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Schedule R (Form 1040) Credit for the Elderly or the Disabled 2005. Summary: This is an example of Schedule R (Form 1040) 2005, Page 1 with items completed per example in the text:

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 and William written above checkbox.