OMB No. 1545-0074
                                     Paid Preparer’s Due Diligence Checklist
Form  8867                           Earned Income Credit (EIC), American Opportunity Tax Credit (AOTC),                          For tax year
(Rev. November 2022)               Child Tax Credit (CTC) (including the Additional Child Tax Credit (ACTC) and                   20
                                   Credit for Other Dependents (ODC)), and Head of Household (HOH) Filing Status
Department of the Treasury  To be completed by preparer and filed with Form 1040, 1040-SR, 1040-NR, 1040-PR, or 1040-SS.     Attachment 
Internal Revenue Service            Go to www.irs.gov/Form8867 for instructions and the latest information.                  Sequence No. 70 
Taxpayer name(s) shown on return                                                                Taxpayer identification number

Preparer’s name                                                                                 Preparer tax identification number

Part I Due Diligence Requirements
Please check the appropriate box for the credit(s) and/or HOH filing status claimed on the return and complete the related Parts I–V 
for the benefit(s) claimed (check all that apply).                        EIC       CTC/ACTC/ODC                             AOTC       HOH
1     Did you complete the return based on information for the applicable tax year provided by the taxpayer                  Yes  No      N/A
      or reasonably obtained by you? (See instructions if relying on prior year earned income.)  .              . . .
2     If  credits  are  claimed  on  the  return,  did  you  complete  the  applicable  EIC  and/or  CTC/ACTC/ODC 
      worksheets found in the Form 1040, 1040-SR, 1040-NR, 1040-PR, 1040-SS, or Schedule 8812 (Form
      1040)  instructions,  and/or  the  AOTC  worksheet  found  in  the  Form  8863  instructions,  or  your  own
      worksheet(s) that provides the same information, and all related forms and schedules for each credit 
      claimed?  .        .  . .  . . . .  . .      . . . . .   . .  . . . .     . . . . .      . .              . . .
3     Did you satisfy the knowledge requirement? To meet the knowledge requirement, you must do both of
      the following.
      • Interview the taxpayer, ask questions, and contemporaneously document the taxpayer’s responses to 
       determine that the taxpayer is eligible to claim the credit(s) and/or HOH filing status.
      • Review information to determine that the taxpayer is eligible to claim the credit(s) and/or HOH filing 
       status and to figure the amount(s) of any credit(s)  .  . .  . . . .     . . . . .      . .              . . .
4     Did  any  information  provided  by  the  taxpayer  or  a  third  party  for  use  in  preparing  the  return,  or 
      information reasonably known to you, appear to be incorrect, incomplete, or inconsistent? (If “Yes,”
      answer questions 4a and 4b. If “No  ,” go  to question 5.)  . . . . .     . . . . .      . .              . . .
a     Did you make reasonable inquiries to determine the correct, complete, and consistent information?  .
b     Did  you  contemporaneously  document  your  inquiries?  (Documentation  should  include  the  questions
      you asked, whom you asked, when you asked, the information that was provided, and the impact the
      information had on your preparation of the return.)  .   . .  . . . .     . . . . .      . .              . . .
5     Did you satisfy the record retention requirement? To meet the record retention requirement, you must 
      keep a copy of your documentation referenced in question 4b, a copy of this Form 8867, a copy of any
      applicable worksheet(s), a record of how, when, and from whom the information used to prepare Form
      8867 and any applicable worksheet(s) was obtained, and a copy of any document(s) provided by the
      taxpayer that you relied on to determine eligibility for the credit(s) and/or HOH filing status or to figure 
      the amount(s) of the credit(s)   .  . .      . . . . .   . .  . . . .     . . . . .      . .              . . .
      List those documents provided by the taxpayer, if any, that you relied on:

6     Did you ask the taxpayer whether he/she could provide documentation to substantiate eligibility for the
      credit(s)  and/or  HOH  filing  status  and  the  amount(s)  of  any  credit(s)  claimed  on  the  return  if  his/her 
      return is selected for audit?  . .  . .      . . . . .   . .  . . . .     . . . . .      . .              . . .
7     Did you ask the taxpayer if any of these credits were disallowed or reduced in a previous year?  .            .
      (If credits were disallowed or reduced, go to question 7a; if not, go to question 8.)
a     Did you complete the required recertification Form 8862?  .   . . . .     . . . . .      . .              . . .
8     If the taxpayer is reporting self-employment income, did you ask questions to prepare a complete and 
      correct Schedule C (Form 1040)?  .    .      . . . . .   . .  . . . .     . . . . .      . .              . . .
For Paperwork Reduction Act Notice, see separate instructions.              Cat. No. 26142H                                  Form 8867 (Rev. 11-2022) 

Form 8867 (Rev. 11-2022)                                                                                                           Page 2 
Part II  Due Diligence Questions for Returns Claiming EIC (If the return does not claim EIC, go to Part III.)
9 a Have you determined that the taxpayer is eligible to claim the EIC for the number of qualifying children              Yes  No  N/A
    claimed, or is eligible to claim the EIC without a qualifying child? (If the taxpayer is claiming the EIC
    and does not have a qualifying child, go to question 10.)       . .  . . . . . .     . . . . . .
b   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? . . .        .   . . . . .  . . . . . .     . . . . . .
c   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)?   . .        .   . . . . .  . . . . . .     . . . . . .
Part III Due Diligence Questions for Returns Claiming CTC/ACTC/ODC (If the return does not claim CTC, ACTC, 
         or ODC, go to Part IV.)
10  Have you determined that each qualifying person for the CTC/ACTC/ODC is the taxpayer’s dependent who is               Yes  No  N/A
    a citizen, national, or resident of the United States?  . . . . . .  . . . . . .     . . . . . .
11  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?   .  . . . . .     . . . . . .
12  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?  .  . . . . .     . .        .   . . . . .  . . . . . .     . . . . . .
Part IV  Due Diligence Questions for Returns Claiming AOTC (If the return does not claim AOTC, go to Part V.)
13  Did the taxpayer provide substantiation for the credit, such as a Form 1098-T and/or receipts for the qualified            Yes No 
    tuition and related expenses for the claimed AOTC? .        . . . .  . . . . . .     . . . . . .      .               .   .
Part V   Due Diligence Questions for Claiming HOH (If the return does not claim HOH filing status, go to Part VI.)
14  Have you determined that the taxpayer was unmarried or considered unmarried on the last day of the tax year                Yes No 
    and provided more than half of the cost of keeping up a home for the year for a qualifying person?  . .               .   .
Part VI  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:
         A. 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);
         B. 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;
         C. Submit Form 8867 in the manner required; and
         D. Keep all five of the following records for 3 years from the latest of the dates specified in the Form 8867 instructions under 
         Document Retention.
         1. A copy of this Form 8867.
         2. The applicable worksheet(s) or your own worksheet(s) for any credit(s) claimed.
         3. 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).
         4. A record of how, when, and from whom the information used to prepare this form and the applicable worksheet(s) was 
         obtained.
         5. 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).
    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  Do you certify that all of the answers on this Form 8867 are, to the best of your knowledge, true, correct, and            Yes No 
    complete? .          . . . . . . . . .     . .        .   . . . . .  . . . . . .     . . . . . .      .               .   .
                                                                                                                          Form 8867 (Rev. 11-2022)