service

Name(s) as shown on return Identifying number

For Paperwork Reduction Act Notice, see instructions. Cat. No. 30732F Form 8873 (2005)

 Attach to your tax return. Attachment

Sequence No. 126

(a) Foreign Trade

Income

(b) Foreign Sale and

Leasing Income

6 Sale, exchange, or other disposition of qualifying foreign trade property 

Enter the amount from line 6, column (a), attributable to the sale of property 

formerly leased or rented for use by the lessee outside the United States

7

Lease or rental of qualifying foreign trade property for use by the lessee

outside the United States. Enter the same amount in both columns

8

Engineering or architectural services for construction projects outside the United States

9

15 Foreign trading gross receipts. Add lines 6 through 13 in column (a)

6

7

8

9

10

15

Part I

Add lines 7 through 14 in column (b)

Cost of goods sold:

Inventory at beginning of year 

Purchases

Cost of labor 

Additional section 263A costs (attach schedule) 

Other costs (attach schedule) 

Total. Add lines 17a through 17e 

Inventory at end of year 

Subtract line 17g from line 17f 

In column (a), subtract line 17h from line 15. In column (b), subtract line 17h 

from line 16

Other expenses and deductions (see instructions) (attach schedule) 

Foreign trade income. In column (a), subtract line 19 from line 18. If -0- or 

less, stop here. You do not qualify for the exclusion 

Foreign sale and leasing income. In column (b), subtract line 19 from line 18

17

a

b

c

d

e

f

g

h

18

19

20

21

16

17a

17b

17c

17d

17e

17f

17g

17h

18

19

20

21

Caution: If a related person is also eligible for an extraterritorial income

exclusion, see Excluded property in the instructions.

Check the box if you are electing under section 942(a)(3) to exclude a portion of your gross receipts from foreign trading gross

receipts on line 15. Attach a schedule indicating which receipts are being excluded 

Elections and Other Information

1

Are you excepted from the foreign economic process requirements because your foreign trading gross

receipts are $5 million or less? 

b If “No,” check the applicable box to indicate how you met the foreign economic process requirements:

You met the 50% foreign direct cost test (see instructions).

You met the alternative 85% foreign direct cost test (see instructions).

Yes No

4a

Part II Foreign Trade Income and Foreign Sale and Leasing Income

See instructions before completing lines 5a through 5c. Note: For transactions for which the exclusion is determined using

the foreign sale and leasing income method (i.e., line 44 equals line 45), complete only lines 5a and 5c(1).

5

a Business activity code

c Check the applicable box to indicate the basis of your reporting:

(1)

(a)

(2)

3 Check the box if the taxpayer is a foreign corporation electing to be treated as a domestic corporation (see instructions) 

Transaction-by-transaction:

Group of transactions (see instructions for an important change made to reflect the American Jobs Creation Act of 2004)

Check the box if you are electing to apply the extraterritorial income exclusion provisions to certain transactions involving a FSC

(see instructions). Attach a schedule listing the affected transactions 

2

Aggregate on Form 8873 Aggregate on tabular schedule Tabular schedule of transactions

b Product or product line

Services related and subsidiary to the sale, exchange, or other disposition of 

qualifying foreign trade property

10 Enter the amount from line 9, column (a), attributable to the sale of property 

formerly leased or rented for use by the lessee outside the United States

11 Services related and subsidiary to the lease of qualifying foreign trade property for use 

by the lessee outside the United States. Enter the same amount in both columns

12

13 Managerial services provided to unrelated persons (see instructions) 

14 Enter the sum of the amounts from lines 6, 9, 12, and 13 of column (a)

attributable to foreign economic processes. Do not include any amounts

already included on lines 7, 8, 10, or 11 in column (b) 

11

12

13

14

16

(1)

(2)

(b) (c)

2005

010

@025 STMnn 020

@035 STMnn 030

040 @045 STMnn

050 055

060

065

070 075

080

085 @090 STMnn 095 @100 STMnn

110 @115 STMnn

120

130

140 150

160

170

180 190

200

210

220

230

240

250 260

270 280

290 300

310 320

330 340

350 360

370 380

390 400

410 420

430 440

450

460

@325 STMnn

@345 STMnn

@445 "STM nn"

B-181
Draft as of

10/06/2005

Form 8873 (2005) Page 2

Form 8873 (2005)

Part III

Extraterritorial Income Exclusion (Net of Disallowed Deductions)

Enter your foreign trade income from line 20 

Multiply line 37 by 15% (.15) 

Enter your foreign trading gross receipts from line 15 

Multiply line 39 by 1.2% (.012) 

Multiply line 38 by 2.0 

Enter the smaller of line 40 or line 41 

Enter your foreign sale and leasing income from line 21 

Multiply line 43 by 30% (.30) 

If line 44 equals line 45, divide the amount on line 45 by the amount

on line 43. Otherwise, divide the amount on line 45 by the amount on 

line 37. Carry the result to at least three decimal places

If line 44 equals line 45, enter the amount from line 19, column (b).

Otherwise, enter the amount from line 19, column (a) 

Multiply line 46 by line 47

Add lines 45 and 48 

37

38

39

40

41

42

43

44

45

46

47

48

37

38

39

40

41

42

45

46

47

48

Enter the greatest of lines 33, 36, 38, 42, or 44. If you are using the alternative computation,

see instructions for the amount to enter 

43

44

Reduction for international boycott operations, illegal bribes, kickbacks, etc. (see instructions)

Qualifying foreign trade income. Subtract line 50 from line 49. If -0- or less, stop here. You do 

not qualify for the exclusion 

49

50

51

49

50

51

52 Subtract line 48 from line 51

Part IV

Marginal Costing (Note: If you are not using Marginal Costing, skip Part III and go to Part IV.)

Section A — Foreign Trade Income Using Marginal Costing Method

Section C — 1.2% of Foreign Trading Gross Receipts Method

Section B — 15% of Foreign Trade Income Method

Foreign trading gross receipts. Enter the amount from line 15 

Costs and expenses allocable to the amount reported on line 22:

Cost of direct material attributable to property sold 

Cost of direct labor attributable to property sold 

Subtract line 23c from line 22

22

23

24

22

23a

23b

23c

24

a

b

c Add lines 23a and 23b 

25 Worldwide gross receipts from sales of the product or product line 25

Costs and expenses allocable to the amount reported on line 25:

Cost of goods sold attributable to property sold 

Other expenses and deductions attributable to gross income 

26

26a

26b

26c

a

b

c Add lines 26a and 26b 

Subtract line 26c from line 25. (Note: If -0- or less, stop here. You may not use Part III to determine 

your qualifying foreign trade income. Go to line 37.)

27

27

Overall profit percentage. Divide line 27 by line 25. Carry the result to at least three decimal

places

28

28

29 Overall profit percentage limitation. Multiply line 22 by line 28 29

30 Foreign trade income using marginal costing. Enter the smaller of line 24 or line 29 30

31 Multiply line 30 by 15% (.15) 31

32 Foreign trade income using full costing. Enter the amount from line 20 32

33 Enter the smaller of line 31 or line 32 33

34 Multiply line 22 by 1.2% (.012) 34

35 Multiply line 30 by 30% (.30) 35

36 Enter the smallest of lines 32, 34, or 35 36

52

b Multiply the amount from line 52 that is attributable to 80% transactions (see instructions) by

80% (0.80) and enter the result here 

Note. If you do not have a reduction for international boycott operations, illegal bribes, kickbacks, etc. (see

the instructions for line 50), skip lines 46 through 51 and enter on line 52 the amount from line 45.

53a Enter the amount from line 52 that is attributable to 100% transactions (see instructions) 

c Multiply the amount from line 52 that is attributable to 60% transactions (see instructions) by

60% (0.60) and enter the result here 

54 Extraterritorial income exclusion (net of disallowed deductions). Add lines 53a through 53c. Enter the result

here and include it on the “other deductions” line of your tax return or schedule (see instructions) 

53b

53c

53a

54

480

490

500

510

520

530

540

550

560

570

580

590

600

610

620

630

640

650

660

670

680

690

700

710

720

730

740

750

760

770

780

790

800

810

820

B-182

830

840

850

860
OMB No. 1545-1804 New Markets Credit

Form 8874

Department of the Treasury

Internal Revenue Service  Attach to your tax return.

Name(s) shown on return

Cat. No. 31663N Form 8874 (2005)

Allowable Credit (See Who must file Form 3800 to find out if you complete Part II or Form 3800)

4 Regular tax before credits:

4

5

Attachment

Sequence No. 127

5 Alternative minimum tax:

6

Identifying number

Part I Current Year Credit

Part II

(e)

Credit

rate

(d)

Amount of qualified

equity investment

(c)

Date of initial

investment

(b)

Employer identification

number of CDE

(a)

Name and address of the qualified

community development entity (CDE)

1

(f)

Credit ((d) (e))

Current year credit. Add the amounts on line 1, column (f), and line 2. S corporations

and partnerships, see instructions

3

● Individuals. Enter the amount from Form 1040, line 44

● Corporations. Enter the amount from Form 1120, Schedule J, line 3;

Form 1120-A, Part I, line 1, or the applicable line of your return

● Estates and trusts. Enter the sum of the amounts from Form 1041,

Schedule G, lines 1a and 1b, or the amount from the applicable line of your return

● Individuals. Enter the amount from Form 6251, line 35

%

%

%

3

● Corporations. Enter the amount from Form 4626, line 14

● Estates and trusts. Enter the amount from Form 1041, Schedule I, line 56

6 Add lines 4 and 5





7a

b

c

d

e

f

8

9

10

11

12

13

14

Foreign tax credit

Credits from Form 1040, lines 48 through 54

Possessions tax credit (Form 5735, line 17 or 27)

Nonconventional source fuel credit (Form 8907, line 23)

Other specified credits (see instructions)

Add lines 7a through 7e

Net income tax. Subtract line 7f from line 6. If zero, skip lines 9 through 12 and enter -0- on line 13

Net regular tax. Subtract line 7f from line 4. If zero or less, enter -0-

Enter 25% (.25) of the excess, if any, of line 9 over $25,000 (see instructions)

Tentative minimum tax (see instructions):

● Individuals. Enter the amount from Form 6251, line 33

● Corporations. Enter the amount from Form 4626, line 12

● Estates and trusts. Enter the amount from Form 1041,

Schedule I, line 54

Enter the greater of line 10 or line 11

Subtract line 12 from line 8. If zero or less, enter -0-

Credit allowed for the current year. Enter the smaller of line 3 or line 13 here and on Form 1040,

line 55; Form 1120, Schedule J, line 6d; Form 1120-A, Part I, line 2; Form 1041, Schedule G, line 2c;

or the applicable line of your return. If line 3 is greater than line 13, see instructions

7a

7b

7c

7d

7e

7f

8

9

10

11

12

13

14



For Paperwork Reduction Act Notice, see instructions.

2 New markets credits from pass-through entities (if from more than one entity, see instructions):

If you are a—

a Shareholder

b Partner

Schedule K-1 (Form 1120S), box 13, code O

Schedule K-1 (Form 1065), box 15, code O

Then enter the total of the current year credits from—

 EIN of pass-through entity

2

2005

*020 +030

*+040 +050 +060

+070 +080 +090 +100

110 120

130 140 150

160 170 180 190

200 210

220 230 240

250 260 270 280

+340

@330 STM nn 350

360

400

410

420

430

520

530

540

550

560

570

580

590

600

610

620

B-183

445
OMB No. 1545-0074

8880 Credit for Qualified Retirement Savings Contributions Form

Department of the Treasury

Internal Revenue Service

Attachment

Sequence No. 129

 Attach to Form 1040 or Form 1040A. 

Name(s) shown on return Your social security number

For Paperwork Reduction Act Notice, see back of form. Cat. No. 33394D Form 8880 (2005)

● The amount on Form 1040, line 38, or Form 1040A, line 22, is more than $25,000 ($37,500 if head of household;

$50,000 if married filing jointly).

You cannot take this credit if either of the following applies.

4

1

Traditional and Roth IRA contributions for 2005. Do not include rollover

contributions

1

3

2

5

6

7

8

9

10

11

12

13

14

Elective deferrals to a 401(k) or other qualified employer plan, voluntary

employee contributions, and 501(c)(18)(D) plan contributions for 2005

(see instructions) 

2

3 Add lines 1 and 2

Certain distributions received after 2002 and before the due date

(including extensions) of your 2005 tax return (see instructions). If

married filing jointly, include both spouses’ amounts in both columns.

See instructions for an exception 

4

5 Subtract line 4 from line 3. If zero or less, enter -0-

6 In each column, enter the smaller of line 5 or $2,000 

8 Enter the amount from Form 1040, line 38*, or Form 1040A, line 22

9 Enter the applicable decimal amount shown below:

Note: If line 9 is zero, stop; you cannot take this credit.

10 Multiply line 7 by line 9 

11 Enter the amount from Form 1040, line 46, or Form 1040A, line 28

Enter the total of your credits from Form 1040, lines 47 through 50, or

Form 1040A, lines 29 through 31

12

13 Subtract line 12 from line 11. If zero, stop; you cannot take this credit 

Credit for qualified retirement savings contributions. Enter the smaller of line 10 or line

13 here and on Form 1040, line 51, or Form 1040A, line 32

14

(a) You (b) Your spouse

● The person(s) who made the qualified contribution or elective deferral (a) was born after January 1, 1988, (b) is

claimed as a dependent on someone else’s 2005 tax return, or (c) was a student (see instructions).

7 Add the amounts on line 6. If zero, stop; you cannot take this credit 

*See Pub. 590 for the amount to enter if you are filing Form 2555, 2555-EZ, or 4563 or you are excluding income from Puerto Rico.

If line 8 is— 

Enter on line 9—

Single, Married filing 

separately, or 

Qualifying widow(er)

Over— But not 

over—

Married

filing jointly

Head of 

household

---

$15,000

$16,250

$22,500

$24,375

$25,000

$30,000

$32,500

$37,500

$50,000

$15,000

$16,250

$22,500

$24,375

$25,000

$30,000

$32,500

$37,500

$50,000

---

.5

.5

.5

.5

.5

.5

.2

.1

.1

.0

.5

.5

.5

.2

.1

.1

.1

.1

.0

.0

.5

.2

.1

.1

.1

.0

.0

.0

.0

.0

X .

And your filing status is—

 See instructions on back.

CAUTION

2005

010 020

030

050 060

040

070 080

090 100

110 120

130

140

150

160

170

180

190

200

B-184

003
OMB No. 1545-1810 Credit for Small Employer Pension Plan

Startup Costs Form 8881

 Attach to your tax return.

Department of the Treasury

Internal Revenue Service

Attachment

Sequence No. 130

Name(s) shown on return Identifying number

Current Year Credit (Members of controlled groups or businesses under common control, see instructions.)

1

2 2

3

4

5

Allowable Credit (See Who must file Form 3800 to find out if you complete Part II or file Form 3800.)

Form 8881 (2005)

Part I

Part II

Qualified startup costs incurred during the tax year. Do not enter more

than $1,000

3 Form 8881 credits from

pass-through entities:

5 Current year credit. Enter the smaller of line 4 or $500

Cat. No. 33435N

Enter one-half of line 1

a

b

Shareholder

Partner

If you are a—

4

Then enter the Form 8881 credits from—

Schedule K-1 (Form 1065) box 15, code F, G, or U

Schedule K-1 (Form 1120S) box 13, code F, G, or U 

● Individuals. Enter the amount from Form 1040, line 44

6

Corporations. Enter the amount from Form 1120, Schedule J, line 3; Form 1120-A,

Part I, line 1; or the applicable line of your return

●

●

9a 9a

b 9b

9d

Foreign tax credit

d

e 9e

Possessions tax credit (Form 5735, line 17 or 27)

f

Nonconventional source fuel credit (Form 8907, line 23)

Other specified credits (see instructions)

Add lines 9a through 9e 9f

10

10 Net income tax. Subtract line 9f from line 8. If zero, skip lines 11 through 14 and enter -0- on

line 15

7 Alternative minimum tax:

● Individuals. Enter the amount from Form 6251, line 35

● Corporations. Enter the amount from Form 4626, line 14 7

● Estates and trusts. Enter the amount from Form 1041, Schedule I, line 56

13 Tentative minimum tax (see instructions):

● Individuals. Enter the amount from Form 6251, line 33

11

● Corporations. Enter the amount from Form 4626, line 12

● Estates and trusts. Enter the amount from Form 1041,

Schedule I, line 54

11

Enter 25% (.25) of the excess, if any, of line 11 over $25,000 (see instructions)

14

Subtract line 14 from line 10. If zero or less, enter -0-

14

15

Credit allowed for the current year. Enter the smaller of line 5 or line 15 here and on

Form 1040, line 55; Form 1120, Schedule J, line 6d; Form 1120-A, Part I, line 2; Form 1041,

Schedule G, line 2c; or the applicable line of your return. If line 15 is smaller than line 5, see

instructions 16



c 9c

6 Regular tax before credits:

8 Add lines 6 and 7 8

12

Enter the greater of line 12 or line 13

12

 13

Estates and trusts. Enter the sum of the amounts from Form 1041, Schedule G, lines 1a

and 1b, or the amount from the applicable line of your return

Net regular tax. Subtract line 9f from line 6. If zero or less, enter -0-

16

15



1

Add lines 2 and 3

For Paperwork Reduction Act Notice, see page 2.

Credits from Form 1040, lines 48 through 54

2005

020

030

@035 "STM nn"

040

050

060

100

110

120

130

220

230

240

250

260

270

280

290

300

310

320

B-185

145
OMB No. 1545-1809 Credit for Employer-Provided Childcare

Facilities and Services

Form 8882

Department of the Treasury

Internal Revenue Service

Name(s) shown on return Identifying number

For Paperwork Reduction Act Notice, see instructions. Cat. No. 33436Y Form 8882 (2005)

Attachment

 Attach to your tax return. Sequence No.131

Part II Allowable Credit (See Who must file Form 3800 to find out if you complete Part II or file Form 3800.)

