$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
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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