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EFTA01220827

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Form 8862 (Rev. December 2012) Deparbnem of the Treasury Interrol Revenue Service Name(s) shown on return Information To Claim Earned Income Credit After Disallowance *Attach to your tax return. ► Information about Form 8862 and its instructions is at www.irs.govilortn8862. OMB No.1545-0074 Attachment Sequence No. 43A Your social secubity number Before you begin:  See your tax return instructions or Pub. 596, Earned Income Credit (EIC), for the year for which you are filing this form to make sure you can take the earned income credit (EIC) and to find out who is a qualifying child.  If you have a qualifying child, complete Schedule EIC before you fill in this form.  Do not file this form if you are taking the EIC without a qualifying child and the only reason your EIC was reduced or disallowed in the earlier year was because it was determined that a child listed on Schedule EIC was not your qualifying child. lag All Filers Enter the year for which you are filing this form (for example, 2012) ► DODO 2 If the only reason your EIC was reduced or disallowed in the earlier year was because you incorrectly reported your earned income or investment income, check "Yes." Otherwise, check "No" . . . . ► K Yes K No Caution. If you checked "Yes," stop. Do not fill in the rest of this form. But you must attach it to your tax return to take the EIC. If you checked "No," continue. 3 Could you (or your spouse if filing jointly) be claimed as a qualifying child of another taxpayer for the year shown on line 1? See the instructions before answering ► K Yes K No Caution. If you checked "Yes," stop. You cannot take the EIC. If you checked "No," continue. Filers With a Qualifying Child or Children Note. Child 1, Child 2, and Child 3 are the same children you listed as Child 1, Child 2, and Child 3 on Schedule EIC for the year shown on line 1 above. 4 Enter the number of days each child lived with you in the United States during the year s

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