● Individuals. Enter the amount from Form 1040, line 44

8

Corporations. Enter the amount from Form 1120, Schedule J, line 3; Form 1120-A,

Part I, line 1; or the applicable line of your return

●

●

11a 11a

b Credits from Form 1040, lines 48 through 54 11b

11d

Foreign tax credit

d

e 11e

Possessions tax credit (Form 5735, line 17 or 27)

f

Nonconventional source fuel credit (Form 8907, line 23)

Other specified credits (see instructions)

Add lines 11a through 11e 11f

12

Net income tax. Subtract line 11f from line 10. If zero, skip lines 13 through 16 and enter -0- on

line 17

9 Alternative minimum tax:

● Individuals. Enter the amount from Form 6251, line 35

● Corporations. Enter the amount from Form 4626, line 14 9

● Estates and trusts. Enter the amount from Form 1041, Schedule I, line 56

13

Tentative minimum tax (see instructions):

● Individuals. Enter the amount from Form 6251, line 33

13

● Corporations. Enter the amount from Form 4626, line 12

● Estates and trusts. Enter the amount from Form 1041,

Schedule I, line 54

Enter 25% (.25) of the excess, if any, of line 13 over $25,000 (see

instructions)

14

Subtract line 16 from line 12. If zero or less, enter -0-

16

15

Credit allowed for the current year. Enter the smaller of line 7 or line 17 here and on Form

1040, line 55; Form 1120, Schedule J, line 6d; Form 1120-A, Part I, line 2; Form 1041, Schedule

G, line 2c; or the applicable line of your return. If line 17 is smaller than line 7, see instructions



c 11c

8 Regular tax before credits:

10 Add lines 8 and 9 10

12

Enter the greater of line 14 or line 15

14

 15

Estates and trusts. Enter the sum of the amounts from Form 1041, Schedule G, lines 1a

and 1b, or the amount from the applicable line of your return

Net regular tax. Subtract line 11f from line 8. If zero or less, enter -0-

16

17



Current Year Credit (Members of controlled groups or businesses under common control, see instructions.)

1

2 2

3

5

Part I

Qualified childcare facility expenditures paid or incurred (see

instructions)

3

5

Current year credit. Enter the smaller of line 6 or $150,000 (S corporations, partnerships,

estates, and trusts, see instructions)

Enter 25% (.25) of line 1

a

b

Shareholder

Partner

If you are a—

4

Then enter the total of the current year credits from—

Schedule K-1 (Form 1065), box 15, code F, G, or U

Schedule K-1 (Form 1120S), box 13, code F, G, or U 

1

Add lines 2, 4, and 5

Qualified childcare resource and referral expenditures paid or incurred

Enter 10% (.10) of line 3

c Beneficiary Schedule K-1 (Form 1041), box 13, code N

6

7

6

7

17

18

18

4

Form 8882 credits from pass-through entities (if more than one entity, see instructions):

EIN of pass-through entity

2005

020

030

040

050

+060

070

@100 "STM nn" 090

150

160

170

180

195

270

280

290

300

310

320

330

340

350

360

370

B-186

*055 "STM nn"
OMB No. 1545-0074

Form 8885 Health Coverage Tax Credit

Department of the Treasury

Internal Revenue Service

Attachment

Sequence No. 134  Attach to Form 1040 or Form 1040NR.

Name of recipient (if both spouses are recipients, complete a separate form for each spouse) Recipient’s social security number

Cat. No. 34641D Form 8885 (2005)

Complete This Part To See if You Are Eligible To Take This Credit

1

Part I

Part II

Check the boxes below for each month in 2005 that all of the following statements were true on the first day of that month.

February March

Health Coverage Tax Credit

2 Amount paid for qualified health insurance coverage for all months checked on line 1 (see

instructions on page 3). Include qualified health insurance premiums paid to “U.S.

Treasury—HCTC” and advance payments from Form 1099-H, box 1

3 Enter the total amount of any (a) Archer MSA and health savings account distributions used

to pay amounts included on line 2 and (b) National Emergency Grants you received for health

insurance in 2005

4 Subtract line 3 from line 2. If zero or less, stop; you cannot take the credit

7 Health coverage tax credit. Subtract line 6 from line 5. If zero or less, enter -0-. Also include

on Form 1040, line 70, or Form 1040NR, line 64, and check box c on that line

For Paperwork Reduction Act Notice, see page 4.

Before you begin: See Definitions and Special Rules that begin on page 2.

5 Multiply line 4 by 65% (.65) and enter the result

6 Advance payments, if any, from Form 1099-H, box 1

January May June April

July November December August September October

Do not complete this form if you can be claimed as a dependent on someone else’s 2005 tax return.

● You were an eligible trade adjustment assistance (TAA) recipient, alternative TAA recipient, or Pension Benefit Guaranty

Corporation (PBGC) pension recipient.

● You were covered by a qualified health insurance plan for which you paid the premiums (including months for which you

paid premiums to “U.S. Treasury—HCTC”).

● You were not covered by, or eligible for coverage under, any employer-sponsored health insurance plan (including any

employer-sponsored health insurance plan of your spouse) (see instructions that begin on page 3).

● You were not enrolled in Medicaid or State Children’s Health Insurance Program (SCHIP).

● You were not enrolled in the Federal Employees Health Benefits Program or eligible to receive benefits under the U.S.

military health system (TRICARE).

● You were not imprisoned under Federal, state, or local authority.

2

3

5

4

7

6

● You were not entitled to Medicare Part A or enrolled in Medicare Part B.

Note. You must attach invoices and proof of payment for any amounts

included on line 2 for which you did not receive an advance payment (see

instructions on page 3).

CAUTION

2005

035

020

045 055 065 075 085

095 105 115 125 135 145

190

200

210

230

240

B 250 -187
Draft as of

10/12/2005

Reportable Transaction Disclosure Statement OMB No. 1545-1800

Form 8886

Department of the Treasury

Internal Revenue Service

Number, street, and room or suite no.

a

b

c

1a

1c Tax shelter registration number (11 digits or 9 digits)

Name of reportable transaction

2 Identify the type of reportable transaction. Check all the box(es) that apply (see instructions).

Form 8886 (Rev. 12-2005)

 Attach to your tax return.

Cat. No. 34654G

Listed transaction

Confidential

6

If the transaction is a “listed transaction” or substantially similar to a listed transaction, identify the listed transaction (see

instructions)  

3

 See separate instructions.

(Rev. December 2005)

Name(s) shown on return Identifying number

City or town, state, and ZIP code

Contractual protection

d

e

f

Loss

Significant book-tax difference

Brief asset holding period

4

Name

Enter the number of transactions reported on this form 

If you invested in the transaction through another entity, such as a partnership, an S corporation, or a foreign

corporation, provide the information below for the entity.

5

Enter below, the name and address of each person to whom you paid a fee with regard to the transaction if that person

promoted, solicited, or recommended your participation in the transaction, or provided tax advice related to the transaction.

(Attach additional sheet, if necessary.)

Attachment

Sequence No. 137

A Enter the form number of the tax return that this form is attached to 

Enter the year of the tax return with which this form is filed 

B Check the box(es) that apply (see instructions).

Protective disclosure

1b Initial year participated in transaction

a Name 

b Type of entity 

c Form number of tax return filed 

d Employer identification number (EIN) 

Number, street, and room or suite no.

City or town, state, and ZIP code

Name

Number, street, and room or suite no.

City or town, state, and ZIP code

For Paperwork Reduction Act Notice, see separate instructions.

a

b

Initial year filer

*030 "STM nn"

+040 050

200 205

*230 "STM nn"

*300 "STM nn"

+310

350

370 380 390

360

+038

018

020

120

130

140

150

405 B-188

013

015

100

110

220

+233

*+237 "STM nn"

+240 245

*+320 "STM nn" +330 +340
Draft as of

10/12/2005

Form 8886 (Rev. 12-2005) Page 2

Printed on recycled paper

Form 8886 (Rev. 12-2005)

Facts. Describe the facts of the transaction that relate to the expected tax benefits, including your participation 

in the transaction. For listed transactions identified in item 2a, also provide the complete name, address, and

nature of involvement of all parties to the transaction (see instructions).

7

Expected tax benefits. Describe the expected tax benefits, including deductions, exclusions from gross income, 

nonrecognition of gain, tax credits, adjustments (or the absence of adjustments) to the basis of property, etc.

(see instructions for more details).

8

Estimated tax benefits. Provide a separate estimate of the amount of each of the expected tax benefits

described above for each affected tax year (including prior and future years).

9

700 710 715 720 725 730 735 740

750 760 765 770 775 780 785 790 

800 810 820 830 840 850 860 870

B-189

@900 "STM nn"
OMB No. 1545-0074

Form 8889 Health Savings Accounts (HSAs)

Department of the Treasury

Internal Revenue Service  Attach to Form 1040.

Name(s) shown on Form 1040

Cat. No. 37621P Form 8889 (2005)

HSA contributions you made for 2005 (or those made on your behalf), including those made

from January 1, 2006, through April 17, 2006, that were for 2005. Do not include employer

contributions or rollovers (see page 2 of the instructions)

HSA Distributions. If you are filing jointly and both you and your spouse each have separate HSAs,

complete a separate Part II for each spouse.

12a Total distributions you received in 2005 from all HSAs (see page 4 of the instructions)

Unreimbursed qualified medical expenses (see page 4 of the instructions)

c

15a

Taxable HSA distributions. Subtract line 13 from line 12c. If zero or less, enter -0-. Also, include

this amount in the total on Form 1040, line 21. On the dotted line next to line 21, enter “HSA”

and the amount 14

Add lines 6 and 7

Subtract line 9 from line 8. If zero or less, enter -0- 

HSA deduction. Enter the smaller of line 2 or line 10 here and on Form 1040, line 25

6

7

8

11

12a

12b

Attachment

Sequence No. 138

b

For Paperwork Reduction Act Notice, see page 5 of the instructions.

4

5

10

 See separate instructions.

