Form Schd WFC Fillable Oregon Working Family Child Care Credit for Full-Year Residents
(all forms fillable on Windows, Mac, Android tablets, and iPad using Adobe Reader XI)

$23 000 0 40 $31 000 0 40 $39 050 0 40 $47 100 0 40 $55 150 0 40 $63 200 0 40 $71 200 0 40 $79 250 0 40 After school activities; Boarding school; Cancelled checks (front and back) or money order Caring for the child(ren) Date and amount of child care paid Dates of care Duplicate checks along with bank statements; and Food gas supplies; or Going to school at least part time; and Include bank statements or bank receipts showing Late payment fees or other fees Lived with you at least half of the year and Name of person or agency paying Overnight camps; Performing an activity of daily living including Provider s identification number (SSN/FEIN) Provider s name address and telephone number Public or private school (K 12); Signed receipts from the child care provider received Sports; The child s full name The method of payment (check money order cash Was a child who qualifies for the additional Was under the age of 13 at the time the care was Working; You had $3 300 or less of investment income (such as You had at least $8 400 of earned income and You paid qualifying child care expenses for your You paid qualifying child care expenses to allow Your adjusted gross income (AGI) was less than the Your child care provider was not the child s parent or Your relative or step relative under age 19 $23 001 24 150 0 36 $31 001 32 550 0 36 $39 051 41 000 0 36 $47 101 49 450 0 36 $55 151 57 900 0 36 $63 201 66 350 0 36 $71 201 74 800 0 36 $79 251 83 200 0 36 $800 a month for care for Barbara Barbara and her doctor (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) 150 101 169 (Rev 12 13) 150 101 169 (Rev 12 13)150 101 169 (Rev 12 13) 24 151 25 300 0 32 25 301 26 450 0 24 26 451 27 600 0 16 27 601 28 750 0 08 28 751 0 00 32 551 34 100 0 32 34 101 35 650 0 24 35 651 37 200 0 16 37 201 38 800 0 08 38 801 0 00 41 001 42 950 0 32 42 951 4 4 900 0 24 44 901 46 850 0 16 46 851 48 850 0 08 48 851 0 00 49 451 51 800 0 32 51 801 54 150 0 24 54 151 56 500 0 16 56 501 58 900 0 08 57 901 60 650 0 32 58 901 0 00 60 651 63 400 0 24 63 401 66 150 0 16 66 151 68 950 0 08 66 351 69 500 0 32 68 951 0 00 69 501 72 650 0 24 72 651 75 800 0 16 74 801 78 350 0 32 75 801 79 000 0 08 78 351 81 900 0 24 79 001 0 00 81 901 85 450 0 16 83 201 87 200 0 32 85 451 89 050 0 08 87 201 91 150 0 24 89 051 0 00 91 151 95 100 0 16 95 101 99 100 0 08 99 101 0 00 a qualifying disability Mason and Barbara can claim a written objection and provided receipts Tonya filled Abby pays Tonya $500 a month in cash During the processing Abby s friend Tonya is Abby s child care provider able to prove that you paid the child care expenses to amount on Schedule amount on Schedule amount on Schedule amount on Schedule Amount paid to provider Qualifying child care amount she actually paid She will enter $1 800 on line 6 amounts shown on line 9 and line 14 should always be and Cate paid a co pay of $150 Cate can only claim the and the children Only one spouse/RDP can qualify for aren t related to you A person cannot be counted in the asked to provide proof showing you actually paid qualifying at least part time or you or your spouse/RDP are at the time of payment and she has no other proof that at the time of payment Receipts should include: attend school at least part time The qualifications are Attending school Check this box if you or your based on $5 000 in qualifying child care expenses bathing dressing feeding toileting etc ; below the waist from an automobile accident care benefits He contributes $4 000 pre tax each care provider section that apply to each child The care worker come to their home daily because she is cash withdrawals if paying in cash or money Cate $600 per month to care for her two qualifying check box 14a and include a separate sheet with Check the boxes child child care expenses Documents provided will child care expenses she paid because she is the custodial child care expenses The child care provider charges Child to provider relationship Identify the relationship child whose exemption is released to Rusty) Deb will child whose exemption she claims and one dependent children Angie works full time and Zach does not work children live more than half the year with Deb Even children Of the $600 per month the state paid $450 claim the exemption on their tax return Don t include claim this credit Acceptable proof may include but is codes on the back of Schedule WFC completed Form WFC DP showing that Barbara has Computation of credit copy of the form at a later date current telephone number to contact the provider Otherwise custody even if you allowed the child s other parent to Daughter D Niece NC Aunt A Brother in law BL Deb s household size is three (herself one dependent didn t live with you in your home for all of 2013 or who disability (see below) and doctor need to fill out Form WFC DP Go to our website dollars from an employer benefit plan You must pay else such as a state assistance agency or a family enter 2 on line 1 of Schedule WFC and 1 on line 2 Enter the child care provider s information If you have Enter the portion of expenses you listed in the child Enter this decimal Enter this decimal Enter this decimal Enter this decimal etc ) Example 1: Rusty and Deb are unmarried and are Example 2: Jay and Rena have three qualifying children Example 3: Jeff works for a company that offers dependent Example 4: Cate qualifies for state assistance to pay her Example 5: Angie and Zach are married and have three Example 6: Mason and Barbara are married and have Example 7: Abby has two children and works full time exception Angie and Zach cannot claim this credit for exempt from this requirement due to a qualifying exemption credit for a child with a disability; and expenses are those paid for your qualifying child for expenses Enter that percentage on Schedule Failure to include or including an incomplete schedule families with qualifying child care expenses To for a total of 3 on line 5 FOR COMPUTER USE ONLY For example if your household size is three use Table 3 for the child care during 2013 for the payments to be for this credit See Form 40N filing instructions Form WFC DP is included Check this box if you or your from working attending school and caring for yourself guardian or have a disability that prevents (or severely restricts) Household size calculation household size on more than one return households and have joint custody of the children The If the amount on If the amount on If the