(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

$2,400 for one qualifying person or $4,800 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.

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—10,000 .30 $20,000—22,000 .24

10,000—12,000 .29 22,000—24,000 .23

12,000—14,000 .28 24,000—26,000 .22

14,000—16,000 .27 26,000—28,000 .21

16,000—18,000 .26 28,000—No limit .20

18,000—20,000 .25  .

Multiply line 6 by the decimal amount on line 8. If you paid 2001

expenses in 2002, see the instructions.

For Paperwork Reduction Act Notice, see Form 1040A instructions. Schedule 2 (Form 1040A) 2002

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) 2002 OMB No. 1545-0085

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 2002 for the person

listed in column (a) First Last

● Dependent Care Benefits ● Qualifying Person(s) ● Qualified Expenses ● Earned Income

10 Enter the amount from Form 1040A, line 28. 10

11

11

Credit for child and dependent care expenses. Enter the smaller

of line 9 or line 10 here and on Form 1040A, line 29.
Schedule 2 (Form 1040A) 2002

Enter the total amount of dependent care benefits you received

for 2002. This amount should be shown in box 10 of your W-2

form(s). 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, if any. See the instructions.

Subtract line 13 from line 12.

13 13

14

Enter the total amount of qualified expenses

incurred in 2002 for the care of the qualifying

person(s).

14

15

Enter the smaller of line 14 or 15.

15

16

Enter your earned income.

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 $2,400 ($4,800 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 2001 expenses in 2002, 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) 2002

● 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.