If any of the distributions included on line 14 meet any of the Exceptions to the Additional

10% Tax (see page 5 of the instructions), check here 

Additional 10% tax (see page 5 of the instructions). Enter 10% (.10) of the distributions included

on line 14 that are subject to the additional 10% tax. Also include this amount in the total on

Form 1040, line 63. On the dotted line next to line 63, enter “HSA” and the amount

HSA Contributions and Deduction. See page 2 of the instructions before completing this part. If you are

filing jointly and both you and your spouse each have separate HSAs, complete a separate Part I for each

spouse (see page 2 of the instructions).

Distributions included on line 12a that you rolled over to another HSA. Also include any excess

contributions (and the earnings on those excess contributions) included on line 12a that were

withdrawn by the due date of your return (see page 4 of the instructions)

Subtract line 12b from line 12a 12c

13 13

14

b

15b

Social security number of HSA

beneficiary. If both spouses have

HSAs, see page 2 of the instructions 

3

Part I

1

2

3

6

If you were age 55 or older at the end of 2005, married, and you or your spouse had family

coverage under an HDHP at any time during 2005, enter your additional contribution amount

(see page 4 of the instructions) 7

Caution: If line 2 is more than line 11, you may have to pay an additional tax (see page 4 of the

instructions).

Before you begin: Complete Form 8853, Archer MSAs and Long-Term Care Insurance Contracts, if required.

Check the box to indicate your coverage under a high-deductible health plan (HDHP) during

2005 (see page 2 of the instructions)  Self-only Family

If you were under age 55 at the end of 2005, and on the first day of every month during 2005, you

were an eligible individual with the same annual deductible and coverage, enter the smaller of:

● Your annual deductible (see page 2 of the instructions), or

● $2,650 ($5,250 for family coverage).

All others, enter the limit from the worksheet on page 3 of the instructions

Enter the amount you and your employer contributed to your Archer MSAs for 2005 from Form

8853, lines 3 and 4. If you or your spouse had family coverage under an HDHP at any time during

2005, also include any amount contributed to your spouse’s Archer MSAs

Subtract line 4 from line 3. If zero or less, enter -0-

Enter the amount from line 5. But if you and your spouse each have separate HSAs and had

family coverage under an HDHP at any time during 2005, see the instructions on page 3 for the

amount to enter.

2

5

4

Employer contributions made to your HSAs for 2005

8

9

10

11

9

2005

Part II

015

035

025

045

055

065

075

085

095

105

115

125

135

145

155

165

175

185

195

B-190

010
Form 8891

Department of the Treasury

U.S. Information Return for Beneficiaries of

Certain Canadian Registered Retirement Plans

 Attach to Form 1040.  See instructions on back of form.

OMB No. 1545-0074

Attachment

Sequence No. 139

Name shown on Form 1040 Identifying number (see instructions)

1 2

3 4

5

6a

b

c

7a

8

9

10

a

b

c

d

e

7b

10a

10b

10c

10d

10e

Name of plan custodian Account number of plan

Address of plan custodian Type of plan (check one box):

Registered Retirement Savings Plan (RRSP)

Registered Retirement Income Fund (RRIF)

Check the applicable box for your status in the plan (see Definitions in the instructions):

Beneficiary

Annuitant (Complete only lines 7a, 7b, and 8.)

Have you previously made an election under Article XVIII(7) of the U.S.–Canada income tax treaty to

defer U.S. income tax on the undistributed earnings of the plan? 

If “Yes,” enter the first year the election came into effect and go to line 7a. If “No,” go to line 6c.

If you have not previously made the election described on line 6a above, you can make an irrevocable

election for this year and subsequent years by checking this box 

Distributions received from the plan during the year. Enter here and include on Form 1040,

line 16a

Taxable distributions received from the plan during the year. Enter here and include on

Form 1040, line 16b

Plan balance at the end of the year. If you checked the “Annuitant” box on line 5, the “Yes” box

on line 6a, or the box on line 6c, stop here. Do not complete the rest of the form

Contributions to the plan during the year

Undistributed earnings of the plan during the year:

Interest income. Enter here and include on Form 1040, line 8a

Qualified dividends. Enter here and include on Form 1040, line 9b

Capital gains. See the instructions for Form 1040, line 13, for how to report

Other income. Enter here and include on Form 1040, line 21. List type and amount 

For Paperwork Reduction Act Notice, see page 2. Cat. No. 37699X Form 8891 (2005)

Yes No

b Total ordinary dividends. Enter here and include on Form 1040, line 9a

7a

8

9

Internal Revenue Service

2005

020 030

035 040 050 060 070 080 090 100

110

120

130

140

150 160

170

180

230

220

210

200

190

260

250

240

*270 "STM nn"

+280

B-191
Draft as of

06/23/2005

OMB No. 1545-1914 Low Sulfur Diesel Fuel Production Credit

Form 8896

 Attach to your tax return. Attachment

Sequence No. 142 Department of the Treasury

Internal Revenue Service

Name(s) shown on return Identifying number

Current Year Credit 

1 Low sulfur diesel fuel produced (in gallons) 1

2 Multiply line 1 by $.05 2

5

6

3 Qualified capital costs limitation (see instructions)

6

Form 8896 (2005)

Part I

Enter the smaller of line 5 or line 2

Cat. No. 37704F

Section references are to the Internal

Revenue Code.

Use Form 8896 to claim the low sulfur

diesel fuel production credit.

General Instructions

Purpose of Form

For Paperwork Reduction Act Notice, see page 2.

Allowable Credit (See Who must file Form 3800 to find out if you complete Part II or file Form 3800.)

● Individuals. Enter the amount from Form 1040, line 44

9

Corporations. Enter the amount from Form 1120, Schedule J, line 3; Form 1120-A,

Part I, line 1; or the applicable line of your return

●

●

12a 12a

b Credits from Form 1040, lines 48 through 54 12b

Foreign tax credit

Possessions tax credit (Form 5735, line 17 or 27)

Credit for fuel from a nonconventional source

Qualified electric vehicle credit (Form 8834, line 20)

Add lines 12a through 12e 12f

13 Net income tax. Subtract line 12f from line 11. If zero, skip lines 14 through 17 and enter -0- on line 18 13

10 Alternative minimum tax:

● Individuals. Enter the amount from Form 6251, line 35

● Corporations. Enter the amount from Form 4626, line 14 10

● Estates and trusts. Enter the amount from Form 1041, Schedule I, line 56

14

Tentative minimum tax (see instructions):

● Individuals. Enter the amount from Form 6251, line 33

15

● Corporations. Enter the amount from Form 4626, line 12

● Estates and trusts. Enter the amount from Form 1041,

Schedule I, line 54

15 Enter 25% (.25) of the excess, if any, of line 14 over $25,000 (see

instructions)

17

Subtract line 17 from line 13. If zero or less, enter -0-

17

18

Credit allowed for the current year. Enter the smaller of line 8 or line 18 here and on Form

1040, line 55; Form 1120, Schedule J, line 6d; Form 1120-A, Part I, line 2; Form 1041, Schedule

G, line 2c; or the applicable line of your return. If line 18 is smaller than line 8, see instructions 19

Part II



9 Regular tax before credits:

11 Add lines 9 and 10 11

16

Enter the greater of line 15 or line 16

 16

c

d

e

12c

12d

Estates and trusts. Enter the sum of the amounts from Form 1041, Schedule G, lines 1a

and 1b, or the amount from the applicable line of your return

Net regular tax. Subtract line 12f from line 9. If zero or less, enter -0-

19

18



12e

f

14

4 Total low sulfur diesel fuel production credits allowed for all prior tax years

5 Subtract line 4 from line 3

refiner’s qualified capital costs limitation on

line 3. This credit is part of the general

business credit.

8 Current year credit. Add lines 6 and 7 8

3

4

If you are a— Then enter the credit(s) from—

a Shareholder Schedule K-1 (Form 1120S), box 13, code F, G, or U

7

7

b Partner

c Patron

Schedule K-1 (Form 1065), box 15, code F, G, or U

Written statement from cooperative

Low sulfur diesel

fuel production

credits from

pass-through

entities: 

The credit generally is 5 cents for every

gallon of low sulfur diesel fuel produced by

a qualified small business refiner during the

tax year. However, the total credits allowed

for all tax years cannot be more than the

Definitions

This is diesel fuel with a sulfur content of

15 parts per million or less.

Low Sulfur Diesel Fuel

production for all facilities that did not

exceed 205,000 barrels for the 1-year

period ending on December 31, 2002. To

figure the average daily domestic refinery

run or retained production, only include

refineries that were refineries of the refiner

or a related person (within the meaning of

section 613A(d)(3)) on April 1, 2003.

However, a refiner is not a small business

refiner for a tax year if more than 1,500

individuals are engaged in the refinery

operations of the business on any day

during the tax year.

A small business refiner generally is a

refiner of crude oil with an average daily

domestic refinery run or average retained

Small Business Refiner

2005

020

030

040

050

060

070

080

090

200

210

220

230

240

250

260

270

280

290

300

310

320

330

340

350

B-192
Information on Qualifying Children OMB No. 1545-0074

Who Are Not Dependents

(For Child Tax Credit)

Form 8901

Complete and attach to Form 1040A or Form 1040. Department of the Treasury

Internal Revenue Service

Attachment

Sequence No. 56

Name(s) shown on return Your social security number



8901

1040A

1040

. . . . . . . . . .

