2009 Form 8914 F8914
User Manual: 8914
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Form 8914 Exemption Amount for Taxpayers Housing Midwestern Displaced Individuals Department of the Treasury Internal Revenue Service Name(s) shown on your return Part I © Attach OMB No. 1545-0074 2009 Attachment Sequence No. 55 Your social security number to Form 1040, Form 1040A, or Form 1040NR. Information on Midwestern Displaced Individuals for Whom You Provided Housing in Your Main Home for at Least 60 Consecutive Days Do not enter information for more than four individuals, for anyone included on line 6d of Form 1040 or 1040A (line 7d of Form 1040NR), or for anyone included on a Form 8914 you filed for 2008. 1 (a) First and last name Part II 2 3 4 5 6 7 8 9 (b) Social security number (see instructions) (c) Former address in disaster area (number and street, city or town, state, and ZIP code) (d) Number of consecutive days housed in your main home Exemption Amount Maximum exemption amount. Enter $2,000 (see instructions if married filing separately) Did you file Form 8914 for 2008? Yes. Enter the amount from your 2008 Form 8914, line 2. . . . . . . . No. Enter -0Subtract line 3 from line 2 . . . . . . . . . . . . . . . . . . . . . Multiply $500 by the total number of individuals listed in Part I above . . . . . . . Enter the smaller of line 4 or line 5 . . . . . . . . . . . . . . . . . . . Multiply $3,650 by the total number of exemptions claimed on line 6d of Form 1040 1040A (line 7d of Form 1040NR) . . . . . . . . . . . . . . . . . . . Add lines 6 and 7 . . . . . . . . . . . . . . . . . . . . . . . . } . . . 2 . . . 3 . . . . . . Form . . . . 4 5 6 . . . or . . 7 8 Is the amount on Form 1040, line 38 (Form 1040A, line 22; or Form 1040NR, line 36), more than the amount shown on line 10 below for your filing status? No. Enter the amount from line 8 above on Form 1040, line 42 (Form 1040A, line 26; or Form 1040NR, line 39). 10 Yes. Enter the amount from Form 1040, line 38 (Form 1040A, line 22; or Form 1040NR, line 36) . . . . . . . . . . . . Enter the amount shown below for your filing status. • Single—$166,800 • Married filing jointly or Qualifying widow(er)—$250,200 . . . . • Married filing separately—$125,100 • Head of household—$208,500 Form 1040NR filers, see instructions Subtract line 10 from line 9 . . . . . . . . . . . . . . . Is line 11 more than $122,500 ($61,250 if married filing separately)? No. Skip line 13; go to line 14. Yes. Multiply $2,433 by the total number of exemptions claimed on line 6d of Form 1040 or Form 1040A (line 7d of Form 1040NR) . . } 11 12 13 14 15 16 17 18 Add lines 6 and 12. Enter the result here and on Form 1040, line 42; Form 1040A, line 26; or Form 1040NR, line 39. Do not complete the rest of this form . . . . . . . . . . . . . . . . . . . 9 10 11 12 13 Divide line 11 by $2,500 ($1,250 if married filing separately). If the result is not a whole number, increase it to the next higher whole number (for 14 example, increase .0004 to 1) . . . . . . . . . . . . . . Multiply line 14 by 2% (.02) and enter the result as a decimal rounded . 15 to at least three places . . . . . . . . . . . . . . . . 16 Multiply line 7 by line 15 . . . . . . . . . . . . . . . . Divide line 16 by 3.0 . . . . . . . . . . . . . . . . . . . . . . . . . . Exemption amount. Subtract line 17 from line 8. Enter the result here and on Form 1040, line 42; Form 1040A, line 26; or Form 1040NR, line 39 . . . . . . . . . . . . . . . . . . For Paperwork Reduction Act Notice, see page 3. Cat. No. 37724X 17 18 Form 8914 (2009) [This page left blank intentionally] Page 3 Form 8914 (2009) General Instructions Purpose of Form Use Form 8914 to claim your personal exemptions, exemptions for dependents, and the additional exemption amount for providing housing in your main home to one or more Midwestern displaced individuals. Additional Exemption Amount You can claim an additional exemption amount of $500 for each Midwestern displaced individual (defined below). You can claim an additional exemption amount only one time for a specific individual. If you claimed an additional exemption amount for an individual in 2008, you cannot claim that amount again for the same individual in 2009. The maximum additional exemption amount you can claim for all displaced individuals is $2,000. Any additional exemption amount you claimed for displaced individuals in 2008 will reduce the $2,000 maximum for 2009. The $2,000 limit applies to a husband and wife, whether the husband and wife file joint returns or separate returns. If married filing separately, the $2,000 can be divided in $500 increments between the spouses. For example, if one spouse claims an additional exemption amount for one displaced individual, the other spouse, if otherwise eligible, can claim additional exemption amounts for three different displaced individuals. If two or more taxpayers share the same main home, only one taxpayer