7 . . OMB No. 1545-0214

om 9095 Residential Energy Credit eres
‘orm

Department of the Treasury > Attach to Form 1040. > See Instructions on back. 1 98 3

Internal Revenue Service > For Paperwork Reduction Act Notice, see instructions on back. 31

Name(s) as shown on Form 1040 Your social security number

Enter the address of your principal residence on which the credit is claimed if it is different from the address shown on Form 1040.

if you have an energy credit carryover from a previous tax year and no energy savings costs this year, skip to Part Ill, line 24.

PART I.—Fill in your energy conservation costs (but do not include repair or maintenance costs).

1 Was your principal residence substantially completed before April 20, 1977? (see instructions). >|

Yes No

Note: You MUST answer this question. Failure to do so will delay the processing of your return. If you checked the ‘No’ box, you

CANNOT claim an energy credit under Part | and you should not fill in lines 2 through 12 of this form.

2 a Insulation. . . A
b Storm (or thermal) windows or r doors. Ce 2b
c Caulkingorweatherstripping . . . te ee ee ee. LBC
d_ Areplacement burner for your existing furnace that reduces fuel ue... 2... ee. . Ld
e Adevice for modifying flue openings to make a heating system moreefficient . . . . . ss. 2e
f  Anelectrical or mechanical furnace ignition system that replacesagaspilotlight . . . . . . - 2t
g Athermostat with anautomaticsetback . . . .... - De ee ee ee LB
h Ameterthatshowsthecostofenergyused . 6. 6 1 ee ee ee ee 2h
3 Total (addlines 2athrough2h) . . . . .. [3
4 Enter the part of expenditures made from nontaxable government grants and subsidized financing 4
5 Subtractline4fromline3. . . . . Ce ee ee LS
6 Maximum amount of cost on which credit can be figured 6 $2,000 | 00
7 Enter the total energy conservation costs for this residence. Add line 2 of your 1978, 1979, and 1980
Forms 5695 and line 3 of your 1981 and 1982 Forms 5695 . Cee ee ee LZ
8 Subtractline7fromline6. 2. . 8
9 Enter the total nontaxable grants and subsidized financing used to purchase qualified energy items for
this residence. Add the amount on line 4 of this form and your 1981and 1982 Forms5695 . . . . . 9
10 Subtract line 9 from line 8. If zero or less, do not complete the rest ofthispart . © 2... ee 10
11 Enter the amount on line 5 or line 10, whichever is less. . Ce ee Pb
12__Enter 15% of line 11 here and include in amount on line 23 below. 12
PART I.—Fill in your renewable energy source costs (but do not include repair or r maintenance costs).
13 a Solar____| __ 13 b Geothermal | 13 ¢ Wind | Total » [13d
14 Enter the part of expenditures made from nontaxable government grants and subsidized financing . . [14
15 Subtract line 14 fromline13 . se
16 Maximum amount of cost on which the credit ¢ can be. figured fn 16 $10,000 | 00
17 Enter the total renewable energy source costs for this residence. Add line 5 of your 1978 Form 5695,
line 9 of your 1979 and 1980 Forms 5695, and line 13d of your 1981 and 1982 Forms 5695... . LZ
18 Subtractline17fromlinel6 . . . . 18
19 Enter the total nontaxable grants and subsidized financing used to purchase qualified energy items for
this residence. Add the amount on line 14 of this form and your 1981 and 1982 Forms5695 . . . . 19
20 Subtract line 19 from line 18. If zero or less, do not complete the restofthispart . . . . 2... 20
21 Enter the amount on line 15 or line 20, whichever isless rr 2
22 Enter 40% of line 21 here and include in amount online 23below |... «(2
PART III. —Fill in this part to figure the limitation.
23 = Addlines 12 and 22. if less than $10, enterzero. . . 23
24 Enter your energy credit carryover from a previous tax year. : Caution—Do not make an nentry on this is line
if your 1982 Form 1040, line 50, showed anamountofmorethanzero . . - - ee ee ee 24
25 Addlines23and24... . . Ce ee BS
26 Enterthe amount of tax shown on Form joao,line40. se PE
27 Add lines 41 through 46 from Form 1040 andenterthetotal. ©. 1 6 ee ee ee ee 27
28 Subtract line 27 from line 26. If zero or less, enterzero. . . . . (28
29 Residential energy credit. Enter the amount on line 25 or line 28, ‘whichever is s less. ‘Also, enter this
amount on Form 1040, line 47. Complete Part IV below if this line islessthanline 25. 29
PART IV.—Fill in this part to figure your carryover to 1984 (Complete only if line 29 is] Tess than line 25).
30 Enter amount from Part Ill, line 25 30
31 Enter amount from Partlll, line29_. i
32__Credit carryover to 1984 (subtract line 31 from line 30) oe ee 182



