Fill - Free fillable Schx I Schedule X, Rev 2019, Tax Credits for Hawaii Residents PDF form

SCHEDULE X STATE OF HAWAII — DEPARTMENT OF TAXATION

(FORM N-11/N-15)

(REV. 2019)

TAX CREDITS FOR HAWAII RESIDENTS 2019

Both pages of Schedule X must be attached

to Form N-11 or N-15

Name(s) as shown on Form N-11 or N-15

Your social security number

SCHEDULE X

PART I: CREDIT FOR LOW-INCOME HOUSEHOLD RENTERS

1 Is your adjusted gross income (Form N-11, line 20; or Form N-15, line 35, Column A) less than $30,000?

If “No,” STOP. You cannot claim this credit. If “Yes,” go to Question 2.

2 Are you a resident who was present in Hawaii more than nine months of the taxable year? If “No,” STOP. You cannot claim this credit. If “Yes,” go to Question 3.

3 Can you be claimed as a dependent by another taxpayer? If “Yes,” STOP. You cannot claim this credit. If “No,” go to line 4.

4 Enter required information for each rental unit that was fully subject to real property tax. Do not list rental units that were wholly or partially exempt from real property tax. If you occupied

more than one qualiﬁed unit, submit the required information for each additional unit on a separate sheet. If you shared the unit with others, enter only your share of the rent.

Address (give Apt. No., if any)

Occupied From

month

, 2019, To

month

, 2019. Total rent paid for this period. $ ______________

Owned by (or agent for owner)

name address (Hawaii Tax I.D. No.)

5 Add up your share of rent paid during the taxable year for all the units you have listed. ............................................. 5

6 Enter the amount of your exclusions (e.g., utilities, parking stalls, ground rent, rental subsidies such as public assistance). ..... 6

7 Line 5 minus line 6. If this amount is $1,000, or less, STOP. You cannot claim this credit. ........................................ 7

8 List YOURSELF, YOUR SPOUSE, AND YOUR DEPENDENTS that meet all of the following: a) Resident of Hawaii, b) Present

in Hawaii for more than nine months in 2019, and c) Cannot be claimed as a dependent by another taxpayer.

Include minor children receiving more than half of their support from public agencies which you can claim as dependents.

Name Relationship Name Relationship

Self

Spouse

Enter the number of qualiﬁed persons listed above. ............................................................................................................................... 8

9 If you are a qualiﬁed exemption and you are age 65 or over, enter 1. Otherwise, enter -0-. ................................................................... 9

10 If you are married ﬁling jointly or married ﬁling separately where your spouse is not ﬁling a Hawaii

return, had no income, and was not the dependent of someone else; and your spouse is a qualiﬁed

exemption; and your spouse is age 65 or over; enter 1. Otherwise, enter -0-. .................................................................................................. 10

11 Add lines 8 through 10. ........................................................................................................................................................................... 11

12 Multiply the number of exemptions on line 11 by $50 and enter the result here and on Form N-11, line 29;

or Form N-15, line 46. This is your credit for low-income household renters. (Whole dollars only) .............................. 12

Caution: Before completing Schedule X, please read the Instructions on pages 34 - 37

of the Form N-11 booklet, or pages 38 - 40 of the Form N-15 booklet.

GE __ __ __ - __ __ __ - __ __ __ __ - __ __

PART II: CREDIT FOR CHILD AND DEPENDENT CARE EXPENSES

You cannot claim a credit for child and dependent care expenses if your ﬁling status is married ﬁling separately unless you meet the requirements listed

in the instructions under “Married Persons Filing Separately.” If you meet these requirements, check this box. 

Section A: Care Provider Information

Complete line 1 columns (a) through (e) for each person or organization that provided the care. If you do not give the information asked for in each column,

or if the information you give is not correct, your credit and, if applicable, the exclusion of employer-provided dependent care beneﬁts may be disallowed.

(a) Care (b) Address (c) Identiﬁcation number (d) Hawaii Tax (e) Amount paid

provider’s name (number, street, city, state, and Postal/ZIP code) (SSN or FEIN) I.D. No.

