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| Calendar year 1960, or other taxable year beginning -....

U.S. Treasury Department—Intarnal Revenue Service
STATEMENT OF EXPENSES FOR CARE OF CHILDREN AND
CERTAIN OTHER DEPENDENTS

++ 1980, and ending ..----.......-

(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 Form 1040W, or if you

file Form 1040A

Name of taxpayer claiming the deduction ....

2. Marital status of taxpayer as of the time the expenses were incurred (check appropriate box):

O Single; O Married; O Widow;

3. Name of child or other dependent for whom
expenses were paid

5. Total amount of expenses paid

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

1. Balance (line 5 less line 6)............ 00: c cece e scence eee ee

8. Enter the amount on line 7 or $600, whichever is lesser. This is the allowable deduction for personsother than working wives.

9. Limitation for working wives (see instruction F):

O Widower;

If under 12 years of
age, please check

C1 Divorced; CD Legally separated.

If 12 years of age or over, explain reason for expenses
(see instruction B)

(a) Enter amount shown on line 11, page 1, of your joint return, Form 1040 or on line 6, page

1, of your joint return, Form 1040W ....
() Less... cee

(©) Balance 2.0... 00.22.60 eee cece cece

10. Allowable deduction for working wives (line 8 less line 9) .

(Enter the amount on line 8 or line 10, whichever is applicable, under

‘Other Deductions’’ on page 2 of your return.)

INSTRUCTIONS,

A. A deduction not to exceed $600 is allowed for expenses paid
during the year by a woman or a widower for the care of one or
more dependents if such care is for the purpose of enabling such
taxpayer to be gainfully employed. The term “widower means a
man who has not remarried since his wife died or since he was
divorced. It also includes a man who is legally separated from his
wife. 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 12 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 dependent,
(2) it must be for a dependent’s care while the taxpayer is gaintully
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 expended
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, cioth
ing, 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 pay-
ments for other benefits which are inseparably a part of the care,
the full amount will be considered to be incurred for care, Thus,
the full amount paid fo a nursery schoo! will be considered to be for
the care cf the child, even though the school aiso 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
quelities 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 woman who is married at the time
the expenses are incurred and whose husband 1s capable of self-
support, the deduction is allowed only if she files a joint return with
her husband for the year in which the expenses are paid. Further-
more the amount on line 8 must be reduced by the amount, if any,
by which the combined adjusted gross income (line 9(a) above) of the
taxpayer and her husband exceeds $4,500. This reduction does not
apply if the husband is physically or mentally incapable of caring for
himself. However, in such case enter on the reverse side of this form:
(1) nature of husband's disabihty, (2) the period of the disability, and
(3) the amount, if any, of the husband's earnings during the period.

U.S. GOVERNMENT PRINTING OFFICE : 19600-85618