(99)

2005

Do not use this form for any child who is claimed as your dependent on Form 1040A or

Form 1040, line 6c.

It will take us longer to process your return and issue your refund if you do not complete all

columns for each qualifying child.

Be sure the child’s name and social security number (SSN) agree with the child’s social security

card. Otherwise, at the time we process your return, we may reduce or disallow your child tax

credit. If the name or SSN on the child’s social security card is not correct, call the Social

Security Administration at 1-800-772-1213.

●

●

● CAUTION

Qualifying Child Information

(a) First name Last name

(b) Child’s

social security number

(c) Child’s relationship to you

(son, daughter, etc.)

Child 1

Child 2

Child 3

Child 4

For Paperwork Reduction Act Notice, see above. Cat. No. 37710J Form 8901 (2005)

Paperwork Reduction Act Notice. We ask for the

information on this form to carry out the Internal Revenue

laws of the United States. You are required to give us the

information. We need it to ensure that you are complying

with these laws and to allow us to figure and collect the right

amount of tax.

The average time and expenses required to complete and

file this form will vary depending on individual circumstances.

For the estimated averages, see the instructions for your

income tax return.

Who Must File

Use Form 8901 to give the IRS information on any qualifying

child (defined on back) who is not your dependent. To figure

the amount of your child tax credit, see the instructions for

Form 1040A, line 33, or Form 1040, line 52.

Purpose of Form

You are not required to provide the information requested

on a form that is subject to the Paperwork Reduction Act

unless the form displays a valid OMB control number. Books

or records relating to a form or its instructions must be

retained as long as their contents may become material in

the administration of any Internal Revenue law. Generally, tax

returns and return information are confidential, as required by

Internal Revenue Code section 6103.

General Instructions

● You, or your spouse if filing jointly, can be claimed as a

dependent on someone else’s 2005 return.

● Your qualifying child is married and files a joint return for

2005 (unless that joint return is filed only as a claim for a

refund and no tax liability would exist for either spouse if

they had filed separate returns).

Use Form 8901 if your qualifying child is not your dependent

because either of the following applies.

If you have suggestions for making this form simpler, we

would be happy to hear from you. See the instructions for

your income tax return.

Specific Instructions

If your child was born and died in 2005 and you do not have

an SSN for the child, you can attach a copy of the child’s

birth certificate instead and enter “Died” in column (b).

If you do not have an SSN for your adopted child, enter

“See page 2” in column (b). Then, on the bottom of page 2,

enter the name and address of any agency or agent (such as

an attorney) that assisted in the adoption.

Column (b)

*010 "STM nn" +020

+030

+040 +050

060 070

080

090

200

100

120 150

160 170

180

190

110 140

130

B-193
Draft as of

12/14/2005

Form 8903 Domestic Production Activities Deduction

OMB No. 1545-xxxx

Department of the Treasury

Internal Revenue Service

Attachment

Sequence No. 143

Name(s) as shown on return Identifying number

1 Domestic production gross receipts 1

2 Allocable cost of goods sold 2

3 Directly allocable deductions, expenses, or losses 3

4 Indirectly allocable deductions, expenses, or losses 4

5 Add lines 2 through 4 5

8

8 Qualified production activities income. Add lines 6 and 7. If zero or less, enter -0- here,

skip lines 9 through 15, and enter -0- on line 16

10

10 Enter the smaller of line 8 or line 9. If zero or less, enter -0- here, skip lines 11 through 15,

and enter -0- on line 16

11 Enter 3% of line 10 11

12 Form W-2 wages (see instructions) 12

15 Form W-2 wage limitation. Enter 50% of line 14 15

19

Domestic production activities deduction. Combine lines 16 through 18 and enter the result 

here and on Form 1040, line 35; Form 1120, line 25; Form 1120-A, line 21; or the applicable 

line of your return

19

Cat. No. 37712F Form 8903 (2005)

6 Subtract line 5 from line 1 6

7 Qualified

production

activities income

from passthrough

entities:

7

9

9 Income limitation (see instructions):

● Individuals, estates, and trusts. Enter your adjusted gross income figured without the 

domestic production activities deduction

● All others. Enter your taxable income figured without the domestic production 

activities deduction (tax-exempt organizations, see instructions)

13

13

14 Add lines 12 and 13 14

16 Enter the smaller of line 11 or line 15 16

17

Domestic production activities deduction from cooperatives. Enter deduction from Form

1099-PATR, box 6

17

If you are a—

a Shareholder

b Partner

Then enter the total qualified production activities income from—

Schedule K-1 (Form 1120S), box 12, code Q

Schedule K-1 (Form 1065), box 13, code U

Schedule K-1 (Form 1065-B), box 9, code S2

Form W-2

wages

from passthrough

entities:

If you are a—

a Shareholder

b Partner

Then enter the total Form W-2 wages from—

Schedule K-1 (Form 1120S), box 12, code R

Schedule K-1 (Form 1065), box 13, code V

Schedule K-1 (Form 1065-B), box 9, code S3

18 Expanded affiliated group allocation (see instructions) 18

2005

 Attach to your tax return.  See separate instructions.

For Paperwork Reduction Act Notice, see separate instructions.







c Beneficiary Schedule K-1 (Form 1041), box 14, code C

c Beneficiary Schedule K-1 (Form 1041), box 14, code D

Printed on Recycled Paper

010

020

030

040

050

060

070

100

210

230

240

310

320

370

380

390

510

520

530

B-194
Form 8914 Exemption Amount for Taxpayers Housing

Not Available as of December 29, 2005 

B-195
Draft as of

12/05/2005

Form

Department of the Treasury

Internal Revenue Service

Qualified Hurricane Katrina Retirement

Plan Distributions and Repayments

OMB No. 1545-0074

 Attach to Form 1040, Form 1040A, or Form 1040NR. Attachment

Sequence No. 156

Total Distributions From All Retirement Plans (Including IRAs) (See instructions.)

1

5 If you completed column (c), enter the excess of the amount on line 4, column (a), over $100,000.

Otherwise, enter the excess of the amount on line 4, column (a), over the amount on line 4, column 

(b). Report these distributions under the normal rules in accordance with the instructions for your 

tax return or, if applicable, on line 21 of this form

10

11

Part I

For Paperwork Reduction Act Notice, see instructions. Cat. No. 37726T Form 8915 (2005)

8915

Name. If married, file a separate form for each spouse required to file Form 8915. See instructions. Your social security number

5

10

Part II Qualified Hurricane Katrina Distributions From Retirement Plans (other than IRAs)

Amount subject to tax in 2005. Subtract line 10 from line 9. If zero or less, enter -0-. Include

this amount in the total on Form 1040, line 16b; Form 1040A, line 12b; or Form 1040NR, line

17b

Enter the total amount of any repayments you made before filing your 2005 tax return. But do

not include repayments made later than the due date (including extensions) for that return.

See instructions

2005

 Fill in Your Address Only

if You are Filing This

Form by Itself and Not

With Your Tax Return

Home address (number and street, or P.O. box if mail is not delivered to your home)

City, town or post office, state, and ZIP code

Complete lines 1 through 4 of one column

before going to the next column

(a)

Total distributions

for 2005

(b)

Qualified distributions

received after August 24,

2005 (see instructions)

(c)

Allocation of column (b)

(see instructions)

Distributions from retirement plans 

2 Distributions from traditional, SEP, and SIMPLE IRAs 

3 Distributions from Roth IRAs 

4 Totals. Combine lines 1 through 3 in columns (a) and (b).

Complete column (c) only if line 4, column (b), is more than

$100,000 100,000

6 Enter the total amount of your qualified Hurricane Katrina distributions from retirement plans

received after August 24, 2005. If you completed Part I, column (c), do not enter more than the

amount from line 1, column (c). See instructions 6

7 Enter the applicable cost of distributions, if any. See instructions 7

8 Subtract line 7 from line 6 8

9

9

11

If you elect NOT to spread the taxable amount over 3 years, check this box  

and enter the amount from line 8. You must check this box if you check

the box on line 17. Otherwise, divide line 8 by 3.0 

Apt. no.

00

025

030 035 040

060 070 080

090 100 110

120 130 140

150 160

170

180

190

200

236

245

260

232

B-196
Draft as of

12/05/2005

Qualified Hurricane Katrina Distributions From Traditional, SEP, SIMPLE, and Roth IRAs

13

Did you receive a qualified Hurricane Katrina distribution from a traditional, SEP, SIMPLE, or Roth 

IRA that is required to be reported on Form 8606?

12

Form 8915 (2005)

Part III

Part IV

EIN 

Qualified Distributions for the Purchase or Construction of a Main Home

in the Hurricane Katrina Disaster Area

Complete this section only if you received a qualified distribution after February 28, 2005, and before August 29,

2005, and you did not purchase or construct the home due to Hurricane Katrina.

Date Preparer’s SSN or PTIN

Paid

Preparer’s

Use Only

Preparer’s

signature

Check if self-  employed 

 Firm’s name (or yours

if self-employed),

address, and ZIP code Phone no. ( )

Form 8915 (2005) Page 2

Yes. Go to line 13. No. Skip lines 13 and 14, and go to line 15.