amount on If the amount on If you have more than one child be sure the information If you qualify complete Schedule WFC Oregon Work If your household size is not listed below contact the department for the tables you need Important: If you did not provide complete information included each year that one of you meets the exception ing Family Child Care Credit Include this schedule with interest dividends and capital gains) and is listed separately for each child Jeff may claim the working family child care credit Keep a copy of the form with your tax records and with limits for your household size shown on the back of Line 15 Enter your federal AGI (Oregon Form 40 line 8) LIne 16 Enter the total qualifying expenses from Schedule Line 17 Use the table on the back of Schedule WFC that Lines 1 5 Generally your household size is the number Lines 10 14 Enter the full name Social Security number Lines 6 9 Provider s full name and complete address live in their home They will enter 7 on line 1 of Schedule married/RDPs both of you must be working or attending Mason and Barbara pay $750 a month for child care and matches your household size line 5 may result in delay or denial of your WFC Your refund member military nonresident or a resident living abroad more than three providers check box 9a and include a must be legally separated or permanently living apart not be returned Be sure to ask for a signed receipt from not limited to legible copies of: not the same as the severely disabled exemption credit Note to RDPs: Use your federal as if return to see if Note: If you re married/RDP filing separately you number (FEIN) or individual taxpayer identification number (ITIN) number for the provider Important: We need a of daily living Zach s disability does not qualify for the of her tax return Abby was asked for proof that of his W 2 Jeff also paid $1 000 with after tax dollars of people you claim as exemptions on your federal of the child to the provider using the relationship of the schedule ($150 12 months) She will not include on December 31 2013 to qualify on Schedule WFC line 15 or attend school and is receiving disability Zach is paralyzed or contact us to get Form WFC DP This form must be or friend to care for your children you may be or ITIN date of birth and relationship to you using order out after Abby s credit was denied Abby cannot claim paid in 2013 parent people you re entitled to claim on your tax return who proof of payment Abby s credit was denied Abby filed Proof of qualifying child care expenses You must be provided or Provider s SSN or FEIN You must include your provider s Provider s telephone number Enter a daytime telephone providers qualify all of the following must be true: qualifying child A qualifying child is your child qualifying child care expenses Qualifying child care expenses do not include amounts Qualifying child information RDP or adoption and live in your home Household Reminder: If you qualify as a special case Oregon resident Rena s household size is five because only five of them reports the $4 000 of dependent care benefits in box 10 Schedule WFC and Schedule WFC instructions for residents Schedule WFC line 15 is: Schedule WFC line 15 is: Schedule WFC line 15 is: Schedule WFC line 15 is: Schedule WFC relationship codes school at least part time school for the expenses to qualify You can claim separate sheet with the same information for the additional she paid Tonya she paid Tonya She did not provide receipts or other she releases the dependent exemption for one child size can include your child of whom you have primary Social Security number federal employer identification Son S Grandchild GC Eligible foster child EF Sister in law SL spouse/RDP had childcare expenses because of attending spouse/RDP has a qualifying disability that keeps you step child grandchild step grandchild brother sister step niece or eligible foster child who: stepbrother stepsister nephew niece step nephew Stepdaughter SD Sister/Brother SB Cousin CS None N Stepson SS Nephew NW Uncle U Other relative O stubs; Table 1 household size = 1 Table 2 household size = 2 Table 3 household size = 3 Table 4 household size = 4 Table 5 household size = 5 Table 6 household size = 6 Table 7 household size = 7 Table 8 household size = 8 tax return who are related to you by blood marriage text) The amount paid for Barbara s care does not qualify for the codes on the back of Schedule WFC for each qualifying the credit because the receipts were not provided to her the exception The other spouse/RDP must still work or the non qualifying expenses paid by the state the parents of two children They maintain separate the primary purpose for you to work or attend school If the same If you have more than four qualifying children the same information for the additional children the year their child care expenses them from all of the following: They also support Rena s parents who live in Mexico They claim seven exemptions on their tax return Jay and this credit this credit even if you pay your expenses with pre tax this credit for the $750 a month they paid for child care This refundable credit is available to low income working though the children are Deb s qualifying children To claim the exception the disabled taxpayer and their to find the percentage you need to apply to your qualifying to Rusty Only Deb may claim the credit based on the To use the exception the disabled spouse/RDP must to work because of a brain tumor Barbara has a home two children Mason works full time Barbara is unable unable to care for herself while Mason is away at work we may ask for additional proof If you pay a relative WFC and 2 on line 4 for a total of 5 on line 5 WFC line 17 WFC line 17:at least: but not more than: WFC line 17:at least: but not more than: WFC line 17:at least: but not more than: WFC line 17:at least: but not more than: WFC line 9 on Schedule WFC line 16 will take longer to process when claiming this credit Working family child care credit 2013 tables Working family child care credit instructions year to a flexible spending arrangement Jeff s employer you and your spouse/RDP to work or attend school You can claim only the expenses you actually paid during You cannot claim expenses that are paid by someone You must complete all information on the schedule you must file as a nonresident and you do not qualify you paid for: you qualify for this credit your child care provider each time you pay for child care your doctor We may contact your doctor or request a your refund may be delayed your return Zach does not need assistance with any of the activities