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Information To Claim Earned Income Credit OMB No. 1545-0074
Form 8862 After Disallowance
(Rev. December 2012) ▶ Attach to your tax return. Attachment
Department of the Treasury ▶ Information about Form 8862 and its instructions is at www.irs.gov/form8862. Sequence No. 43A
Internal Revenue Service
Name(s) shown on return Your social security number

Before you begin: ✓ See your tax return instructions or Pub. 596, Earned Income Credit (EIC), for the year for which you are filing
this form to make sure you can take the earned income credit (EIC) and to find out who is a qualifying child.
✓ If you have a qualifying child, complete Schedule EIC before you fill in this form.
✓ Do not file this form if you are taking the EIC without a qualifying childand the only reason your EIC was
reduced or disallowed in the earlier year was because it was determined that a child listed on Schedule
EIC was not your qualifying child.
Part I All Filers
1 Enter the year for which you are filing this form (for example, 2012) . . . . . . . . . . . . ▶
2 If the only reason your EIC was reduced or disallowed in the earlier year was because you incorrectly
reported your earned income or investment income, check “Yes.” Otherwise, check “No” . . . . ▶ Yes No
Caution. If you checked “Yes,” stop. Do not fill in the rest of this form. But you must attach it to your tax return to take the
EIC. If you checked “No,” continue.
3 Could you (or your spouse if filing jointly) be claimed as a qualifying child of another taxpayer for the year
shown on line 1? See the instructions before answering . . . . . . . . . . . . . . . ▶ Yes No
Caution. If you checked “Yes,” stop. You cannot take the EIC. If you checked “No,” continue.
Part II Filers With a Qualifying Child or Children
Note. Child 1,Child 2, and Child 3are the same children you listed as Child 1, Child 2, and Child 3 onSchedule EICfor the year
shown on line 1 above.
4 Enter the number of days each child lived with you in the United States during the year shown on line 1 above:
a Child 1 ▶ b Child 2 ▶ c Child 3 ▶
Caution. If you entered less than 183 (184 if the year on line 1 is a leap year) for any child, you cannot take the EIC based on
that child, unless the special rule for a child who was born or died during the year shown on line 1 applies. See the instructions.
5 If your child was born or died during the year shown on line 1, enter the month and day the child was born and/or died.
Otherwise, skip this line.
a Child 1 ▶ (1) Month and day of birth (MM/DD) ▶ / (2) Month and day of death (MM/DD) ▶ /
b Child 2 ▶ (1) Month and day of birth (MM/DD) ▶ / (2) Month and day of death (MM/DD) ▶ /
c Child 3 ▶ (1) Month and day of birth (MM/DD) ▶ / (2) Month and day of death (MM/DD) ▶ /
6 Enter the address where you and the child lived together during the year shown on line 1. If you lived with the child at more
than one address during the year, attach a list of the addresses where you lived:
a Child 1 ▶ Number and street
City or town, state, and ZIP code
b Child 2 ▶ If same as shown for child 1, check this box. ▶ Otherwise, enter below:
Number and street
City or town, state, and ZIP code
c Child 3 ▶ If same as shown for child 1, check this box. ▶ Or if same as shown for child 2 (and
this is different from address shown for child 1), check this box. ▶ Otherwise, enter below:
Number and street
City or town, state, and ZIP code
7 Did any other person (except your spouse, if filing jointly, and your dependents under age 19) live with
child 1, child 2, or child 3 for more than half the year shown on line 1? . . . . . . . . . . . ▶ Yes No
If “Yes,” enter that person’s name and relationship to the child below. If more than one other person lived
with the child for more than half the year, attach a list of each person’s name and relationship to the child:
a Other person living with child 1: Name
Relationship to child 1
b Other person living with child 2: If same as shown for child 1, check this box. ▶ Otherwise, enter below:
Name
Relationship to child 2
c Other person living with child 3: If same as shown for child 1, check this box. ▶ Or if same as shown
for child 2 (and this is different from the person living with child 1), check this box. ▶
Otherwise, enter below:
Name
Relationship to child 3
Caution. The IRS may ask you to provide additional information to verify your eligibility to claim the EIC.
For Paperwork Reduction Act Notice, see page 3. Cat. No. 25145E Form 8862 (Rev. 12-2012)

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Form 8862 (Rev. 12-2012)                                                                                               Page 2 
Part III Filers Without a Qualifying Child
8 Enter the number of days during the year shown on line 1 that you lived in the United States  . . . ▶
  Caution.  If you entered less than 183 (184 if the year on line 1 is a leap year),   stop.  You cannot take the EIC. See the
  instructions.
9 If married filing a joint return, enter the number of days during the year shown on line 1 that your spouse 
  lived in the United States . . .   . .      . . . . . .   . .   . .    . .  . .    . .    . . . . . ▶
  Caution.  If you entered less than 183 (184 if the year on line 1 is a leap year)  stop.,   You cannot take the EIC. See the
  instructions.
                                                                                                         Form 8862 (Rev. 12-2012)

