Form D-2441 Fillable Child and Dependent Care Credit for Part-Year Residents
(all forms fillable on Windows, Mac, Android tablets, and iPad using Adobe Reader XI)

1 Total 2015 employment related dependent care expenses From federal Form 2441 Line 3 1 $ 00 2 Employment related dependent care expenses paid in 2015 while you were a DC resident 2 $ 00 3 Divide Line 2 amount by Line 1 amount (The result will be a decimal for example: 0 55) 3 4 DC full year dependent care credit Multiply your allowable federal credit (from federal Form 2441 5 DC part year dependent care credit Multiply Line 4 amount by the Line 3 decimal 5 $ 00 or total expenses paid (page 2 Line 6 of this form) Round cents to You are a part year resident of DC; You are filing a part year DC D 40 return; and You were eligible to claim the child and dependent care credit on your federal return *152410110002* *152410120002* 2015 D 2441 P1 2015 D 2441 P2 6 Total expenses paid Address Social security or Federal employer ID Address Social security or Federal employer ID Address Social security or Federal employer ID ATTACH THIS FORM TO YOUR FORM D 40 Before you begin Care Credit for Part Year Residents Child and Dependent Care Credit for Part Year Residents D 2441 Child and Dependent D 2441 PAGE 2 DC credit Round cents to the nearest dollar Dependent care expenses Complete for all people or organizations who provided care during 2015 so that you could work or look for work District of Columbia Enter dates you were a DC resident in 2015 From To Enter the amount on Line 22 of Form D 40 Enter your last name Enter your social security number First name M I Last name First name M I Last name Government of the If an individual identify their relationship to you If an individual identify their relationship to you If an individual identify their relationship to you If the amount is zero leave the line blank If you need to list additional dependents attach a statement with the same information for them Important: First calculate your federal return child and dependent care credit Line 9 x 32) 4 $ 00 Lived in your household from MMDDYY to MMDDYY Lived in your household from MMDDYY to MMDDYY M M D D M M D D Name as shown on Form D 40 Your social security number Name From (MMDD) To (MMDD) Amount paid Name From (MMDD) To (MMDD) Amount paid Name From (MMDD) To (MMDD) Amount paid OFFICIAL USE ONLY Vendor ID# 0002 Qualifying dependents Complete for all qualifying individuals for whom you claimed expenses on your federal Form 2441 Revised 11/2015 Social security number Relationship to you Date of birth (MMDDYYYY) Social security number Relationship to you Date of birth (MMDDYYYY) the nearest dollar You must meet the following requirements to use this form: