Form 9452 (2017)
Purpose of Form
Use Form 9452 to see if you must file a
Federal income tax return for 2017.
However, see Special Situations below
before you begin.
If any of the following special situations
apply to you, you must file a Federal
income tax return for 2017 even if your
gross income is less than the amount
shown in the chart in Part Il.
Advance payment of the premium tax
credit. If you purchased health care
coverage from a Health Insurance
Marketplace, advanced payments of the
premium tax credit may have been made
to the health insurer to help pay for the
insurance coverage of you, your spouse,
or your dependent. If advance payments
of the premium tax credit were made, you
must file a 2017 tax return and Form
8962, Premium Tax Credit, even if you
are otherwise not required to file. If you
enrolled someone who is not claimed as
a dependent on your tax return or for
more information, see the instructions for
Withholding. If you had taxes withheld
from a job or your annuity or pension
income, and you want to get a refund of
the withheld taxes, you will need to file.
Earned Income Credit
1. If you wish to apply for the earned
income credit you will need to file.
2. You must file if you received any
advance earned income credit payments
from your employer. These payments
should be shown in box 9 of your W-2
1. You must file if you owe any special
tax on a qualified retirement plan
including an Individual Retirement
Arrangement (IRA), Archer Medical
Savings Account (MSA), or Coverdell
Education Savings Account (ESA). You
may owe this tax if you:
• Received an early distribution from (a)
an IRA or other qualified retirement plan,
(b) an annuity, or (c) a modified
endowment contract entered into after
June 20, 1988.
• Made excess contributions to your IRA,
Archer MSA, or Coverdell ESA.
• You received distributions from
Coverdell ESAs in excess of your
qualified higher education expenses.
• Were born before July 1, 1946, and you
received less than the minimum required
distribution from your qualified retirement
2. You must file if you have a gain or
loss on the sale of stocks or a gain from
the sale of bonds or your home.
3. You must file if you owe social
security and Medicare tax on tips you did
not report to your employer.
4. You must file if you owe uncollected
social security and Medicare or Tier 1
Railroad Retirement (RRTA) tax on tips
you reported to your employer or on
group-term life insurance.
5. You must file if you owe alternative
6. You must file if you owe recapture
Taxable self-employment income
You must file if you had net self-
employment income of at least $400.
Church employee income
You must file if you had wages of
$108.28 or more from a church or
qualified church-controlled organization
that is exempt from employer social
security and Medicare taxes.
If someone else can claim you as a
dependent, you may have to file a tax
return even if your own income is
much lower than the total gross
income amounts in Part Il. If your
gross income was $4,050 or more,
you usually cannot be claimed as a
dependent unless at the end of 2017
you were under age 19 (or a student
under age 24).
Complete Part I to figure your gross
income for 2017.
Gross income means all income you
received in the form of money, goods,
property, and services that is not exempt
from tax including any income from
sources outside the United States (even
if you may exclude part or all of it).
Social security benefits
1. Social security payments are NOT
taxable unless one-half of all your net
social security benefits plus your
adjusted gross income and any tax
exempt interest total more than $25,000
if you are single (or married filing
separately and you lived apart from your
spouse for all of 2017), or $32,000 if
married filing a joint return. Enter only the
taxable portion of your social security
benefits on line 6, Other taxable income.
Use the table in Part II to determine your
If you were born on January 1, 1953, you
are considered to be age 65 at the end of
Paperwork Reduction Act Notice.
Your use of this worksheet is optional. It
is provided to aid you in determining
whether you must file a Federal tax
You are not required to provide the
information requested on a form that is
subject to the Paperwork Reduction Act
unless the form displays a valid OMB
control number. Books or records relating
to a form or its instructions must be
retained as long as their contents may
become material in the administration of
any Internal Revenue law. Generally, tax
returns and return information are
confidential, as required by Internal
Revenue Code section 6103. The time
needed to complete this worksheet will
vary depending on individual
circumstances. The estimated average
time is 30 minutes.
If you have comments concerning the
accuracy of this time estimate or
suggestions for making this form simpler,
we would be happy to hear from you.
You can write to the Internal Revenue
Service, Tax Products Coordinating
Committee, SE:W:CAR:MP:T:T:SP, 1111
Constitution Ave. NW, IR-6406,
Washington, DC 20224.