//1ä1FORM 2441ò CREDIT FOR CHILD AND DEPENDENT CARE EXPENSESò 1990 * 21Ýò =OMB No. 1545-0068Ýò-OÝò =SSN:ßãNAME*ßDãSSN*Ýò=OÝPART I - PERSONS OR ORGANIZATIONS PROVIDING THE CAREÝ 1. (a) Nameò | (b) Addressò | (c) ID Number | (d) Amt PaidÝò-|ò-|ò-|ò- Ýò |ò |ò |ßîáïßîáïß5îáïßEîáïÝò |ò |ò |ßîáïÝò-|ò-|ò-|ò- Ýò |ò |ò |ßîáïßîáïß5îáïßEîá ïÝò |ò |ò |ßîáïÝò-|ò-|ò-|ò- Ýò |ò |ò |ßîá ïßîá ïß5îá ïßEîáïÝò |ò |ò |ßîá ïÝò-A|ò- Ý 2. Add the amounts in column (d)ò.2.|ßEîáïÝ ò-JÝ NOTE: If you paid cash wages of $50 or more in a calendar quarter toÝ an individual for services performed in your home, you must file anÝ employment tax return. Get Form 942 for details.Ýò=OÝPART II - CREDIT FOR CHILD AND DEPENDENT CARE EXPENSESÝò-NÝ 3. Number of qualifying persons cared for in 1990ò. 3.| [ ]ßGáÝò A|ò- Ý 4. Qualified expenses incurred and actually paid in 1990.ò |Ý DO NOT include any excluded benefits shown on line 25ò.4.|ßEáÝò 2ò-|ò- Ý 5. Enter $2400 ($4800 if ln 3 is more than 1)..5.|ò |ò# ß7áÝò 2|ò- |ò# Ý 6. Excluded benefits, if any, from line 25.....6.|ò |ò# ß7áÝò 2ò-|ò- Ý 7. Subtract line 6 from line 5ò.7.|ßEáÝò A|ò- Ý 8. Enter smaller of line 4 and line 7ò.8.|ßEáÝò A|ò- Ý 9. Your earned incomeò.(9.|ßEáÝò A|ò- Ý10. If married, filing joint, enter spouse's earned income....10.|ßEáÝò A|ò- Ý11. If married, filing a joint return, enter the smallerò |Ý of the amounts on line 9 and 10ò.11.|ßEáÝò A|ò- Ý12. o If married, filing a joint return, compare amounts onò |Ýò lines 8 and 11. Enter the smaller of the two here.ò |Ý o All others, compare the amounts on lines 8 and 9.ò |Ýò Enter the smaller of the two amounts hereò.12.|ßEáÝò A|ò- Ý13. Percentage from table to calculate creditò.13.|ò xßKãDEC1*Ýò A|ò- Ý14. Multiply line 12 by line 13ò.14.|ßEáÝò A|ò- Ý15. Credit for 1989 expenses paid in 1990ò.15.|ßEáÝò A|ò- Ý16. Add lines 14 and 15. Enter on Form 1040, line 41ò. 16.|ßEáÝò=OÝFor Paperwork Reduction Act Notice, see instructionsò Form 2441 (1990)ÝAM Software H838ðä2ÝÝFORM 2441 (1990)ò 8Page 2ÝÝò=OÝPART III - EMPLOYER-PAID DEPENDENT CARE BENEFITSÝò Complete this part only if you received employer-provided dependentÝò care benefits. Also, be sure to also complete Part I.Ýò-OÝ17. Enter the total amount of employer-provided dependent care |Ý benefits you received for 1990. Do not include any amounts |Ý reported to you as wages in Box 10 of Form(s) W-2ò. 17.|ßEá Ýò A|ò- Ý18. Enter the amount forfeited, if anyò.18.|ßEá!Ýò A|ò- Ý19. Subtract line 18 from line 17ò.19.|ßEá"Ýò A|ò- Ý20. Enter the total qualified expenses incurred in 1990 forò |Ý the care of a qualifying person (see instructions)ò.20.|ßEá#Ýò A|ò- Ý21. Enter the smaller of line 19 and line 20ò.21.|ßEá$Ýò A|ò- Ý22. You must enter your earned incomeò.22.|ßEá%Ýò A|ò- Ý23. If you were married at end of 1990, you must enter yourò |Ý spouse's earned income (or see instructions)ò.23.|ßEá&Ýò A|ò- Ý24. o If you were married at the end of 1990, compare theò |Ýò amounts on lines 22 and 23 and enter the smaller.ò |Ý o If you were unmarried, enter the amount from line 22.....24.|ßEá'Ýò A|ò- Ý25. Excluded benefits. Enter the smallest of the following:ò |Ý o The amount from line 21, orò |Ý o The amount from line 24, orò |Ý o $5,000 ($2,500 if married, not filing joint)ò. 25.|ßEá(Ýò A|ò- Ý26. Taxable benefits. Subtract line 25 from line 19. Enterò |Ý the result, but not less than zero. Also include thisò |Ý amount in the total on Form 1040, line 7. On the dottedò |Ý line next to line 7, write "DCB"ò.26.|ßEá)Ýò=OÝAM Software H838ð//2ä1ôN9024411*ß" XÝÝßF2441ÝÝÝÝÝÝßãNAME*ßDãSSN*ÝÝÝÝÝÝÝÝÝßáßáÝßáß7áßEáÝßáßáÝßáß7áßEá Ýßá ßá Ýßá ß7á ßEáÝßEáÝÝÝÝÝßMáÝÝÝßEáÝÝß4áÝÝß4áÝÝßEáÝßEáÝßEáÝÝßEáÝÝßEáÝÝßEáÝÝÝÝßLãDEC1*ÝÝÝÝÝÝÝÝßDáÝÝÝßDáÝßDáðä2ôN9024412*ß" XÝÝÝÝÝÝÝÝßEá ÝÝßEá!ÝÝßEá"ÝÝßEá#ÝÝßEá$ÝÝßEá%ÝÝÝßEá&ÝÝßEá'ÝÝÝÝßEá(ÝÝÝßEá)ðÿÿÿ