in that main home can claim the additional exemption amount for a specific displaced individual. In order for you to be considered to have provided housing, you must have a legal interest in the main home (that is, own or rent the home). Midwestern Displaced Individual To qualify as a Midwestern displaced individual, an individual must meet the following three conditions. • The individual must have had his or her main home in one of the counties listed in Table 1 or Table 2 on page 4 on an applicable disaster date shown in the table for that county, and he or she must have been displaced from that home. In addition, if the individual’s main home was in a county listed in Table 2, the home must have been damaged by the storms, tornadoes, or flooding that gave rise to the disaster declaration for that county, or the individual must have been evacuated from the home because of the storms, tornadoes, or flooding. • He or she must have been provided housing in your main home free of charge for a period of at least 60 consecutive days ending in 2009. See Compensation for Housing below. • He or she cannot be your spouse or dependent. Compensation for Housing You cannot claim the additional exemption amount if you received rent (or any other amount) from any source for providing the housing. You are permitted to receive payments or reimbursements that do not relate to normal housing costs, including the following. • Food, clothing, or personal items consumed or used by the displaced individual. • Reimbursement for the cost of any long distance telephone calls made by the displaced individual. • Reimbursement for the cost of gasoline for the displaced individual’s use of your vehicle. However, you cannot claim the additional exemption amount if you received any reimbursement for the extra costs of heat, electricity, or water used by the displaced individual. Specific Instructions Line 1, Column (a) Enter the first and last names of up to four displaced individuals who were provided housing in your main home for a period of at least 60 consecutive days ending in 2009. If less than 60 consecutive days, you cannot claim an additional exemption amount for this individual. Do not enter the name of any individual you included on a Form 8914 you filed for 2008. Line 1, Column (b) Enter the displaced individual’s social security number (SSN) or individual taxpayer identification number (ITIN). You must provide this information in column (b) to claim an exemption amount. You can use Form W-9, Request for Taxpayer Identification Number and Certification, to request an SSN or ITIN from the displaced individual. Line 1, Column (c) Enter the street address where the displaced individual’s main home was located on the applicable disaster date. That home must have been located in a Midwestern disaster area on that date. Include the number and street, city or town, state, and ZIP code. Line 1, Column (d) Enter the number of consecutive days the displaced individual was provided housing in your main home free of charge. Line 10 If you are filing Form 1040NR, enter the amount shown below for your filing status. • Filing status box 1 or 2 — $166,800 • Filing status box 3, 4, or 5 — $125,100 • Filing status box 6 — $250,200 Paperwork Reduction Act Notice. We ask for the information on this form to carry out the Internal Revenue laws of the United States. You are required to give us the information. We need it to ensure that you are complying with these laws and to allow us to figure and collect the right amount of tax. You are not required to provide the information requested on a form that is subject to the Paperwork Reduction Act unless the form displays a valid OMB control number. Books or records relating to a form or its instructions must be retained as long as their contents may become material in the administration of any Internal Revenue law. Generally, tax returns and return information are confidential, as required by Internal Revenue Code section 6103. The average time and expenses required to complete and file this form will vary depending on individual circumstances. For the estimated averages, see the instructions for your income tax return. If you have suggestions for making this form simpler, we would be happy to hear from you. See the instructions for your income tax return. Page 4 Form 8914 (2009) Table 1 Table 2 The counties listed in Table 1 below are Midwestern disaster areas. You may be eligible for the additional $500 exemption for housing a Midwestern displaced individual if that individual had his or her main home in one of the counties listed in this table on an applicable disaster date shown for that county and was displaced from that home. The counties listed in Table 2 below are Midwestern disaster areas. You may be eligible for the additional $500 exemption for housing a Midwestern displaced individual if that individual had his or her main home in one of the counties