SCHEDULE EIC
(Form 1040A or 1040)
Department of the Treasury
Internal Revenue Service (99)
Earned Income Credit
Qualifying Child Information
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Complete and attach to Form 1040A or 1040 only if you have a qualifying child.
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Information about Schedule EIC (Form 1040A or 1040) and its instructions is at www.irs.gov/scheduleeic.
1040A
. . . . . . . . . .
1040
EIC
◀
OMB No. 1545-0074
2015
Attachment
Sequence No.
43
Name(s) shown on return
Your social security number
Before you begin:
• See the instructions for Form 1040A, lines 42a and 42b, or Form 1040, lines 66a and 66b, to make
sure that (a) you can take the EIC, and (b) you have a qualifying child.
• Be sure the child’s name on line 1 and social security number (SSN) on line 2 agree with the child’s social security card.
Otherwise, at the time we process your return, we may reduce or disallow your EIC. If the name or SSN on the child’s
social security card is not correct, call the Social Security Administration at 1-800-772-1213.
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CAUTION
• You can't claim the EIC for a child who didn't live with you for more than half of the year.
• If you take the EIC even though you are not eligible, you may not be allowed to take the credit for up to 10 years. See the instructions for details.
• It will take us longer to process your return and issue your refund if you do not fill in all lines that apply for each qualifying child.
Qualifying Child Information
Child 1 Child 2 Child 3
1 Child’s name
If you have more than three qualifying
children, you have to list only three to get
the maximum credit.
First name Last name First name Last name First name Last name
2 Child’s SSN
The child must have an SSN as defined in
the instructions for Form 1040A, lines 42a
and 42b, or Form 1040, lines 66a and 66b,
unless the child was born and died in
2015. If your child was born and died in
2015 and did not have an SSN, enter
“Died” on this line and attach a copy of
the child’s birth certificate, death
certificate, or hospital medical records.
3 Child’s year of birth
Year
If born after 1996 and the child is
younger than you (or your spouse, if
filing jointly), skip lines 4a and 4b;
go to line 5.
Year
If born after 1996 and the child is
younger than you (or your spouse, if
filing jointly), skip lines 4a and 4b;
go to line 5.
Year
If born after 1996 and the child is
younger than you (or your spouse, if
filing jointly), skip lines 4a and 4b;
go to line 5.
4
a
Was the child under age 24 at the end of
2015, a student, and younger than you (or
your spouse, if filing jointly)?
Yes.
Go to
line 5.
No.
Go to line 4b.
Yes.
Go to
line 5.
No.
Go to line 4b.
Yes.
Go to
line 5.
No.
Go to line 4b.
b
Was the child permanently and totally
disabled during any part of 2015?
Yes.
Go to
line 5.
No.
The child is not a
qualifying child.
Yes.
Go to
line 5.
No.
The child is not a
qualifying child.
Yes.
Go to
line 5.
No.
The child is not a
qualifying child.
5
Child’s relationship to you
(for example, son, daughter, grandchild,
niece, nephew, foster child, etc.)
6 Number of months child lived
with you in the United States
during 2015
• If the child lived with you for more than
half of 2015 but less than 7 months,
enter “7.”
• If the child was born or died in 2015 and
your home was the child’s home for more
than half the time he or she was alive
during 2015, enter “12.”
months
Do not enter more than 12
months.
months
Do not enter more than 12
months.
months
Do not enter more than 12
months.
For Paperwork Reduction Act Notice, see your tax
return instructions.
Cat. No. 13339M
Schedule EIC (Form 1040A or 1040) 2015