13 Enter the amount, if any, from Form 8606, line 15b

14 Enter the amount, if any, from Form 8606, line 25b 14

15

Enter the total amount of your qualified Hurricane Katrina distributions from IRAs received after 

August 24, 2005, and not reported on Form 8606. If you completed Part I, column (c), do not

enter more than the amount from line 2, column (c). See instructions

15

16

17

18

16 Add lines 13, 14, and 15

If you elect NOT to spread the taxable amount over 3 years, check this box  

and enter the amount from line 16. You must check this box if you checked

the box on line 9. Otherwise, divide line 16 by 3.0

17

Enter the total amount of any repayments you made before filing your 2005 tax return. But do

not include any repayments made later than the due date (including extensions) for that

return. See instructions

18

Amount subject to tax in 2005. Subtract line 18 from line 17. If zero or less, enter -0-. Include

this amount in the total on Form 1040, line 15b; Form 1040A, line 11b; or Form 1040NR, line 16b

19

Before you begin: Complete Form 8606, Nondeductible IRAs, if required.

Did you receive a qualified distribution from a traditional, SEP, SIMPLE, or Roth IRA that is

required to be reported on Form 8606?

20

Yes.

No. Go to line 21.

Complete lines 21 through 25 only if you had qualified distributions not required

to be reported on Form 8606.

21

Enter the total amount of qualified distributions you received after February 28, 2005, and before 

August 29, 2005, for the purchase or construction of a main home. Do not include any amounts

reported on Form 8606. Also, do not include any distributions you reported on line 6 or line 15.

See instructions

21

22 Enter the applicable cost of distributions, if any. See instructions 22

23 Subtract line 22 from line 21 23

24

Enter the total amount of any repayments you made after August 24, 2005, and before March

1, 2006. Do not include any repayments treated as qualified rollovers on Form 8606. See

instructions

24

25 25 Taxable amount. Subtract line 24 from line 23

Please

Sign

Here

Under penalties of perjury, I declare that I have examined this form, including accompanying attachments, and to the best of my knowledge and

belief, it is true, correct, and complete.

Your signature Date

Note: You may be subject to an additional 10% tax on the amount on line 25. See instructions.

● If the distribution is from an IRA, include this amount in the total on Form 1040, line 15b; Form 1040A, line 11b; or

Form 1040NR, line 16b.

● If the distribution is from a retirement plan (other than an IRA), include this amount in the total on Form 1040, line 16b;

Form 1040A, line 12b; or Form 1040NR, line 17b.

Signature. Complete only if you are filing this form by itself and not with your tax return.

Before you begin: Complete Form 8606, Nondeductible IRAs, if required.

19

Printed on Recycled Paper

290

300

310

340

356

365

380

410

420

430

440

450

270 280

352

390

400

B-197
Draft as of

08/30/2005

4 Amount paid: a In cash

b In interest-bearing notes

c In non-interest-bearing notes

5a Amount of other consideration

b Explain the nature of other consideration and how you determined the amount shown on line 5a.

6 Legal expenses

7 Cruising, surveying, and other acquisition expenses

8 Total cost or other basis of property. Add lines 4a through 7

9 Allocation of total cost or other basis on books: Number of units Total cost or other basis Cost or other 

basis per unit Unit

a Forested land Acre

b Other unimproved land Acre

c Improved land (describe)  Acre

Merchantable timber. Estimate the quantity

of merchantable timber present on the

acquisition date (see Regulations section

1.611-3(e)). Details of the timber estimate,

made for purposes of the acquisition, should

be available if your return is examined.

d

Premerchantable timber. Make an allocation

here only if it is a factor in the total cost or

value of the land.

e

f Improvements (list separately)

Mineral rights

h Total cost or other basis (same amount as line 8). Add lines 9a through 9g 





3a Name and address of seller or person from whom property was acquired b Date acquired

Acquisitions

1 Name of block and title of account

2 Location of property (by legal subdivisions or map surveys)

Part I

Form T (Timber) (Rev. 12-2005)

OMB No. 1545-0007 Form Forest Activities Schedule

(Rev. December 2005)  Attach to your tax return.

Attachment

Sequence No. 117 Department of the Treasury

Internal Revenue Service For tax year ended , 20 .

Name(s) as shown on return Identifying number

T (Timber)

Cat. No. 16717G

 See separate instructions.

For Paperwork Reduction Act Notice, see separate instructions.

g

020

030

040 050 060 070 080 090

100

110

120

130

@135 "STM nn"

140

150

160

170 180 190

200 210 220

225

230 240 250

+270 +280 +290

300 310 320 330

340 350 360 370

380 390 400 410

420 430 440 450

460 470 480 490

+510 +520 +530

540 550 560 570

580 590 600 610

620 630 640 650

*660 "STM nn" +680 +690 +700

710 720 730 740 750

760 770 780 790 800

810 820 830 840 850

860 870 880 890 900

910 920 930 940 950

960 970 980 990

@1005 "STM nn" 1000

B-198

*260 "STM nn"

*500 "STM nn"

*+670 "STM nn"
Draft as of

08/30/2005

Form T (Timber) (Rev. 12-2005) Page 2

Unit rate returnable through depletion, or basis of sales or losses. Divide line 7,

column (b), by line 7, column (a)

9 Quantity of timber cut during tax year

10 Depletion for the current tax year. Multiply line 8 by line 9

11 Quantity of standing timber sold or otherwise disposed of during tax year

12 Allowable as basis of sale. Multiply line 8 by line 11

13 Quantity of standing timber lost by fire or other cause during tax year

14 Allowable basis of loss plus any excess amount where decrease in FMV (before

and after the casualty) exceeds the standard depletion amount, but not the

block basis (see instructions)

15 Total reductions during tax year:

a In column (a), add lines 9, 11, and 13

b In column (b), add lines 10, 12, and 14

16 Net quantity and value at end of tax year. In column (a), subtract line 15a from

line 7(a). In column (b), subtract line 15b from line 7(b)

17 Quantity of cut timber that was sold as logs or other rough products

Timber Depletion (see instructions)

Quantity

1 Name of block and title of account 

Cost or

other basis

(b) (a)

2 Estimated quantity of timber and cost or other basis returnable through depletion

at end of the preceding tax year

3 Increase or decrease of quantity of timber required by way of correction

4a Addition for growth (number of years covered  )

b Transfers from premerchantable timber account

c Transfers from deferred reforestation account

5 Timber acquired during tax year

6 Addition to capital during tax year

7 Total at end of tax year, before depletion. Add lines 2 through 6

8

Form T (Timber) (Rev. 12-2005)

Part II

If you express timber quantity in thousand board feet (MBF),

log scale, name the log rule used. If another unit of measure is

used, provide details 

18 Section 631(a):

a

b

Are you electing, or have you made an election in a prior tax year that is in effect, to report gains or

losses from the cutting of timber under section 631(a)? (see instructions)

Are you revoking your section 631(a) election?

Effective date 

Yes No

Yes No

*1040 "STM nn"

1050 1060

1070

1080 1090

1100 1110

1120 1130

1140 1150

1160

1170 1180

1190

1200

1210

1220

1230

1240

1250

1260

1270

1280 1290

1300

B-199

1030

*1045 "STM nn"

1310

@1315 "STM nn" @1325 "STM nn"

1380

@1335 "STM nn" @1345, @1355, @1365 "STM nn"

1370

1390 1400
Draft as of

08/30/2005

Form T (Timber) (Rev. 12-2005) Page 3

3a Purchaser’s name and address b Date of sale

4 Amount received: a In cash

b In interest-bearing notes

c In non-interest-bearing notes

5a

b

6 Total amount received for property. Add lines 4a, 4b, 4c, and 5a

Cost or other

basis per unit 7 Cost or other basis of property: Unit Number of units Total cost or other basis

a Forested land Acre

b Nonforested land Acre

c Improved land (describe)  Acre

Merchantable timber. Estimate in detail the

quantity of merchantable timber on the date

of sale or exchange. Include the quantity of

timber in each species of timber by

diameter at breast height (DBH) classes.

State the log rule used if the unit of measure

is thousand board feet (MBF), log scale. If

another unit of measure is used, provide

details. 

d

e Premerchantable timber

f Improvements (list separately)

g Mineral rights

h Total cost or other basis. Add lines 7a through 7g

i Direct sale expenses (cruising, marking, selling)

8 Profit or loss. Subtract the sum of lines 7h and 7i from line 6





1 Name of block and title of account

2 Location of property (by legal subdivisions or map surveys)

Form T (Timber) (Rev. 12-2005)

Amount of other consideration

Explain the nature of other consideration and how you determined the amount shown on line 5a:

Part III Profit or Loss From Land and Timber Sales (see instructions)

1430

1440

1450 1460 1470 1480 1490

1500

1510

1520

1530

1540

@1545 "STM nn"

1550

1560 1570 1580

1590 1600 1610

1620

1630 1640 1650

+1680 +1690

+1700 1710 1720 1730

1740 1750 1760 1770

1780 1790 1800 1810

1820 1830 1840 1850

1860 1870 1880 1890

1900 1910 1920 1930

1940 1950 1960 1970

1980 1990 2000 2010

2020 2030 2040 2050

2070 2080 2090

2100 2120 2130 2140

*2150 "STM nn" +2160 +2170 +2180 2190 2200

2210 2260 2220 2230 2240 2250

2270 2280 2290 2300

2310 2320 2330 2340

+2380 +2390 2400

2410 2420

*1665 "STM nn"

B-200

@1535 "STM nn"

*+1670 "STM nn" 2060

2110

*2350 "STM nn"

*+2360 "STM nn"

+2370

2430 2440

2450 2460 2470 2480

2490 2500 2510 2520

2530 2540 2550 2560

2570 2580 2590 2595

2600 2610 2620 2630

2640

2660

2650
Draft as of

08/30/2005

Form T (Timber) (Rev. 12-2005) Page 4

Land Ownership

Show all changes in land accounts. Attach as many additional sheets as needed, following the format of lines 1 through 6.

