8862 OMB No. 1545-1619

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. 12-2004)

 See back of form.

Name(s) shown on return Your social security number

(Rev. December 2004)

Form

Part I All Filers

1

Yes

Enter the year for which you are filing this form (for example, 2004) 

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 use this form for a year prior to 2002. Instead, use the November 2000 revision of Form 8862.

Do not file this form if, for a year after 2001, 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
Form 8862 (Rev. 12-2004) Page 2

General Instructions

Do not use these instructions for a year prior to 2002.

Instead, use the November 2000 revision of the

Instructions for Form 8862.

Purpose of Form

You must complete Form 8862 and attach it to your tax return

if both of the following apply.

1. Your EIC was reduced or disallowed for any reason other

than a math or clerical error for a year after 1996.

2. You now want to claim the EIC and you meet all the

requirements.

But do not file Form 8862 if either of the following applies.

● After your EIC was reduced or disallowed in an earlier year

(a) you filed Form 8862 (or other documents) and your EIC

was then allowed, and (b) your EIC has not been reduced or

disallowed again for any reason other than a math or clerical

error.

● 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.

Also, do not file Form 8862 or take the credit for the:

● 2 years after the most recent tax year for which there was

a final determination that your EIC was reduced or

disallowed due to reckless or intentional disregard of the EIC

rules, or

● 10 years after the most recent tax year for which there was a

final determination that your EIC was reduced or disallowed due

to fraud.

You also must attach Schedule EIC to your return if

you have a qualifying child or children. In addition

to filing Form 8862 and, if required, Schedule EIC,

you may be asked to provide other information

before any refund claimed on your return is issued. The process of establishing your eligibility to take the EIC will delay

your refund.

Additional Information

For more details on the EIC, including the definition of a qualifying child and who is eligible to take the EIC, see your tax

return instructions or Pub. 596, Earned Income Credit, for the

year for which you are filing Form 8862.

Specific Instructions

Need More Space for an Item?

If you do, attach a statement that is the same size as

Form 8862. Number each entry on the statement to correspond with the line number on Form 8862. Put your name

and social security number on the statement and attach it

at the end of your return.

Lines 4 and 5

Enter the number of days you lived in the United States during

the year shown on line 1.

Example. You are single and are filing Form 8862 for

2003. Your home was in the United States for all of 2003.

On line 4, you would enter “365.”

Members of the military. If you were on extended active duty

outside the United States, your home is considered to be in

the United States during that duty period. Include your active

duty time on line 4 and your spouse’s, if applicable, on line 5.

See Pub. 596 for the definition of extended active duty.

Lines 6 and 7

Temporary absences, such as for school, vacation, medical

care, or detention in a juvenile facility, count as time lived

at home.

Child born or died. If your child was born or died during the

year entered on line 1 and your home was the child’s home

for the entire time he or she was alive during that year,

replace the number entered on line 6 for that child with

“365.”

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.

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 time needed to complete and file this form will vary

depending on individual circumstances. The estimated

average time is:

Recordkeeping 26 min.

Learning about the law or the form 9 min.

Preparing the form 16 min.

Copying, assembling, and sending

the form to the IRS 20 min.

If you have comments concerning the accuracy of these time

estimates or suggestions for making this form simpler, we

would be happy to hear from you. See the instructions for the

tax return with which this form is filed.

CAUTION

CAUTION