Free 2008 Form 8914 - Federal

Form

8914

Exemption Amount for Taxpayers Housing Midwestern Displaced Individuals
Attach to Form 1040, Form 1040A, or Form 1040NR

OMB No. 1545-0074

Department of the Treasury Internal Revenue Service Name(s) shown on your return

Attachment Sequence No.

2008
55

Your social security number

Part I

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 or for anyone included on line 6d of Form 1040 or 1040A (line 7d of Form 1040NR).

1

(a) First and last name

(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

Part II
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Exemption Amount
2 3 4

Multiply $500 by the total number of individuals listed in Part I above. Do not enter more than $2,000 ($1,000 if married filing separately) Multiply $3,500 by the total number of exemptions claimed on line 6d of Form 1040 or Form 1040A (line 7d of Form 1040NR) Add lines 2 and 3 Is the amount on Form 1040, line 38 (Form 1040A, line 22; or Form 1040NR, line 36), more than the amount shown on line 6 below for your filing status? No.
STOP

Enter the amount from line 4 above on Form 1040,

line 42 (Form 1040A, line 26; or Form 1040NR, line 39). 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--$159,950 Married filing jointly or Qualifying widow(er)--$239,950 Married filing separately--$119,975 Head of household--$199,950 Form 1040NR filers, see instructions Subtract line 6 from line 5 Is line 7 more than $122,500 ($61,250 if married filing separately)? No. Skip line 9; go to line 10. Yes. Multiply $2,333 by the total number of exemptions claimed on line 6d of Form 1040 or Form 1040A (line 7d of Form 1040NR) 9 Add lines 2 and 8. Enter the result on Form 1040, line 42; Form 1040A, line 26; or Form 1040NR, line 39. Do not complete the rest of this form Divide line 7 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 example, increase .0004 to 1) 5

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11 12 13 14

Multiply line 10 by 2% (.02) and enter the result as a decimal rounded . 11 to at least three places Multiply line 3 by line 11 Divide line 12 by 3.0 Exemption amount. Subtract line 13 from line 4. Enter the result here and on Form 1040, line 42; Form 1040A, line 26; or Form 1040NR, line 39
Cat. No. 37724X

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Form

For Paperwork Reduction Act Notice, see page 3.

8914

(2008)

Form 8914 (2008)

Page

3

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.

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 at least 60 consecutive days during 2008. If less than 60 consecutive days, you cannot claim an additional exemption amount for this individual.

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 claim 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 ($1,000 if married filing separately). Any additional exemption amount you claim for displaced individuals in 2008 will reduce the $2,000 maximum for 2009. 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. If married filing separately, only one spouse 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).

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.

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 the 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 the tax year in which the exemption is claimed. See Compensation for Housing below. He or she cannot be your spouse or dependent.

Line 6
If you are filing Form 1040NR, enter the amount shown below for your filing status. Filing status box 1 or 2 -- $159,950 Filing status box 3, 4, or 5 -- $119,975 Filing status box 6 -- $239,950

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.

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.

Form 8914 (2008)

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4

Table 1
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 the applicable disaster date shown for that county and was displaced from that home.
Applicable Disaster Date* State Affected Counties -- Midwestern Disaster Areas

Table 2
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 the 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 Date*

05/02/2008

Arkansas

Arkansas, Benton, Cleburne, Conway, Crittenden, Grant, Lonoke, Mississippi, Phillips, Pulaski, Saline, and Van Buren Adams, Calhoun, Clark, Coles, Crawford, Cumberland, Douglas, Edgar, Hancock, Henderson, Jasper, Jersey, Lake, Lawrence, Mercer, Rock Island, Whiteside, and Winnebago 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 Barry, Jasper, and Newton 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 Buffalo, Butler, Colfax, Custer, Dawson, Douglas, Gage, Hamilton, Holt, Jefferson, Kearney, Lancaster, Platte, Richardson, Sarpy, and Saunders 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

06/01/2008

Illinois

State

Affected Counties -- Midwestern Disaster Areas

06/06/2008

Indiana

06/01/2008 06/06/2008

Illinois Indiana

Greene, Madison, Monroe, Pike, Randolph, St. Clair, and Scott Benton, Boone, Fountain, Franklin, Jay, Montgomery, Ohio, Switzerland, Union, and Wabash Carroll, Cherokee, Lyon, Palo Alto, Pocahontas, Taylor, and Wayne 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 Allegan, Barry, Eaton, Ingham, Lake, Manistee, Mason, Missaukee, Osceola, Ottawa, Saginaw, and Wexford Cook, Fillmore, Freeborn, Houston, Mower, and Nobles 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 Gage, Johnson, Morrill, Nemaha, and Pawnee

05/25/2008

Iowa

05/25/2008

Iowa

05/22/2008

Kansas

06/06/2008

Michigan

06/07/2008 06/01/2008

Minnesota Missouri

05/10/2008 06/01/2008

Missouri Missouri

05/22/2008

Nebraska

04/23/2008

Nebraska

06/05/2008

Wisconsin

05/22/2008

Nebraska

* In some cases, the date will be later due to the continuation of the severe storms, tornadoes, or flooding that began on the above date. For more details, go to www.fema.gov.

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 Dodge, Douglas, Sarpy, and Saunders Lafayette

06/27/2008 06/05/2008

Nebraska Wisconsin

* In some cases, the date will be later due to the continuation of the severe storms, tornadoes, or flooding that began on the above date. For more details, go to www.fema.gov.