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Form 8867 (Rev. 11-2024)Page Form (Rev. 11-2024) 420502 11-13-24 2 Due Diligence Questions for Returns Claiming EIC 9a b c (If the taxpayer is claiming the EIC and does not have a qualifying child, go to question 10.) Yes No N/A Due Diligence Questions for Returns Claiming CTC/ACTC/ODC 10 11 12 Yes No N/A Due Diligence Questions for Returns Claiming AOTC 13 Yes No Due Diligence Questions for Claiming HOH 14 Yes No Eligibility Certification You will have complied with all due diligence requirements for claiming the applicable credit(s) and/or HOH filing status on the return of the taxpayer identified above if you: and If you have not complied with all due diligence requirements, you may have to pay a penalty for each failure to comply related to a claim of an applicable credit or HOH filing status (see instructions for more information). 15 Yes No 8867 Document Retention. (If the return does not claim EIC, go to Part III.) Have you determined that the taxpayer is eligible to claim the EIC for the number of qualifying children claimed, or is eligible to claim the EIC without a qualifying child? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Did you ask the taxpayer if the child lived with the taxpayer for over half of the year, even if the taxpayer has supported the child the entire year?~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Did you explain to the taxpayer the rules about claiming the EIC when a child is the qualifying child of more than one person (tiebreaker rules)? (If the return does not claim CTC, ACTC, or ODC, go to Part IV.) Have you determined that each qualifying person for the CTC/ACTC/ODC is the taxpayer's dependent who is a citizen, national, or resident of the United States?~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Did you explain to the taxpayer that he/she may not claim the CTC/ACTC if the child has not lived with the taxpayer for over half of the year, even if the taxpayer has supported the child, unless the child's custodial parent has released a claim to exemption for the child?~~~~~~~~~~~~~~~~~~~~~~~~~~ Did you explain to the taxpayer the rules about claiming the CTC/ACTC/ODC for a child of divorced or separated parents (or parents who live apart), including any requirement to attach a Form 8332 or similar statement to the return? (If the return does not claim AOTC, go to Part V.) Did the taxpayer provide substantiation for the credit, such as a Form 1098-T and/or receipts for the qualified tuition and related expenses for the claimed AOTC? (If the return does not claim HOH filing status, go to Part VI.) Have you determined that the taxpayer was unmarried or considered unmarried on the last day of the tax year and provided more than half of the cost of keeping up a home for the year for a qualifying person? A. B. C. D. Interview the taxpayer, ask adequate questions, contemporaneously document the taxpayer's responses on the return or in your notes, review adequate information to determine if the taxpayer is eligible to claim the credit(s) and/or HOH filing status and to figure the amount(s) of the credit(s); Complete this Form 8867 truthfully and accurately and complete the actions described in this checklist for any applicable credit(s) claimed and HOH filing status, if claimed; Submit Form 8867 in the manner required; Keep all five of the following records for 3 years from the latest of the dates specified in the Form 8867 instructions under 1. 2. 3. 4. 5. A copy of this Form 8867. The applicable worksheet(s) or your own worksheet(s) for any credit(s) claimed. Copies of any documents provided by the taxpayer on which you relied to determine the taxpayer's eligibility for the credit(s) and/or HOH filing status and to figure the amount(s) of the credit(s). A record of how, when, and from whom the information used to prepare this form and the applicable worksheet(s) was obtained. A record of any additional information you relied upon, including questions you asked and the taxpayer's responses, to determine the taxpayer's eligibility for the credit(s) and/or HOH filing status and to figure the amount(s) of the credit(s). Do you certify that all of the answers on this Form 8867 are, to the best of your knowledge, true, correct, and complete? Part II Part III Part IV Part V Part VI Ran & Sharon Oz 621-77-9016 X X X X 22 10440220 163039 1I9016RA 2024.02060 OZ, RAN 1I9016R1