2018 _ Form 1040 _ Tax Returns - Laserfiche WebLink

Home Browse Search

Part I Part II Part III column A) Form 8962 (2018) DAA For Paperwork Reduction Act Notice, see your tax return instructions. 2018 Attach to Form 1040 or Form 1040NR. Your social security numberName shown on your return  Go to www.irs.gov/Form8962 for instructions and the latest information.Sequence No. Attachment OMB No. 1545-0074 73 Premium Tax Credit (PTC) Department of the Treasury Internal Revenue Service Form 8962 1 2a 3 4 5 6 7 8a Tax family size. Enter your tax family size (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8b 7 5 4 3 2b 1 10 9 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 29 28 27 24 25 26 27 28 29 Annual Totals January February March April May June July August September October November December Annual Calculation Monthly Calculation (c) Annual (d) Annual maximum (e) Annual premium tax (f) Annual advance (f) Monthly advance(e) Monthly premium tax(d) Monthly maximum(c) Monthly (a) Annual enrollment premiums (Form(s) 1095-A, line 33A) 1095-A, lines 21-32, premiums (Forms(s) (a) Monthly enrollment 21-32, column B) (b) Monthly applicable SLCSP premium (Form(s) 1095-A, lines Modified AGI. Enter your modified AGI (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . Enter the total of your dependents' modified AGI (see instructions) . . . . . . . . . . . . . . . . 2a b Household income. Add the amounts on lines 2a and 2b (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Federal poverty line. Enter the federal poverty line amount from Table 1-1, 1-2, or 1-3 (see instructions). Check the appropriate box for the federal poverty table used.a bcAlaska Hawaii Other 48 states and DC Household income as a percentage of federal poverty line (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Did you enter 401% on line 5? (See instructions if you entered less than 100%.) No. Continue to line 7. Yes. You are not eligible to take the PTC. If advance payment of the PTC was made, see the instructions for how to report your excess advance PTC repayment amount. Applicable Figure. Using your line 5 percentage, locate your "applicable figure" on the table in the instructions . . . 8aline 7. Round to nearest whole dollar amount Annual contribution amount. Multiply line 3 by b Monthly contribution amount. Divide line 8a by 12. Round to nearest whole dollar amount . Yes. Skip to Part IV, Allocation of Policy Amounts, or Part V, Alternative Calculation for Year of Marriage. Are you allocating policy amounts with another taxpayer or do you want to use the alternative calculation for year of marriage (see instructions)? No. Continue to line 10. No. Continue to lines 12-23. Compute your monthly PTC and continue to line 24. See the instructions to determine if you can use line 11 or must complete lines 12 through 23. and continue to line 24. Yes. Continue to line 11. Compute your annual PTC. Then skip lines 12-23 Net premium tax credit. If line 24 is greater than line 25, subtract line 25 from line 24. Enter the difference here and on Schedule 5 (Form 1040), line 70, or Form 1040NR, line 65. If line 24 equals line 25, enter -0-. Stop here. If line 25 is greater than line 24, leave this line blank and continue to line 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Total premium tax credit. Enter the amount from line 11(e) or add lines 12(e) through 23(e) and enter the total here Advance payment of PTC. Enter the amount from line 11(f) or add lines 12(f) through 23(f) and enter the total here Excess advance payment of PTC. If line 25 is greater than line 24, subtract line 24 from line 25. Enter the difference here . . . . . . . . . Repayment limitation (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Excess advance premium tax credit repayment. Enter the smaller of line 27 or line 28 here and on Schedule 2 (Form 1040), line 46, or Form 1040NR, line 44 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Form(s) 1095-A, SLCSP premium (b) Annual applicable line 33B) contribution amount (line 8a) contribution amount (amount from line 8b or alternative marriage monthly calculation) premium assistance (subtract (c) from (b), if premium assistance (subtract (c) from (b), if credit allowed (smaller of (a) or (d)) credit allowed (smaller of (a) or (d)) payment of PTC (Form(s) 1095-A, lines 21-32, payment of PTC (Form(s) column C) % You cannot take the PTC if your filing status is married filing separately unless you qualify for an exception (see instructions). If you qualify, check the box . . Annual and Monthly Contribution Amount Premium Tax Credit Claim and Reconciliation of Advance Payment of Premium Tax Credit zero or less, enter -0-) 1095-A, line 33C) zero or less, enter -0-) Repayment of Excess Advance Payment of the Premium Tax Credit  WESLEY C BROWN 595-42-0794 4 165,954 165,954 X 24,600 401 X 0.0000 00 X X 54 540 540 540 540 540 540 540 540 0 4,374 4,374 4,374