Form 2441 Child and Dependent Care Expenses 2009

Summary: This is an example of Form 2441 (2009) as pertains to the text. The completed line items are:

Name(s) shown on Form 1040 field contains Joan Thomas
Your social security number field contains 559-00-3436
Under Part I: Persons or Organizations Who Provided the Care:
- 1(a) Care provider's name field contains
- - Pat Green
  - ACME Computers
- 1(b) Address (number, street, apartment number, city, state, and ZIP code) field contains
- - 12 Ash Avenue, Hometown, Texas 75240
  - (See W-2)
- 1(c) Identifying number (SSN. or EIN) field contains
- - 240-00-3811
- 1(d) Amount paid (see instructions) field contains
- - 2,400
Under Part II: Credit for Child and Dependent Care Expenses:
- 2. Information about your qualifying person(s).
- (a) Qualifying person's name: First Last field contains
- - Seth Thomas
  - Susan Thomas
- (b) Qualifying person's social security number field contains
- - 559-00-1234
  - 559-00-5678
- (c) Qualified expenses you incurred and paid in 2010 for the person listed in column (a) field contains
- - 2,400
- 3. Add the amounts in column (c) of line 2. Do not enter more then $3,000 for one qualifying person or $6,000 for two or more persons. If you completed Part III, enter the amount from line 31 field contains 2,400
- 4. Enter your earned income field contains 29,000
- 5. If married filing jointly, enter your spouse's earned income (if your spouse was a student or was disabled, see the instructions); all others, enter the amount from line 4 field contains 29,000
- 6. Enter the smallest of line 3, 4, or 5 field contains 2,400
- 7. Enter the amount from Form 1040, line 38, Form 1040A, line 22, or Form 1040NR, line 37 field contains 29,000
- 8. Enter on line 8 the decimal amount shown below that applies to the amount on line 7 field contains .28
- 9. Multiply line 6 by the decimal amount on line 8. If you paid 2009 expenses in 2010, see the instructions field contains 672
- 10. Tax liability limit. Enter the amount from the Credit Limit Worksheet in the instructions. field contains 973
- 11. Credit for child and dependent care expenses. Enter the smaller of line 9 or line 10 here and on Form 1040, line 48, Form 1040A, line 29, or Form 1040NR, line 46 field contains 672

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