General Instructions

Paperwork Reduction Act Notice.—We ask
for this information to carry out the Internal
Revenue laws of the United States. We need it to
ensure that taxpayers are complying with these
laws and to allow us to figure and collect the right
amount of tax. You are required to give us this,
information.

Purpose of Form.—Use this form to figure
your residential energy credit if you had qualified
energy saving items installed in your principal
residence. The instructions below list conditions
you must meet to take the credit. If you have an
energy credit carryover from the previous tax year
and no energy saving costs this year, skip to Part
Ilof the form. Attach Form 5695 to your tax
return. For more information, please get
Publication 903, Energy Credits for Individuals.

Two energy credits make up the residential
energy credit, each with its own conditions and
limits. These credits are based on: (1) Costs for
home energy conservation, and (2) Costs for
renewable energy source property.

The credit is based on the cost of items
installed in your principal residence after April
19, 1977, and before January 1, 1986

What is your principal residence?—To
qualify as your principal residence, your
residence must be the home in the United States
where you live (you may own it or rent it from
another person).

Asummer or vacation home does not qualify.

Special Rules.—If you live ina
condominium, cooperative apartment, occupy a
dwelling unit jointly, or share the cost of energy
property, see Publication 903 for more details.

What are energy saving items?—You can
take the credit for energy conservation and
renewable energy source items,

Energy conservation items are limited to:

@ insulation (fiberglass, cellulose, etc.) for
ceilings, walls, floors, roofs, water heaters,
etc.

@ storm (or thermal) windows or doors for
the outside of your residence.

@ caulking or weatherstripping for windows.
or doors for the outside of your residence.

@ a replacement burner for your existing
furnace that reduces fuel use. The burner
must replace an existing burner. It does
not qualify if it is acquired as a component
of, or for use in, a new furnace or boiler.

@ a device for modifying flue openings to
make a heating system more efficient.

@ anelectrical or mechanical furnace
ignition system that replaces a gas pilot
light.

@ a thermostat with an automatic setback.

@ ameter that shows the cost of energy
used.

To take the credit for an energy conservation
item, you must:

© install the item in your principal residence
which was substantially completed before
April 20, 1977,

@ be the first one to use the item, and
@ expect it to last at least 3 years.
The maximum accumulated credit for energy

conservation items cannot be more than $300
($2,000 x 15%) for each principal residence.

Renewable energy source items include
solar, wind, and geothermal energy items that
heat ‘or cool your principal residence or provide
hot water or electricity for it.

Examples of solar energy items that may
qualify include:
@ collectors,
@ =rockbeds,
@ heat exchangers, and
@ solar panels installed on roofs (including
those installed as a roof or part of a roof).

‘An example of an item that uses wind energy
is a windmill that produces energy in any form
(usually electricity) for your residence.

Geothermal energy property expenditures
must be made in connection with a “'geothermal
deposit.”’ A geothermal deposit is one having a
temperature exceeding 50 degrees Celsius (122
degrees Fahrenheit) as measured at the
wellhead or in the case of a natural hot spring
(where no well is drilled), at the intake to the
distribution system . Generally , the qualifying
geothermal resources that are economically
recoverable are located in States west of the
Rocky Mountains (except for geothermal springs
located in Arkansas).

To take the credit for a renewable energy
source item, you must:

© be the first one to use the item, and
© expect it to last at least 5 years.

The maximum accumulated credit for
renewable energy source items cannot be more
than $4,000 ($10,000 x 40%) for each principal
residence.

