Schedule R, Page 2

Summary: This is an example of Schedule R (Form 1040A or 1040) 2009, Page 2 with the following line items listed under Part III: Figure Your Credit completed:

10. If you checked (in Part I): Enter: field contains 7,500
11. If you checked (in Part I): field contains 7,900
12. If you completed line 11, enter the smaller of line 10 or line 11; all others, enter the amount from line 10 field contains 7,500
13a. Nontaxable part of social security benefits and Nontaxable part of railroad retirement benefits treated as social security. See page R-3. field contains 2,750
13c. Add lines 13a and 13b. (even though these income items are not taxable, they must be included here to figure your credit.) If you did not receive any of the types of nontaxable income listed on line 13a or 13b, enter 0 on line 13c. field contains 2,750
14. Enter the amount from Form 1040, line 38 field contains 19,000
15. If you checked (in Part I): Enter: field contains 10,000
16. Subtract line 15 from line 14. If zero or less, enter 0 field contains 9,000
17. Enter one-half of line 16 field contains 4,500
18. Add lines 13c and 17 field contains 7,250
19. Subtract line 18 from line 12. If zero or less, stop; you cannot take the credit. Otherwise, go to line 20 field contains 250
20. Multiply line 19 by 15% (.15) field contains 38
21. Enter the amount from Form 1040, line 46 field contains 30
22. Add the amounts from Form 1040, lines 47 and 48, and enter the total field contains 0
23. Subtract line 22 from line 21 field contains 30
24. Credit for the elderly or the disabled. Enter the smaller of line 20 or line 23. Also enter this amount on Form 1040A, line 30, or include on Form 1040, line 53 (check box c and enter Sch R in the space next to that line field contains 38

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