SCHEDULE 5
(Form 1040)
Department of the Treasury
Internal Revenue Service
Other Payments and Refundable Credits
Attach to Form 1040.
Go to www.irs.gov/Form1040 for instructions and the latest information.
OMB No. 1545-0074
2018
Attachment
Sequence No.
05
Name(s) shown on Form 1040 Your social security number
Other
Payments
and
Refundable
Credits
65 Reserved . . . . . . . . . . . . . . . . . . . . . . . . 65
66
2018 estimated tax payments and amount applied from 2017 return . . . .
66
67a Reserved . . . . . . . . . . . . . . . . . . . . . . . . 67a
b Reserved . . . . . . . . . . . . . . . . . . . . . . . . 67b
6869 Reserved . . . . . . . . . . . . . . . . . . . . . . . . 6869
70 Net premium tax credit. Attach Form 8962 . . . . . . . . . . . . . 70
71 Amount paid with request for extension to file (see instructions) . . . . . . 71
72 Excess social security and tier 1 RRTA tax withheld . . . . . . . . . . 72
73 Credit for federal tax on fuels. Attach Form 4136 . . . . . . . . . . . 73
74 Credits from Form: a 2439 b Reserved c 8885 d 74
75 Add the amounts in the far right column. These are your total other payments
and refundable credits. Enter here and include on Form 1040, line 17. . . . 75
For Paperwork Reduction Act Notice, see your tax return instructions.
Cat. No. 71482C Schedule 5 (Form 1040) 2018