What items are NOT eligible for the energy
credit?—Do not take credit for:

© carpeting;

drapes;

wood paneling;

wood or peat-burning stoves;

hydrogen fueled residential equipment;
siding for the outside of your residence;
heat pumps (both air and water);
fluorescent replacement lighting systems;
replacement boilers and furnaces; and
swimming pools used to store energy.

Federal, State, or local government
nontaxable grants and subsidized
financing.— Qualified expenditures financed
with nontaxable Federal, State, or local
government grants cannot be used to figure the
energy credit. Also, if Federal, State, or local
government programs provide subsidized
financing for any part of qualified expenditures,
that part cannot be used to figure the energy
credit. You must reduce the expenditure limits on
energy conservation and renewable energy
source property for a dwelling by the part of
expenditures financed by Federal, State, or local
government subsidized energy financing, as well
as by the amount of nontaxable Federal, State, or
local government grants used to purchase
conservation or renewable energy source
property.

Figuring the credit for more than one
principal residence.—You can take the
maximum credit for each principal residence you
live in. If you use all of your credit for one
residence and then move, you may take the
maximum credit amount on your next residence.

To figure your 1983 energy credit for more
than one principal residence:

(1) Fill out Part | or lon a separate Form
5695 for each principal residence.

(2) Enter the total of all parts on line 23 of
one of the forms.

(3) _ Inthe space above line 23, write “More
than one principal residence.””

(4) Attach all forms to your return.

Caution: You should keep a copy of each
Form 5695 that you file for your records. For
example, if you sell your principal residence, you
will need to know the amount of the credit
claimed in prior tax years. If the items for which
you took the credit increased the basis of your
principal residence, you must reduce the basis by
the credit you took.

If the credit is more than your tax.—If your
energy credit for this year is more than your tax
minus certain other credits, you can carry over
the excess energy credit to the following tax year
or until the maximum accumulated credit is used.

Specific Instructions

Part I, line 1.— For energy conservation
items to qualify, your principal residence must
have been substantially completed before April
20, 1977. A dwelling unit is considered
substantially completed when it can be used as a
personal residence even though minor items
remain unfinished.

Part |, lines 2a through 2h.—Enter your
energy conservation costs (including
expenditures made with nontaxable government
grants and subsidized financing) only for this tax
year. Count the cost of the item and its
installation in or on your principal residence. Do
not include the cost of repairs or maintenance for
energy conservation items.

Part |, line 4.—Enter the amount of
nontaxable government grants and subsidized
financing used to purchase the energy items on
lines 2a through 2h. If you do not know the
amount, check with the government agency that
gave you the grant or subsidized financing.

Part I, line 7.—Enter your total energy
conservation costs from 1978, 1979, 1980,
1981, and 1982 for this principal residence. If
you had energy conservation costs in the previous
tax year but could not take a credit because it was
less than $10, enter zero.

Part I, line 9.—Enter the part of nontaxable
government grants and subsidized financing
received under Federal, State, or local programs
to purchase energy items in 1981 through 1983.
You must use the amounts received under these
programs to reduce the maximum amount of cost
used to figure the credit. If you do not know the
amount of the nontaxable grant, check with the
government agency which gave you the grant or
Subsidized financing,

Part Il, lines 13a through 13d.—Enter your
renewable energy source costs (including
expenditures made with nontaxable government
grants and subsidized financing) only for this tax
year. Do not include the cost of repairs or
maintenance for renewable energy source items.

Part Il, line 14.—See Part |, line 4 for an
explanation

Part Il, line 17.—Enter your total renewable
energy source costs from 1978, 1979, 1980,
1981, and 1982 for this principal residence. If
you had renewable energy source costs in the
Previous tax year but could not take a credit
because it was less than $10, enter zero.

Part Il, line 19.—See Part |, line 9 for an
explanation.

Part Ill, line 24.—Generally, your energy
credit carryover will be computed on your prior
year Form 5695, Part lV. Exception—If the
alternative minimum tax applied, see
Publication 909, Minimum Tax and Alternative
Minimum Tax.

Part IV.—Complete this part only if line 29 is
less than line 25. You can carry over the amount
entered on line 32 to your next tax year.