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may request proof of the disability. For requirements, see Section 2—Qualifying individuals
“Disability” in the definition section.
List each qualifying individual in order from youngest to
Example 5. Jean and Glen are married and have three chil- oldest. Enter their full name, SSN or ITIN, relationship to
dren in child care. Jean works full time and Glen doesn’t you (using the codes from the relationship code table), and
work or attend school and is receiving disability payments.
date of birth. Check the box if the qualifying individual is
Despite his disability, Glen is physically and mentally able
to care for himself. Jean and Glen can’t claim this credit for disabled. Don’t list anyone who isn’t a qualifying individual
their child-care expenses because Glen didn’t work, look even if you paid for their care.
for work, or go to school; and he is able to care for himself. If you have more than three qualifying individuals, fill out
Section 1—Providers and include an additional page 3 of Schedule OR-WFHDC.
Add the totals from the additional page onto lines 8, 9, and
Enter the provider's full name or business name and com-
10 of the original page 4.
plete address. Enter the rest of the provider’s information.
Lines 5h, 6h, and 7h.
If you have more than three providers, fill out and include Enter the total amount of expenses paid
an additional page 2 of Schedule OR-WFHDC. Add the total for each qualifying individual in lines 5h, 6h and 7h. Include
from the additional page onto line 4 of the original page 2. all expenses that would be considered a qualified expense
even if you didn’t pay for them yourself.
Provider’s SSN, ITIN, or FEIN. You must enter your pro-
vider’s Social Security Number (SSN) or Individual Taxpayer Lines 5i, 6i, and 7i. Enter the portion of expenses that were
Identification Number (ITIN) in the “Provider’s SSN” box or paid by someone else on your behalf, such as the Employ-
enter the Federal Employer Identification Number (FEIN) in ment Related Day Care program, a family member, the
the “Provider’s FEIN” box. child’s other parent, etc.
If the provider is a tax-exempt organization, leave these two Lines 5j, 6j, and 7j. Enter the portion of total expenses that
boxes blank and have the provider fill out federal Form W-10.
you
If you file electronically, submit federal Form W-10 with paid or that were deducted from your salary. These are
the Oregon return or as a PDF attachment. If you don’t file your qualified expenses (see page 2).
electronically, include federal Form W-10 with your return Limitation on qualified expenses. Enter the maximum
and keep a copy with your records. amount of expenses that will be allowed on line 16. Enter
Provider’s phone. Enter a daytime phone number for the $12,000 for one qualifying individual or $24,000 for two or
provider. We need a current phone number to contact the more qualifying individuals.
provider; otherwise, your refund may be delayed.
The limit doesn’t need to be divided equally between the
Qualifying individual to provider relationship code. qualified individuals. For example, if you paid $2,000 for the
Identify the relationship of the qualifying individual to the care of one qualifying individual and $13,000 for the care
provider using the code from the relationship code table.
of another qualifying individual, you can use the total of
Amount you paid to provider. Enter the total amount of $15,000 to figure your credit. It’s also possible one qualifying
qualified expenses (see page 2) you paid in 2023 to the pro- individual could have no expenses and a second qualify-
vider. Don’t include amounts someone else paid for you. ing individual could have expenses exceeding $12,000. You
should list 0 for the first qualifying individual and the actual
Relationship code table
amount for the second qualifying individual. The $24,000
Title Code Relationships included limit is still used to figure your credit.
Son/Daughter SD Son, daughter, adopted child.
Example 6. Lois works for a company that offers dependent
Stepchild SC Stepson, stepdaughter. care benefits. She contributes $4,000 pre-tax to a flexible
Foster child FC Foster child. spending arrangement. Lois’s employer reports the $4,000 of
Sibling SB Brother, sister, half‑brother, dependent care benefits in box 10 of her W-2. Lois also paid
half‑sister, stepbrother, stepsister, $1,000 with after-tax dollars for qualified expenses. Lois will
brother‑in‑law, sister‑in‑law. enter $5,000 on line 5h for the total expenses. She will enter
Parent PT Father, mother, stepfather, $0 on line 5i and $5,000 on line 5j for the amount she paid.
stepmother, father‑in‑law,
mother‑in‑law. Example 7. Thalia receives government assistance to pay
Spouse SP Husband, wife. her child-care expenses. The child-care provider charges
Grandparent GP Grandmother, grandfather. Thalia $600 per month to care for her qualifying child. Of
the $600 per month, the state paid $450, and Thalia paid a
Grandchild GC Grandson, granddaughter.
co-pay of $150. Thalia’s credit will only be based upon the
Aunt/Uncle AU Aunt, uncle.
amount she paid herself. Thalia will enter $7,200 ($600 x 12)
Niece/Nephew NN Niece, nephew.
on line 5h for the total expenses paid. She will enter $5,400
Other relative OR Son‑in‑law, daughter‑in‑law, cousin, ($450 x 12) on line 5i for the state assistance that was paid
etc. on her behalf. She will enter $1,800 ($150 x 12) on line 5j for
No relation NR Any other qualifying individual. the amount she paid.
150-101-195-1 (Rev. 10-12-23) Schedule OR-WFHDC Instructions, Page 5 of 8
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