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Form 8862 (Rev. 12-2012)                                                                                                          Page 3 

General Instructions                                                  Line 3
                                                                      If your filing status is married filing jointly for the year shown on 
Future Developments                                                   line 1, check “No” on line 3.
For the latest information about developments related to Form         Also check “No” if you could be claimed as a qualifying child 
8862 and its instructions, such as legislation enacted after they     of another person for the year shown on line 1 but the other 
were published, go to www.irs.gov/form8862.                           person is not required to file, and is not filing, a tax return for 
                                                                      that year or is filing it only as a claim for refund. A claim for 
Purpose of Form                                                       refund is a return filed only to get a refund of withheld income 
You must complete Form 8862 and attach it to your tax return if       tax or estimated tax paid. A return is not a claim for refund if the 
both of the following apply.                                          EIC or any other refundable credit is claimed on it.
  1. Your EIC was reduced or disallowed for any reason other          Lines 4 and 5
than a math or clerical error for a year after 1996.
                                                                      Temporary absences, such as for school, vacation, medical 
  2. You now want to take the EIC and you meet all the                care, or detention in a juvenile facility, count as time lived at 
requirements.                                                         home.
Exception 1. Do not file Form 8862 if either of the following         Child born or died. If your child was born or died during the 
applies.                                                              year entered on line 1 and your home was the child’s home for 
• After your EIC was reduced or disallowed in an earlier year (a)     more than half the time he or she was alive during that year, 
you filed Form 8862 (or other documents) and your EIC was             replace the number entered on line 4 for that child with 
then allowed, and (b) your EIC has not been reduced or                “365” ("366" if the year on line 1 is a leap year) and complete 
disallowed again for any reason other than a math or clerical         line 5.
error.
• You are taking the EIC without a qualifying child and the only      Lines 8 and 9
reason your EIC was reduced or disallowed in the earlier year         Enter the number of days you lived in the United States during 
was because it was determined that a child listed on Schedule         the year shown on line 1.
EIC was not your qualifying child.                                    Example. You are single and are filing Form 8862 for 2012. 
  In either of these cases, you can take the EIC without filing       Your home was in the United States for all of 2012. On line 8, 
Form 8862 if you meet all the EIC eligibility requirements.           you would enter “366.”
Exception 2. Do not file Form 8862 and do not take the EIC for        Members of the military. If you were on extended active duty 
the:                                                                  outside the United States, your home is considered to be in the 
• 2 years after the most recent tax year for which there was a        United States during that duty period. Include your active duty 
final determination that your EIC claim was due to reckless or        time on line 8 and your spouse’s, if applicable, on line 9. See 
intentional disregard of the EIC rules, or                            Pub. 596 for the definition of extended active duty.

• 10 years after the most recent tax year for which there was a       Paperwork Reduction Act Notice. We ask for the information  
final determination that your EIC claim was due to fraud.             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 
          You also must attach Schedule EIC to your return if         to ensure that you are complying with these laws and to allow 
          you have a qualifying child or children. In addition to     us to figure and collect the right amount of tax.
▲!        filing Form 8862 and, if required, Schedule EIC, you 
CAUTION
          may be asked to provide other information before any        You are not required to provide the information requested on 
refund claimed on your return is issued. The process of               a form that is subject to the Paperwork Reduction Act unless 
establishing your eligibility to take the EIC will delay your refund. the form displays a valid OMB control number. Books or 
                                                                      records relating to a form or its instructions must be retained as 
Additional Information                                                long as their contents may become material in the 
                                                                      administration of any Internal Revenue law. Generally, tax 
For more details on the EIC, including the definition of a            returns and return information are confidential, as required by 
qualifying child and who is eligible to take the EIC, see your tax    Internal Revenue Code section 6103.
return instructions or Pub. 596, Earned Income Credit (EIC), for 
the year for which you are filing Form 8862.                          The average time and expenses required to complete and file 
                                                                      this form will vary depending on individual circumstances. For 
Specific Instructions                                                 the estimated averages, see the instructions for your income tax 
                                                                      return.
Need More Space for an Item?                                          If you have suggestions for making this form simpler, we 
If you do, attach a statement that is the same size as Form           would be happy to hear from you. See the instructions for your 
8862. Number each entry on the statement to correspond with           income tax return.
the line number on Form 8862. Put your name and social 
security number on the statement and attach it at the end of 
your return.

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