Total cost

or other basis. Give

amount of March 1,

1913 appreciation, if

included

1 Name of block and title of account  Average rate

per acre

Acres

2 Balance at beginning of year

3 Acquisitions during year

4 Sales during year

5 Other changes

Balance at end of year. Add lines 2 and 3, subtract line 4 and

add or subtract line 5

6

Form T (Timber) (Rev. 12-2005)

Reforestation and Timber Stand Activities (see instructions)

Kind of activity (burning, chopping,

spraying, planting, seeding, thinning,

pruning, fertilizing, etc.)

Number of

acres treated

Total

expenditures

Account, block, tract, area, or stand ID for each

Qualified Timber Property (QTP)

Total

Part V

Part IV

Total reforestation expenses

Amount to be amortized under IRC 194(a), including remaining reforestation

expenditures not expensed under section 194(b)

Additional Information.

1

2

3

b

Amount to be expensed under section 194(b). 

(See instructions for limitations)

4a

*2690 "STM nn" *+2700 "STM nn" +2710 +2720

2730 2740 2750 2760

2770 2780 2790 2800

2810 2820 2830 2840

2970 2980

3050

B-201

2850 2860 2870 2880

2890 2900 2910 2920

2930 2940 2950 2960

2990 3000

3020

3040

3070

3100

3130

3080

3110

3140

3060

3090

3120

3150

3180 3190

3170

3200

3160

@3205 "STM nn"
Authentication Record

This record is included with IRS e-file and On-Line returns for taxpayers that use the

PINs instead of Form 8453 or 8453-OL. The following illustrate the fields by their form

field (SEQ nnnn) numbers, just like the preceding forms and schedules. This exhibit is

useful in correcting reject conditions in acknowledgement files for this record.

PIN Type Code

Primary Date of Birth Y Y Y Y MMDD

Primary Prior Year AGI

Primary Taxpayer Signature (PIN)

Spouse Date of Birth Y Y Y Y MMDD

Spouse Prior Year AGI

Spouse Signature (PIN)

Taxpayer Signature Date Y Y Y Y MMDD

Jurat/Disclosure Code

PIN Authorization Code

ERO EFIN/PIN

Signature of Preparer Other Than Taxpayer

Signature Explanation

Fiduciary Name (1)

Fiduciary Title (1)

Fiduciary Name (2)

Fiduciary Title (2)

008

010

020

040

050

065

070

075

080

090

B-202
Allocation Record 

This record is included with IRS e-file and Online returns for taxpayers that use the 

Married Filing Separate filing status in community property states. The following illustrate 

the fields by their form field (SEQ nnnn) numbers, just like the preceding forms and 

schedules. This exhibit is used in correcting reject conditions in acknowledgement files 

for this record.

010

020

030

040

050

060

070

080

090

100

110

120

130

140

150

160

170

B-203

180
Total Rents / Royalties/ 

Partnership / Estates / Trusts

 Husband Rents / Royalties / 

 Partnership / Estates / Trusts 

Wife Rents / Royalties / 

Partnership / Estate / Trust

 Total Other Income 

Husband Other Income 

Wife Other Income 

Total Income 

Husband Total Income 

Wife Total Income 

Total Payments 

Husband Payments 

Wife Payments 

 

 

 

 

 

 

 

 

 

 

 

 

190

200

210

220

230

240

250

260

270

280

290

300

B-204
Form Payment Record

This record is included with IRS e-file and On-Line returns for taxpayers that elect to

pay their balances due by electronic withdrawal. The following illustrates the fields by

their form field (SEQ nnnn) numbers, just like the preceding forms and schedules. This

exhibit is useful in correcting reject conditions in acknowledgement files for this record.

Primary SSN

Secondary SSN

Routing Transit Number

Bank Account Number

Type of Account  1 = Checking; 2 = Savings

Amount of Tax Payment

Tax Type Code  1040E; 1040A; 1040Z; 1040S;

4868E; 2350E; 0709P; 0709S

Requested Payment Date Y Y Y YMMDD

Taxpayer’s Daytime Phone Number

010

020

030

040

050

060

070

080

090

B-205
OMB No. 1545-0074

Form 9465 Installment Agreement Request

Department of the Treasury

Internal Revenue Service

 If you are filing this form with your tax return, attach it to the

front of the return. Otherwise, see instructions.

1 Your first name and initial Last name Your social security number

If a joint return, spouse’s first name and initial Last name Spouse’s social security number

Your current address (number and street). If you have a P.O. box and no home delivery, enter your box number. Apt. number

City, town or post office, state, and ZIP code. If a foreign address, enter city, province or state, and country. Follow the country’s practice for entering the

postal code.

If this address is new since you filed your last tax return, check here 

Your home phone number

Enter the tax year for which you are making this request (for example, 2005) 

Enter the total amount you owe as shown on your tax return (or notice)

Enter the date you want to make your payment each month. Do not enter a date later than the 28th 

Your signature Date Spouse’s signature. If a joint return, both must sign. Date

2

3 4 ( )

7

8

9

11

12

5 6 Name of your bank or other financial institution:

Cat. No. 14842Y

(Rev. November 2005)

Form 9465 (Rev. 11-2005)

Best time for us to call Ext.

Your employer’s name: 

Address

City, state, and ZIP code

Address

City, state, and ZIP code

Your work phone number

( )

Best time for us to call

10 Enter the amount of any payment you are making with your tax return (or notice). See instructions

Caution: Do not file this form if you are currently making payments on an installment agreement. Instead, call 1-800-829-1040.

If you are in bankruptcy or we have accepted your offer-in-compromise, see Bankruptcy or offer-in-compromise on

page 2.

If you want to make your payments by electronic funds withdrawal from your checking account, see the instructions and fill in lines 13a

and 13b. This is the most convenient way to make your payments and it will ensure that they are made on time.

13

Enter the amount you can pay each month. Make your payments as large as possible to limit

interest and penalty charges. The charges will continue until you pay in full

General Instructions

11

10

Enter the tax return for which you are making this request (for example, Form 1040) 

I authorize the U.S. Treasury and its designated Financial Agent to initiate a monthly ACH electronic funds withdrawal entry to

the financial institution account indicated for payments of my federal taxes owed, and the financial institution to debit the entry

to this account. This authorization is to remain in full force and effect until I notify the U.S. Treasury Financial Agent to terminate

the authorization. To revoke payment, I must contact the U.S. Treasury Financial Agent at 1-800-829-1040 no later than 7

business days prior to the payment (settlement) date. I also authorize the financial institutions involved in the processing of the

electronic payments of taxes to receive confidential information necessary to answer inquiries and resolve issues related to

the payments.

 a Routing number

 b Account number

9

For Privacy Act and Paperwork Reduction Act Notice, see page 3.

Section references are to the Internal Revenue Code.

Guaranteed installment agreement. Your request for an

installment agreement cannot be turned down if the tax you

owe is not more than $10,000 and all three of the following

apply.

Purpose of Form

Use Form 9465 to request a monthly installment plan if you

cannot pay the full amount you owe shown on your tax

return (or on a notice we sent you). Generally, you can have

up to 60 months to pay. In certain circumstances, you can

have longer to pay or your agreement can be approved for

an amount that is less than the amount of tax you owe. But

before requesting an installment agreement, you should

consider other less costly alternatives, such as a bank loan

If you do not wish to enter into an installment agreement

on Form 9465, the IRS offers alternative payment options.

Some of these options that you may qualify for are:

● 120 day extension to pay, and

● Payroll deduction installment ageement.

For information on these and other methods of payment,

call 1-800-829-1040.

or credit card payment. If you have any questions about this

request, call 1-800-829-1040.

010

015

020

030

035

040

050 060

070 080 090

100

110 120 130 140

150

160

170

180 190 200

210

220

230 240 250

260

270

290

300

310

330

340

B-206

155

280

380 390
Form 56

(Rev. July 2004) Notice Concerning Fiduciary Relationship OMB No. 1545-0013

Department of the Treasury

Internal Revenue Service (Internal Revenue Code sections 6036 and 6903)

Identification

Name of person for whom you are acting (as shown on the tax return) Identifying number

Address of person for whom you are acting (number, street, and room or suite no.)

City or town, state, and ZIP code (If a foreign address, see instructions.)

Fiduciary’s name

Address of fiduciary (number, street, and room or suite no.)

City or town, state, and ZIP code Telephone number (optional)

Authority

1 Authority for fiduciary relationship. Check applicable box:

a(1) Will and codicils or court order appointing fiduciary (2) Date of death

b(1) Court order appointing fiduciary (2) Date (see instructions)

c Valid trust instrument and amendments

d Other. Describe  

Nature of Liability and Tax Notices

2 Type of tax (estate, gift, generation-skipping transfer, income, excise, etc.)  

3 Federal tax form number (706, 1040, 1041, 1120, etc.)  

4 Year(s) or period(s) (if estate tax, date of death) 

Revocation or Termination of Notice

Section A—Total Revocation or Termination

Check this box if you are revoking or terminating all prior notices concerning fiduciary relationships on file with the Internal

Revenue Service for the same tax matters and years or periods covered by this notice concerning fiduciary relationship 

7

Reason for termination of fiduciary relationship. Check applicable box:

a Court order revoking fiduciary authority

b Certificate of dissolution or termination of a business entity

c Other. Describe 

Section B—Partial Revocation

Check this box if you are revoking earlier notices concerning fiduciary relationships on file with the Internal Revenue Service for

the same tax matters and years or periods covered by this notice concerning fiduciary relationship 

8a

Specify to whom granted, date, and address, including ZIP code.



b

For Paperwork Reduction Act and Privacy Act Notice, see back page. Form 56 (Rev. 7-2004)

Part IV

Part I

Part II

Part III

( )

Cat. No. 16375I

Decedent’s social security no.

