Publication 17: Your Federal Income Tax;

This is archived information that pertains only to the 2004 Tax Year. If you
are looking for information for the current tax year, go to the Tax Prep Help Area.

Schedule R (Form 1040): Credit for the Elderly or the Disabled. Summary: This is an example of Schedule R (Form 1040) 2004, Page 1 with items included as described in the text. Additional items completed are:

Name(s) shown on Form 1040 field contains William M. White and Helen A. White

Your social security number field contains 220-00-3333

Under Part I: Check the Box for Your Filing Status and Age:

In the section Married filing jointly, line item 5. Both spouses were under 65, and both retired on permanent and total disability checkbox checked

Under Part II: Statement of Permanent and Total Disability

2. Due to your continued disabled condition, you were unable to engage in any substantial gainful activity in 2004, check this box: checkbox checked. The name William is written above the checkbox.