Form 5695 Residential Energy Credit

Department of the Treasury
Internal Revenue Serv

> Attach to Form 1040. > See Instructions on back.

OMB No. 1545-0214

1981

Name(s) as shown on Form 1040

Your social security number

Enter in the space below 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.

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

»

Was your principal residence substantially completed before April 20,1977. . . . . «

[Jes [Jno

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 I and you should not fill in lines 2 through 12 of this form.
2i

2a Insulation. . . Be |__
b Storm (or thermal) windows ordoors. . 6 6 ee ee ee ee eee [RD ___
c Caulking or weatherstripping. . . . Soe ee ee woe ee eee ee [BE —_
d A replacement burner for your existing furnace that reduces fueluse . . . . . . ~~ «| 2d —
e A device for modifying flue openings to make a heating system more efficient. . . . . . . . |_2€ —_
f An electrical or mechanical furnace ignition system that replaces a gas pilot light. . . . . . |__2f | ___
g A thermostat with an automatic setback. © 2 6 6 1 ee ee eee ee ee ee | BY __
h A meter that shows the cost of energyused. . 2. 2. 1 ee ee ee ee ee ee | 2 ___
3 Total (add lines 2a through 2h). . . Be ee E38 __
4 Enter the part of expenditures made from nontaxable government grants and subsidized financing . . | 40 —
5 Subtract line 4fromline3. . . « sone ee ee ee LLB
6 Maximum amount of cost on which credit can be figured. . . . . . . sss ss. ss [8 | $2,000] 00°
7 Enter the total energy conservation costs for this residence from your 1978, 1979, and 1980 Form 5695,
8 Subtract line 7 from line6 . . 2 __
9 Enter the amount of nontaxable government grants and subsidized financing entered on line4. . . |_9_| —
10 Subtract line 9 from line 8. If zero or less, do not complete the rest of thispart. . . . . . . . {20 _| —_
11 Enter the amount on line 5 or line 10, whichever is less. . eo ee ee ee ee [AL _
12 Enter 15% of line 11 here and include in amount on line 23 below... 12
Fill in your renewable energy source costs (but do not include repair or maintenance costs).
13 a Solar_______| 13 b Geothermal | 33 © Wind [total p [134
14 Enter the part of expenditures made from nontaxable government grants and subsidized financing. . |14 | _
15 Subtract line 14fromline13. 6 6 ee ee ee ee ee ew | —_
16 Maximum amount of cost on which credit can be figured. . . . - . . - . 2 a ee « {16} $10,000 | 00_
17 Enter the total renewable energy source cost for this residence from your 1978 Form 5695, line 5 and
your 1979 and 1980 Forms 5695, line9. 6. ee ee ee ee ee ee ee ee [AZ __
18 Subtract line 17 from line 16. 6 6 ee ee ee ee ee ee we 8 _
19 Enter the amount of nontaxable government grants and subsidized financing entered on line14. . . |19_| _
20 Subtract line 19 from line 18. If zero or less, do not complete the rest of this part. . . . . . . | 20_| __
21 Enter the amount on line 15 or line 20, whichever isless. . . . res 2 —
22 Enter 40% of line 21 here and include in amount on line 23 below. . . . . . . . . . . [22
Pear ii Fill in this part to figure the limitation
23 Add lines 12 and 22. If less than $10, enter zero. . . . « res ie _
24 Enter your energy credit carryover from a previous tax year. Caution—Do not make an entry on this line
if your 1980 Form 1040, line 47, showed an amount of more than zero. . . . « . «~~ «| 24 | _
25 Add lines 23 and 24. . - ee eee Be ee ee LBB —_
26 Enter the amount of tax shown on Form 1040, line Po ee 26 _| —
27 Add lines 38 through 44 from Form 1040 andenterthetotal. . . . . 2. 2. 2. eee «| 27) _
28 Subtract line 27 from line 26. If zero or less, enter zero... 1 ee ee ee ee ee [28 __
29 Residential energy credit. Enter the amount on line 25 or line 28, whichever is less. Also, enter this
amount on Form 1040, line 45. Complete Part IV below if this line is less than line 25 . 29
Fill in this part to figure your carryover to 1982 (Complete only if line 29 is Tess than line 25)
30 Enter amount from Part Ill, line 25.0. 0... ee ee ee ee ee ee 180) _
31 Enter amount from Part Ill, line 29. . . fa __
32 Credit carryover to 1982 (subtract line 31 from line 30)... ss 182
For Paperwork Reduction Act Notice, see instructions on back. 343-210-1


Paperwork Reduction Act Notice

The Paperwork Reduction Act of 1980
says we must tell you why we are collect-
ing this information, how we will use it, and
whether you have to give it to us. We ask
for the information to carry out the Internal
Revenue laws of the United States. 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
required to give us this information.