GE __ __ __ - __ __ __ - __ __ __ __ - __ __

Section B: Dependent Care Beneﬁts — (If you did not receive dependent care beneﬁts, skip to line 21)

2 Enter the total amount of dependent care beneﬁts you received in 2019. Amounts you received as an employee

should be shown in Box 10 of your federal Form(s) W-2. If you were self-employed or a partner, include amounts

you received under a dependent care assistance program from your sole proprietorship or partnership. .................. 2

3 Enter the amount, if any, you carried over from 2018 and used in 2019 during the grace period. ............................... 3

4 Enter the amount, if any, you forfeited or carried forward to 2020. (See the Instructions) ........................................... 4

5 Combine lines 2 through 4. .......................................................................................................................................... 5

( )

ID NO 01SCHX_I 2019A 01 VID01

Clear Form

SCHEDULE X (FORM N-11/N-15) (REV. 2019) PAGE 2

Name(s) as shown on Form N-11 or N-15 Your social security number

6 Enter the total amount of qualiﬁed expenses incurred in 2019 for the care of the qualifying person(s). .... 6

7 Enter the smaller of line 5 or 6. ..................................................................................... 7

8 Enter your earned income. (See the Instructions) ........................................................ 8

9 If married ﬁling jointly, enter your spouse’s earned income (if you or your spouse

was a student or disabled, see the Instructions); if married ﬁling separately,

see the Instructions; all others, enter the amount from line 8. ...................................... 9

10 Enter the smallest of line 7, 8, or 9. .............................................................................. 10

11 Enter $5,000 ($2,500 if married ﬁling separately and you were required to enter your

spouse’s earned income on line 9). .............................................................................. 11

12 Is any amount on line 2 from your sole proprietorship or partnership?

No. Enter -0-.

Yes. Enter the amount here. .............................................................................................................................................. 12

13 Line 5 minus line 12 ...................................................................................................... 13

14 Deductible beneﬁts. Enter the smallest of line 10, 11, or 12. Also, include this amount on the appropriate line(s) of

your return. ......................................................................................................................................................................... 14

15 Excluded beneﬁts. If line 12 is zero, enter the smaller of line 10 or 11. Otherwise, subtract line 14 from the smaller of

line 10 or 11. If zero or less, enter -0-. ............................................................................................................................... 15

16 Taxable beneﬁts. Line 13 minus line 15. If zero or less, enter -0-. Also, include this amount on Form N-15, line 7.

On the dotted line next to line 7, write “DCB.” (Form N-11 ﬁlers, see the Instructions) ...................................................... 16

17 Enter $2,400 ($4,800 if two or more qualifying persons) ................................................................................................... 17

18 Add lines 14 and 15. ......................................................................................................................................................... 18

19 Line 17 minus line 18. If zero or less, STOP. You cannot take the credit. Exception. If you paid 2018 expenses in

2019, see the Instructions for line 28. ................................................................................................................................ 19

20 Complete line 21. Do not include in column (d) any beneﬁts shown on line 18. Then, add the amounts in column (d)

and enter the total here. ..................................................................................................................................................... 20

Section C: Credit for Child and Dependent Care Expenses — (Generally, married persons must ﬁle a joint return to claim the tax credit.)

(d) Qualiﬁed expenses

21 (a) Qualifying person’s name (b) Relationship (c) Qualifying person’s social

you incurred and paid

security number

in 2019 for the person

listed in column (a)

22 Add the amounts in column (d) of line 21. Do not enter more than $2,400 for one qualifying person or $4,800 for two

or more persons. If you completed Section B, enter the smaller of line 19 or 20. ..................................................................... 22

23 Enter your earned income. (See the Instructions) ............................................................................................................. 23

24 If married ﬁling jointly, enter your spouse’s earned income (if you or your spouse was a student or disabled,

see the Instructions); all others, enter the amount from line 23 ......................................................................................... 24

25 Enter the smallest of line 22, 23, or 24. ............................................................................................................................. 25

26 Enter your adjusted gross income from Form N-11, line 20; or Form N-15, line 35,

Column A ...................................................................................................................... 26

27 Enter on line 27 the decimal amount shown below that applies to the amount on line 26.

27 X

28 Multiply line 25 by the decimal amount on line 27. If you paid 2018 expenses in 2019, see the Instructions.

Enter the result here and on Form N-11, line 30; or Form N-15, line 47. This is your credit for child and

dependent care expenses. (Whole dollars only) ................................................................................................................ 28

If line 26 is: Decimal amount is:

Under $25,001 .25

$25,001 – 30,000 .24

$30,001 – 35,000 .23

$35,001 – 40,000 .22

If line 26 is: Decimal amount is:

$40,001 – 45,000 .21

$45,001 – 50,000 .20

$50,001 and over .15

ID NO 01SCHX_I 2019A 02 VID01

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