vo 2441

U.S. Treasury Department
Internal Revenue Service

1.1966, and ending -

Statement of Expenses for Care of Children
and Certain Other Dependents

For the year January 1-December 31, 1966, or other taxable year beginning

1966

1 19.

(ATTACH - THIS STATEMENT TO YOUR INDIVIDUAL INCOME TAX RETURN)
The deduction for ‘‘child care” is not allowable if you take the standard deduction on Form 1040 or if you file Form 1040A

Name of taxpayer claiming the deduction .....

N

CO Single
( Married man—Wife institutionalized

Married woman
C1 Widow
Note: If you checked more than one box do not use this form.

Name of child or other dependent for whom
expenses were paid

w

o
Oo

o

2

(J Married woman—Husband incapacitated
(0 Widower
Contact any Internal Revenue Service office for further information.

If under 13 years of
age, please check

Status of taxpayer as of the time the expenses were incurred (check appropriate box):

( Married man—Wife incapacitated

CO Divorced J Legally separated.

If 13 years of age or over, explain reason for expenses
(see instruction B)

Person(s) or organization(s) to whom payments were made and amount paid to each:

COMPUTATION OF DEDUCTION

Total amount of expenses paid

Amount, if any, paid for services other than direct care of dependent(s) listed in line 3 (see instruction D)

Enter the amount from line 7 or $600 ($900 i if two or more dependents), whichever is lesser (eee instruction a”

5

6

7 Balance (line 5 less line 6)
8

9

Limitation for taxpayers filing a joint return (see instruction F):

(a) Enter amount shown on line 9, page 1, of your joint return, Form 1040. . . 1 1 ee $n

(b) Less

(@) Balance

10 Allowable deduction for taxpayers filing a joint return (line 8 less line 9) : oe Foe
11 Enter the amount on line 8 or line 10, whichever is applicable, here and in ‘Miscellaneous deductions,” Part IV, page 2, Form

1040

6,000.00

INSTRUCTIONS

A. A deduction not to exceed $600 for the care of one depend-
ent, $900 for the care of two or more dependents, is allowed for
expenses paid during the year by a woman or a widower if such
care is for the purpose of enabling such taxpayer to be gainfully
employed. However, if circumstances occurred which would
change the maximum deduction, for example, $900 to $600, while
these expenses were being incurred, contact any Internal Revenue
Service office for method of determining the amount of your
deduction. The term “widower” means a man who has not re-
married since his wife died or since he was divorced. _It also
includes a man who is legally separated from his wife. This de-
duction is now allowed a married man for expenses incurred while
his wife is incapacitated if she is physically or mentally incapable
of caring for herself for a period of at least 90 consecutive days
(whether or not within one taxable year) or a shorter period if
terminated by her death. In such case, enter on the reverse side
of this form the nature of her disability and the period of her
incapacitation. The deduction is not allowed for amounts which
you pay to a dependent for the care of another dependent.

B. The only dependents for whom the ‘‘child care’ deduction
is allowed are those who are either (1) under 13 years of age, or
(2) physically or mentally incapable of caring for themselves.

C. In general for this expense to be deductible it must meet
three conditions: (1) The expense must be for the care of a de-
pendent, (2) it must be for a dependent’s care while the taxpayer
is gainfully employed or in search of gainful employment, and
(3) the expense must be for the purpose of enabling the taxpayer
to be gainfully employed. :

D. Expenses for the care of a dependent are amounts ex-
pended for the primary purpose of assuring the dependent’s well-
being and protection. They do not include all benefits which
may be bestowed upon him. Accordingly, amounts expended to

provide food, clothing, or education are not in themselves
amounts expended for ‘care’ so as to be deductible. However,
where the manner of providing care is such that the expense
which must be incurred includes payments for other benefits
which are inseparately a part of the care, the full amount will be
considered to be incurred for care. Thus, the full amount paid
to a nursery school will be considered to be for the care of the
child, even though the school also furnished lunch, recreational
activities, and other benefits. In those cases in which you pay
a person to do both housework and take care of a dependent,
only that part of the expense which is for the dependent’s care
qualifies for the deduction.

E. The deduction is allowed only with respect to such expenses
actually paid during the taxable year regardless of when incurred.

F. If the expenses are paid by a taxpayer who is married at the
time the expenses are incurred, the deduction is allowed if (1)
the wife files a separate return because she has been deserted
by her husband, did not know his whereabouts at any time dur-
ing the year, and has applied to a court to compel him to pay
support or otherwise to comply with the law or a judicial order
(give details on reverse side); (2) taxpayers file a joint return,
in which case, the deduction is reduced by the amount (if any)
by which their combined income, line 9(a) above, exceeds $6,000.
This reduction does not apply if (a) the husband is physically
or mentally incapable of caring for himself or (b) the wife is
institutionalized for a period of at least 90 consecutive days
(whether or not within one taxable year) or a shorter period if
terminated by her death. However, in such case enter on the
reverse side of this form: (1) the nature of disability, (2) the
period of disability, and (3) the amount, if any, of the husband’s
earnings during a pericd when ke is disabled. If the wife is
institutionalized, give the name and location of such institution,
and the exact dates she resided in such institution.

U.S. GOVERNMENT PRINTING OFFICE : 1967 0—245-605