Form    8828                          Recapture of Federal Mortgage Subsidy                                                  OMB No. 1545-0074
(Rev. March 2010)
                                                                                                                             Attachment   
Internal Revenue Service (99) 
Department of the Treasury                  © Attach to Form 1040.      © See separate instructions.                         Sequence No. 64 
Name(s)                                                                            Social security number (as shown on page 1 of your tax return) 

Part I  Description of Home Subject to Federally Subsidized Debt 
1       Address of property (number and street, city or town, state, and ZIP code) 

2       Check the box that describes the type of federal subsidy you had on the loan for your home. 
a       Mortgage loan from the proceeds of a tax-exempt bond 
b       Mortgage credit certificate 
        Note.    If  neither  box  applies,  you  are  not  subject  to  recapture  tax  on  the  sale  or  other  disposition  of  your  home.  Do  not 
        complete this form. 
3       Name of the bond or certificate issuer 
                                                        State                 Political subdivision (city, county, etc.)          Agency, if any 
4       Name and address of original lending institution 
5       Date of closing of the original loan  .  .   .  . .   . . .       . . . . . .  .
                                                                                                     Month               Day           Year
        Note. If the date of closing of the loan was before January 1, 1991, recapture tax does not apply. Do not complete this form.  If
        you  (1)  checked  the  box  on  line  2b  (mortgage  credit  certificate),  (2)  refinanced  your  home,  and  (3)  received  a  reissued 
        mortgage credit certificate, see Refinancing your home on page 1 of the instructions. 
6       Date of sale or other disposition of your interest in the home  .   . . . . .  .
                                                                                                     Month               Day           Year 
7       Number of years and full months between original closing date (line 5) and date of sale or disposition (line 6): 
                                                                                                                                  Years  Full months
8       Date  of  full  repayment  of  the  original  loan  including  a  refinancing  other  than  one  for  which  a  replacement  mortgage  credit 
        certificate was issued (see instructions)  . .  . .   . . .       . . . . . .  .
                                                                                                     Month               Day           Year 
Part II Computation of Recapture Tax 
9       Sales price of your interest in the home sold or disposed of (see instructions)  . .  .      . .   .             9 
10      Expenses of sale. Include sales commissions, advertising, legal fees, etc.  .  .   .  .      . .   .             10 
11      Amount realized. Subtract line 10 from line 9  .  .   . . .       . . . . . .  .   .  .      . .   .             11 

12      Adjusted basis of your interest in the home sold or disposed of (see instructions)  . .      . .   .             12 
13      Gain or (loss) from sale or disposition. Subtract line 12 from line 11. If a loss, stop here and 
        attach this form to your Form 1040. You do not owe recapture tax  .     . . .  .   .  .      . .   .             13 

14      Multiply line 13 by 50% (.50)   .   . .  .   .  . .   . . .       . . . . . .  .   .  .      . .   .             14 
15      Modified adjusted gross income (see instructions)  .    . .       . . . . . .  .   .  .      . .   .             15 

16      Adjusted qualifying income (see instructions)  .  .   . . .       . . . . . .  .   .  .      . .   .             16 

17      Subtract line 16 from line 15. If zero or less, stop here and attach this form to your Form 1040. 
        You do not owe recapture tax  .     . .  .   .  . .   . . .       . . . . . .  .   .  .      . .   .             17 
18      Income percentage. If the amount on line 17 is $5,000 or more, enter “100.” Otherwise, divide 
        the amount on line 17 by $5,000 and enter the result as a percentage. Round to the nearest 
        whole percentage  .   .  .   .  .   . .  .   .  . .   . . .       . . . . . .  .   .  .      . .   .             18                      %
19      Federally subsidized amount (see instructions)    .   . . .       . . . . . .  .   .  .      . .   .             19 
20      Holding period percentage (see instructions)  .   .   . . .       . . . . . .  .   .  .      . .   .             20                      %

21      Multiply line 19 by the percentage on line 20   . .   . . .       . . . . . .  .   .  .      . .   .             21 

22      Recapture amount. Multiply line 21 by the percentage on line 18       . . . .  .   .  .      . .   .             22 

23      Tax. Enter the smaller of line 14 or line 22. Also, include this amount on the line for total tax on
        Form 1040. For details, see the Instructions for Form 1040        . . . . . .  .   .  .      . .   .             23 
For Paperwork Reduction Act Notice, see Form 1040 instructions.                            Cat. No. 13049F                  Form  8828  (Rev. 3-2010)