General Instructions

Two energy credits make up the residen-
tial energy credit, each with its own condi-
tions and limits. These credits are based
on: (1) Costs for home energy conserva-
tion, 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.

Purpose.—Use this form to figure your
residential energy credit if you had quali-
fied 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 carry-
over from the previous tax year and no
energy saving costs this year, skip to Part
IIL of the form. Attach Form 5695 to your
tax return. For more information, please
get Publication 903, Energy Credits for
Individuals.

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).

A summer or vacation home does not
qualify.

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

Special Rules.—If you live in a condo-
minium, 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:
e 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 win-
dows or doors for the outside of your
residence.
a replacement burner for your exist-
ing furnace that reduces fuel use.
The burner must replace an existing
burner. It does not qualify if it is ac-
quired 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 ef-
ficient.
an electrical or mechanical furnace
ignition system that replaces a gas
pilot light.
a thermostat with an automatic set-

back.
a meter that shows the cost of energy
used.

To take the credit for an energy conser-
vation item, you must:

© install the item in your principal resi-
dence which was substantially com-
pleted before April 20, 1977,
© be the first one to use the item, and
© expect it to last at least 3 years.
The maximum credit for energy conser-
vation items cannot be more than $300
($2,000 x 15%) for each principal resi-
dence.

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 (in-

cluding 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.

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 credit for renewable
energy source items cannot be more than
$4,000 ($10,000 x 40%) for each princi-
pal 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 equip-
ment;

© siding for the outside of your resi-
dence;

© heat pump (both air and water);

. fluorescent replacement lighting sys-
em;

@ replacement boilers and furnaces;
and

@ swimming pools used to store energy.

Federal, State, or local government non-
taxable grants and subsidized financing.—
Qualified expenditures financed with non-
taxable Federal, State, or local government
grants cannot be used to figure the energy
credit. Also, if Federal, State, or local gov-
ernment programs provide subsidized fi-
nancing for any part of qualified expendi-
tures, that part cannot be used to figure
the energy credit. You must reduce the ex-
penditure limits on energy conservation
and renewable energy source property for
a dwelling by the part of expenditures fi-
nanced by Federal, State, or local govern-
ment subsidized energy financing, as well
as by the amount of nontaxable Federal,
State, or local government grants used to
purchase conservation or renewable en-
ergy source property.

Figuring the credit for more than one
principal residence.—You can take the
maximum credit for each principal resi-
dence 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 1981 energy credit for
more than one principal residence:

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

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

‘Ye US, GOVERNMENT PRINTING OFFICE : 1981—O-343-210

(3) In the space above line 23, write
“More than one principal resi-
dence.”

(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 res-
idence, 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 resi-
dence, you must reduce the basis by the
credit you took.

If the credit is more than your tax.—lIf
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.

Specific Instructions

Part I, lines 2a through 2h.—Enter
your energy conservation costs (including
expenditures made with nontaxable govern-
ment 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 con-
servation items.

Part I, line 4.—Enter the amount of non-
taxable government grants and subsidized
financing used to purchase the energy
items. If you do not know the amount,
check with the government agency that
gave you the grant or subsidized fi-
nancing.

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

Part I, line 9.—Enter the part of non-
taxable government grants and subsidized
financing received under Federal, State, or
local programs to purchase energy items.
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 non-
taxable grant, check with the government
agency which gave you the grant or sub-
sidized financing.

Part Il, lines 13a through 13d.—Enter
your renewable energy source costs (in-
cluding expenditures made with nontax-
able 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 II, line 14.—See Part I, line 4 for
explanation.

Part Il, line 17.—Enter your total renew-
able energy source costs from 1978, 1979,
and 1980 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
explanation.

Part_Ill, line 24.—If line 47 of your
1980 Form 1040 is zero or less and on
your 1980 Form 5695, line 20 is less than
line 17, enter the difference between line
20 and line 17 on line 24 of this year’s
form. Exception—lIf the alternative mini-
mum tax applied, see Publication 909,
Minimum Tax and Maximum Tax.

Part IV.—Complete this part only if line
29 is less than line 25. You can carryover
the amount entered on line 32 to your next
tax year. Exception—If the alternative
minimum tax applies, see Publication 909.

343-210-1