Oregon Oregon Working Family Household and Dependent Care Credit for Part-year and Nonresidents

Oregon Working Family Household and Dependent Care Credit for Part-year and Nonresidents
2019 Worksheet OR-WFHDC, Oregon Working Family Household and Dependent Care Credit Worksheet, 150-101-197
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2019 Worksheet OR-WFHDC
Page 1 of 2, 150-101-197
(Rev. 09-10-19 ver. 01)

Office use only

Oregon Department of Revenue

18891901010000

Working Family Household and Dependent Care Credit for Prior Year Expenses
Submit original form—do not submit photocopy
First name

Last name

Social Security number (SSN)

Spouse’s first name

Spouse’s last name

Spouse’s SSN if joint return

–
–

–
–

Instructions. Only use this worksheet if you paid providers in early 2019 for services received toward the end of the year in 2018.
You will need information from your 2018 Oregon return and Schedule OR-WFHDC or Schedule OR-WFHDC-NP to complete this
worksheet. If you did not claim this credit for tax year 2018, you will need to complete federal Form 2441, Child and Dependent Care
Expenses, for 2018 even if you did not claim the federal credit.
	 1.	 Enter your 2018 qualified expenses paid in 2018..................................................................................... 1.

.00

	 2.	 Enter your 2018 qualified expenses paid in 2019..................................................................................... 2.

.00

	 3.	 Add lines 1 and 2...................................................................................................................................... 3.

.00

	 4.	 Enter the amount from line 23 of your 2018 Schedule OR-WFHDC or Schedule OR-WFHDC-NP......... 4.

.00

	 5.	
		
		
		
		

Enter the smaller of your and your spouse’s 2018 earned income. If you claimed the WFHDC
credit in 2018, this is the smaller of lines 22 and 23 on your 2018 Schedule OR-WFHDC or
Schedule OR-WFHDC-NP. If you didn’t claim the credit in 2018, fill out federal Form 2441 for 2018.
Use the amounts listed on lines 4 and 5 (or lines 18 and 19 if lines 4 or 5 are blank). Do not enter
less than zero............................................................................................................................................ 5.

	 6. 	 Enter the smallest amount from lines 3, 4, or 5 above............................................................................. 6.
	 7.	 If you claimed the credit in 2018, enter the amount you claimed on line 24 of your 2018 Schedule
		 OR-WFHDC or Schedule OR-WFHDC-NP. If you did not claim the credit in 2018, enter zero................7.
	 8.	 Subtract line 7 from line 6 and enter the result. If zero or less, stop here. You cannot increase
		 your 2019 credit based on prior year’s expenses. If more than zero, continue to line 9......................... 8.
	 9.	 Enter your 2018 federal adjusted gross income (2018 Form OR-40, line 7; Form OR-40-N or
		 Form OR-40-P, line 29F)........................................................................................................................... 9.
	 0.	 Enter your 2018 Oregon adjusted gross income (2018 Form OR-40, line 7; Form OR-40-N or
1
		 Form OR-40-P, line 29S)......................................................................................................................... 10.
	11.	 Enter the greater of line 9 or line 10.........................................................................................................11.
	12.	 Enter your decimal value from line 25 of your 2018 Schedule OR-WFHDC or
		 Schedule OR-WFHDC-NP. If you did not claim this credit in 2018, use the online calculator for
		 tax year 2018 and enter the decimal value............................................................................................. 12.
	 3.	 Multiply line 8 by line 12. If you filed a 2018 full-year resident return, enter this amount on your
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		 2019 Schedule OR-­WFHDC, line 31. If you filed a 2018 part-­year or nonresident return,
		 continue to line 14................................................................................................................................... 13.

.00
.00
.00
.00
.00
.00
.00
.
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	14.	 Enter the decimal value from line 35 of your 2018 Form OR-­40-­N or Form OR-­40-­P.......................... 14.

.

	15.	 Multiply line 13 by line 14 and enter this amount on your 2019 Schedule OR-WFHDC, line 31............ 15.

.00

—Keep this worksheet with your tax records.—

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2019 Worksheet OR-WFHDC
Page 2 of 2, 150-101-197
(Rev. 09-10-19 ver. 01)

18891901020000

Oregon Department of Revenue

Providers. Complete all information for each provider you paid in 2019 for expenses incurred in 2018. Only list the amounts you paid
in 2019 that apply to services provided in 2018. If you have more than three providers, submit an additional page 2.
16.

Provider’s full name

Provider’s SSN

–
Address

Provider’s federal employer identification number (FEIN)

–

–

Provider’s phone

(

)

Qualifying person to provider relationship code

–

State ZIP code

City

.00

Amount you paid to provider
17.

Provider’s full name

Provider’s SSN

–
Address

Provider’s FEIN

–

–

Provider’s phone

(

)

Qualifying person to provider relationship code

–

State ZIP code

City

.00

Amount you paid to provider
18.

Provider’s full name

Provider’s SSN

–
Address

Provider’s FEIN

–

–

Provider’s phone

(

)

Qualifying person to provider relationship code

–

State ZIP code

City

Amount you paid to provider

.00

19.	 Total the amounts you paid to all of the providers. Enter the result here.............................................. 19.

.00

Qualifying persons. Complete all information for each qualifying individual who received care in 2018 that you paid for in 2019. Only
list the amounts paid in 2019 that apply to services provided in 2018. If you have more than three qualifying individuals, submit an
additional page 2.
(a) Total expenses paid for care

20. First name

SSN

Code*

–

–

/

.00

.00

.00

.00

.00

.00

.00

.00

.00

.00

.00

/
Disabled

Last name
SSN

Code*

–

Date of birth

/

/

22. First name

Disabled

Last name
SSN

Code*

–

you paid for care

Date of birth

First name

–

(c) Portion of expenses

else paid on your behalf
Disabled

Last name

21.

(b) Portion of expenses someone

–

Date of birth

/

/

*Qualifying individual to taxpayer relationship code—see instructions to determine the appropriate code.

23.	 Total the amounts in columns (a)–(c) for all
	
qualifying individuals. Enter results here..........23.

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—Keep this worksheet with your tax records.—