Schedule H (Form 1040) Household Employment Taxes 2005. Summary: This is an example of Schedule H (Form 1040) 20054, as pertains to the text. The line items completed are:

“Name of employer” field contains Susan Green

“Social security number” field contains 000-11-1111

“Employer identification number” field contains 00-1234567

“A. Did you pay any one household employee cash wages of $1,400 or more in 2005? (If any household employee was your spouse, your child under age 21, your parent, or anyone under age 18, see the line A instructions on page 3 before you answer this question.) Yes. Skip lines B and C and go to line 1.” checkbox checked

Under “Part I: Social Security, Medicare, and Income Taxes”:

“1. Total cash wages subject to social security taxes (see page 3)” field contains 2,300.00 “2. Social security taxes. Multiply line 1 by 12.4% (.124)” field contains 285.20 “3. Total cash wages subject to Medicare taxes (see page 3)” field contains 2,300.00 “4. Medicare taxes. Multiply line 3 by 2.9% (.029)” field contains 66.70 “6. Total social security, Medicare, and income taxes (add lines 2, 4, and 5)” field contains 351.90 “8. Net taxes (subtract line 7 from line 6)” field contains 351.90 “9. Did you pay total cash wages of $1,000 or more in any calendar quarter of 2004 or 2005 to household employees? (Do not count cash wages paid in 2004 or 2005 to your spouse, your child under age 21, or your parent). No. Stop. Enter the amount from line 8 above on Form 1040, line 62. If you are not required to file Form 1040, see the line 9 instructions on page 4.” checkbox checked