5 If the fiduciary listed in Part I is the person to whom notices and other written communications should be sent for all items

described on lines 2, 3, and 4, check here 

6 If the fiduciary listed in Part I is the person to whom notices and other written communications should be sent for some (but not all)

of the items described on lines 2, 3, and 4, check here  and list the applicable Federal tax form number and the year(s) or

period(s) applicable

Section C—Substitute Fiduciary

Check this box if a new fiduciary or fiduciaries have been or will be substituted for the revoking or terminating fiduciary and

specify the name(s) and address(es), including ZIP code(s), of the new fiduciary(ies) 

9



010

020

030

050

060 070 080

040

090 100 110 120

130

140

150

160 170 180 190 200 210 220 225 230

240 250

260 270

280

290 300

310

320

330 332 334 340 342 344 350

360

370

380

390 400

410

420 425 430 440 450 460 462

470

480 482 485 487 490 492

B-207

351

352

353 354 355 356 357 358 359
Court and Administrative Proceedings

Name of court (if other than a court proceeding, identify the type of proceeding and name of agency) Date proceeding initiated

Address of court Docket number of proceeding

City or town, state, and ZIP code Date Time a.m. Place of other proceedings

p.m.

I certify that I have the authority to execute this notice concerning fiduciary relationship on behalf of the taxpayer.

Please

Sign

Here  Fiduciary’s signature Title, if applicable Date

Page 2

Part V

Form 56 (Rev. 7-2004)

Part VI Signature

Form 56 (Rev. 7-2004)

500 503 508

540 550 560 570 580 590

610 620 630

510

520 530

B-208
OMB No. 1545-0074 Application for Extension of Time 2350 To File U.S. Income Tax Return Form

Department of the Treasury

Internal Revenue Service

For U.S. Citizens and Resident Aliens Abroad Who Expect To Qualify for Special Tax Treatment

or other tax year ending , because my tax home is in a foreign country and I expect to qualify

for special tax treatment by meeting the “bona fide residence test” or the “physical presence test” (see instructions).

1

2 Were you previously granted an extension of time to file for this tax year? Yes No

3 Will you need additional time to allocate moving expenses? Yes No

4a Date you first arrived in the foreign country

b Date qualifying period begins ; ends

c Your foreign home address

d Date you expect to return to the United States

Note. This is not an extension of time to pay tax. Full payment is required to avoid interest and late payment charges.

5 Enter the amount of income tax paid with this form  5

Signature and Verification

Signature of taxpayer  Date 

Signature of spouse 

Signature of preparer

other than taxpayer 

For Privacy Act and Paperwork Reduction Act Notice, see page 4. Cat. No. 11780H Form 2350 (2005)

 See instructions on page 3.

Date 

Date 

Please fill in the Return Label below with your name, address, and social security number. The IRS will complete the Notice to Applicant and

return it to you. If you want it sent to another address or to an agent acting for you, enter the other address and add the agent’s name.

Notice to

Applicant

We have approved your application.

We have not approved your application.

However, we have granted a 45-day grace period to . This grace period is

considered a valid extension of time for elections otherwise required to be made on a timely return.

We have not approved your application. After considering the above information, we cannot grant your

request for an extension of time to file. We are not granting a 45-day grace period.

We cannot consider your application because it was filed after the due date of your return.

Other 

Director Date

Under penalties of perjury, I declare that I have examined this form, including accompanying schedules and statements, and to the best of my knowledge and belief,

it is true, correct, and complete; and, if prepared by someone other than the taxpayer, that I am authorized to prepare this form.

Please fill in the Return Label at the bottom of this page.

To Be

Completed

by the IRS

(Do not detach)

Your first name and initial Last name Your social security number

If a joint return, spouse’s first name and initial Last name Spouse’s social security number

Taxpayer’s name (and agent’s name, if applicable). If a joint return, also give spouse’s name.

Number and street (include suite, room, or apt. no.) or P.O. box number

City or town, province or state, and country (including postal or ZIP code)

Please

print or

type.

File by

the due

date for

filing

your

return.

Taxpayer’s social security number

Spouse’s social security number

Return Label(Please print or type)

Home address (number and street)

City or town, province or state, and country (including postal or ZIP code)

Agents:

Always include taxpayer’s name on Return Label.

2005

I request an extension of time until to file my income tax return for the calendar year 2005,

010

020

030

040

050

060

070

080 090 100

110

120 130 150

160

170

180 190

200 210

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230 240

250

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355

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370 380

400 410

470

480

B-209

430

440 450 460

390
Application for Automatic Extension of Time OMB No. 1545-0074

To File U.S. Individual Income Tax Return Form 4868

Department of the Treasury

Internal Revenue Service

Your social security number

Your name(s) (see instructions)

Spouse’s social security number

Address (see instructions)

City, town, or post office

For Privacy Act and Paperwork Reduction Act Notice, see page 4. Cat. No. 13141W

1

2 3

4 Estimate of total tax liability for 2005 $

Total 2005 payments

Balance due. Subtract line 5 from line

4 (see instructions)

5

6

 DETACH HERE 

OMB No. 1545-0074 Application for Automatic Extension of Time

To File U.S. Individual Income Tax Return Form 4868

Department of the Treasury

Internal Revenue Service

Part I Part II Identification Individual Income Tax

7 Amount you are paying (see instructions) 

For calendar year 2005, or other tax year beginning , 2005, ending , 200 .

Form 4868 (2005)

(99)

It’s Convenient,

Safe, and Secure

IRS e-file is the IRS’s electronic filing program. You can get an

automatic extension of time to file your tax return by filing Form

4868 electronically. You will receive an electronic

acknowledgment once you complete the transaction. Keep it

with your records. Do not send in Form 4868 if you file

electronically.

If you think you may owe tax and wish to make a payment,

you can pay by electronic funds withdrawal using option 1 or

you can pay by credit card using option 2. See 1 and 2 on this

page for details.

Complete Form 4868 to use as a worksheet. If you think you

may owe tax when you file your return, you will need to estimate

your total tax liability and subtract how much you have already

paid (lines 4, 5, and 6 below).

E-file Using Your Personal

Computer or Through a Tax

Professional

Refer to your tax software package or tax preparer for ways to

file electronically. Be sure to have a copy of your 2004 tax

return—you will be asked to provide information from the return

for taxpayer verification. If you wish to make a payment, you can

pay by electronic funds withdrawal (see page 4) or send your

payment to the address shown in the middle column under

Where To File a Paper Form 4868 on page 4.

E-file and Pay by Credit

Card

You can get an extension if you pay part or all of your estimate

of income tax due by using a credit card (American Express®

Card, Discover® Card, MasterCard® card, or Visa® card). Your

payment must be at least $1. You can pay by phone or over the

Internet through one of the service providers listed below.

Official Payments Corporation

1-888-PAY-1040sm

Link2Gov Corporation

1-800-2PAY-TAXsm

File a Paper Form 4868

If you wish to file on paper instead of electronically, fill in the

Form 4868 below and mail it to the address shown on

page 4. If you are a fiscal year taxpayer, you must file a paper

Form 4868.

1

2

Each service provider will charge a convenience fee based on

the amount of the tax payment you are making. Fees may vary

between service providers. You will be told what the fee is

during the transaction and will have the option to continue or

cancel the transaction. You can also obtain the convenience fee

by calling the providers’ toll-free automated customer service

numbers or visiting their websites. Do not add the convenience

fee to your tax payment.

(1-800-272-9829)

1-877-754-4413 (Customer Service)

www.officialpayments.com

(1-888-729-1040)

1-888-658-5465 (Customer Service)

www.PAY1040.com

2005

2005

Caution: Incorrect or missing information may cause a delay in processing.

8 Check here if you are “out of the country” and a U.S.

citizen or resident 

State ZIP code

Enter confirmation number here 

What’s New

● You can now use Form 4868 to obtain an automatic 6-month

extension (generally 4 months if you are “out of the country”).

You no longer need to file Form 2688 for an additional extension

of time. See General Instructions on page 2.

● If you are “out of the country” and are a U.S. citizen or

resident, you must check the box on line 8. See When To File

Form 4868 on page 2 and the instructions for line 8 on page 3.

Confirmation number. You will receive a confirmation number

when you pay by credit card. Enter the confirmation number

below and keep for your records.

010 

030

032

034 036

120

130

140

150

090 100 B-210

040

050 060 070

080

160
Department of the Treasury

Internal Revenue Service

www.irs.gov

Publication 1345A (Rev.12-05)

Catalog Number 15713E

IRS

OS:CIO:I:ET:S:SP 

C4-236 NCFB 

5000 Ellin Road 

Lanham, MD 20706 

Official Business

Penalty for Private Use, $300

Presorted Standard 

Postage and Fees Paid 

Internal Revenue Service 

Permit No. G-48