listed in this table on an applicable disaster date shown for that county and was displaced from that home and either: • That home was damaged by the storms, tornadoes, or flooding that gave rise to the disaster declaration for that county, or • The individual was evacuated from that home because of the storms, tornadoes, or flooding. Applicable Disaster Dates* State Affected Counties — Midwestern Disaster Areas 05/02/2008 through 05/12/2008 Arkansas Arkansas, Benton, Cleburne, Conway, Crittenden, Grant, Lonoke, Mississippi, Phillips, Pulaski, Saline, and Van Buren 06/01/2008 through 07/22/2008 Illinois Adams, Calhoun, Clark, Coles, Crawford, Cumberland, Douglas, Edgar, Hancock, Henderson, Jasper, Jersey, Lake, Lawrence, Mercer, Rock Island, Whiteside, and Winnebago 05/30/2008 through 06/27/2008 Indiana 05/25/2008 through 08/13/2008 Iowa Adams, Bartholomew, Brown, Clay, Daviess, Dearborn, Decatur, Gibson, Grant, Greene, Hamilton, Hancock, Hendricks, Henry, Huntington, Jackson, Jefferson, Jennings, Johnson, Knox, Lawrence, Madison, Marion, Monroe, Morgan, Owen, Parke, Pike, Posey, Putnam, Randolph, Ripley, Rush, Shelby, Sullivan, Tippecanoe, Vermillion, Vigo, Washington, and Wayne Adair, Adams, Allamakee, Appanoose, Audubon, Benton, Black Hawk, Boone, Bremer, Buchanan, Butler, Cass, Cedar, Cerro Gordo, Chickasaw, Clarke, Clayton, Clinton, Crawford, Dallas, Davis, Decatur, Delaware, Des Moines, Dubuque, Fayette, Floyd, Franklin, Fremont, Greene, Grundy, Guthrie, Hamilton, Hancock, Hardin, Harrison, Henry, Howard, Humboldt, Iowa, Jackson, Jasper, Johnson, Jones, Keokuk, Kossuth, Lee, Linn, Louisa, Lucas, Madison, Mahaska, Marion, Marshall, Mills, Mitchell, Monona, Monroe, Montgomery, Muscatine, Page, Polk, Pottawattamie, Poweshiek, Ringgold, Scott, Story, Tama, Union, Van Buren, Wapello, Warren, Washington, Webster, Winnebago, Winneshiek, Worth, and Wright 05/10/2008 through 05/11/2008 Missouri 06/01/2008 through 08/13/2008 Missouri Adair, Andrew, Callaway, Cass, Chariton, Clark, Gentry, Greene, Harrison, Holt, Johnson, Lewis, Lincoln, Linn, Livingston, Macon, Marion, Monroe, Nodaway, Pike, Putnam, Ralls, St. Charles, Stone, Taney, Vernon, and Webster 05/22/2008 through 06/24/2008 Nebraska Buffalo, Butler, Colfax, Custer, Dawson, Douglas, Gage, Hamilton, Holt, Jefferson, Kearney, Lancaster, Platte, Richardson, Sarpy, and Saunders 06/05/2008 through 07/25/2008 Wisconsin Adams, Calumet, Columbia, Crawford, Dane, Dodge, Fond du Lac, Grant, Green, Green Lake, Iowa, Jefferson, Juneau, Kenosha, La Crosse, Manitowoc, Marquette, Milwaukee, Monroe, Ozaukee, Racine, Richland, Rock, Sauk, Sheboygan, Vernon, Walworth, Washington, Waukesha, and Winnebago Applicable Disaster Dates* State Affected Counties — Midwestern Disaster Areas 06/01/2008 through 07/22/2008 Illinois Greene, Madison, Monroe, Pike, Randolph, St. Clair, and Scott 05/30/2008 through 06/27/2008 Indiana Benton, Boone, Fountain, Franklin, Jay, Montgomery, Ohio, Switzerland, Union, and Wabash 05/25/2008 through 08/13/2008 Iowa Carroll, Cherokee, Lyon, Palo Alto, Pocahontas, Taylor, and Wayne 05/22/2008 through 06/16/2008 Kansas Barber, Barton, Bourbon, Brown, Butler, Chautauqua, Cherokee, Clark, Clay, Comanche, Cowley, Crawford, Decatur, Dickinson, Edwards, Elk, Ellis, Ellsworth, Franklin, Gove, Graham, Harper, Haskell, Hodgeman, Jackson, Jewell, Kingman, Kiowa, Lane, Linn, Logan, Mitchell, Montgomery, Ness, Norton, Osborne, Pawnee, Phillips, Pratt, Reno, Republic, Riley, Rooks, Rush, Saline, Seward, Sheridan, Smith, Stafford, Sumner, Thomas, Trego, Wallace, and Wilson 06/06/2008 through 06/13/2008 Michigan Allegan, Barry, Eaton, Ingham, Lake, Manistee, Mason, Missaukee, Osceola, Ottawa, Saginaw, and Wexford 06/06/2008 through 06/12/2008 Minnesota Cook, Fillmore, Freeborn, Houston, Mower, and Nobles 06/01/2008 through 08/13/2008 Missouri Atchison, Audrain, Bates, Buchanan, Cape Girardeau, Carroll, Christian, Daviess, Grundy, Howard, Jefferson, Knox, Mercer, Miller, Mississippi, Morgan, New Madrid, Pemiscot, Perry, Pettis, Platte, Polk, Randolph, Ray, Saline, Schuyler, Scotland, Shelby, St. Genevieve, St. Louis, the Independent City of St. Louis, Scott, Sullivan, and Worth 04/23/2008 through 04/26/2008 Nebraska Gage, Johnson, Morrill, Nemaha, and Pawnee 05/22/2008 through 06/24/2008 Nebraska Adams, Blaine, Boone, Boyd, Brown, Burt, Cass, Chase, Cherry, Cuming, Dundy, Fillmore, Frontier, Furnas, Garfield, Gosper, Greeley, Hall, Hayes, Howard, Johnson, Keya Paha, Lincoln, Logan, Loup, Merrick, McPherson, Morrill, Nance, Nemaha, Otoe, Phelps, Polk, Red Willow, Rock, Saline, Seward, Sherman, Stanton, Thayer, Thomas, Thurston, Valley, Webster, Wheeler, and York 06/27/2008 Nebraska Dodge, Douglas, Sarpy, and Saunders 06/05/2008 through 07/25/2008 Wisconsin Lafayette Barry, Jasper, and Newton * For more details, go to www.fema.gov. * For more details, go to www.fema.gov.
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