Schedule R (Form 1040A or 1040), Credit for the Elderly or the Disabled 2012

Summary: This is an example of Schedule R (Form 1040A or 1040) 2012, Page 1 with items completed per example in the text:

Name(s) shown on Form 1040 field contains William M. Henry and Helen A. Henry
Your social security number field contains 220-00-3333
UnderPart I: Check the Box for Your Filing Status and Age:
- In the sectionMarried filing jointly, line item5. Both spouses were under 65, and both retired on permanent and total disability checkbox checked
UnderPart II: Statement of Permanent and Total Disability:
- 2. Due to your continued disabled condition, you were unable to engage in any substantial gainful activity in 2012, check this box checkbox checked and William is written above checkbox.