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This worksheet is for a non-parent claimant. If the taxpayer is the child’s mother or father, use the regular dependent questions instead. The purpose is to document why a non-parent taxpayer believes they may claim the child and to identify facts that require follow-up before filing.

STOP / Eligibility Trigger

Are you the child’s biological, adoptive, or step mother or father?If YES: stop this worksheet and use the standard dependent interview. If NO: continue below.

Claimant & Child

Taxpayer Full Legal NameTaxpayer SSN / ITIN

Child Full Legal NameChild SSN / ITIN

Child Date of BirthExact Relationship to Child (grandparent, sibling, aunt/uncle, foster placement, other)Why are you claiming this child instead of the child’s mother or father?

Mother / Father Facts

Child’s Mother - Full NameMother’s Address During the Tax YearChild’s Father - Full NameFather’s Address During the Tax YearWhy is the mother or father not claiming the child?Could either parent otherwise claim the child?Do you know whether either parent filed or plans to file a tax return?Is there any written custody arrangement, court order, placement document, or release affecting who may claim the child?

Residency

Exactly how many nights did the child live with you during the tax year?List every other address where the child stayed and approximate dates/nightsWhat address did the school/daycare/medical provider use for the child?Were there temporary absences for school, medical care, vacation, camp, or another reason? Explain.Who else lived in your household with the child?

Support & Household Costs

Child’s Approximate Gross IncomeDid the child provide more than half of their own support?What support did you provide for the child?What support was provided by the parents, relatives, child support, SSI, SNAP, housing assistance, or other sources?Approximate Total Cost of Keeping Up the HomeApproximate Amount You Paid Toward Keeping Up the HomeWho paid rent/mortgage, utilities, food, repairs, insurance, and other household costs?

Due-Diligence Follow-Up

Could any other person claim this child?If yes or unsure, identify the person and explain why they might claim the child.Do any records show a different address for the child? Explain.Did any answer conflict, change, or appear incomplete? Record the follow-up questions and answers.Preparer notes: what evidence or additional research is needed before determining eligibility?

Supporting Uploads

Upload Child Identity / SSN Documentation

Upload Residency Support (school, medical, lease, daycare, etc.)

Upload Custody / Court / Placement / Support Documents

Secure upload requires a private invitation from Tax Max.

You may complete, download, and print this form without uploading it.

This worksheet supports due diligence; it cannot make a return “audit-proof.” The preparer must ask follow-up questions when facts are incomplete, inconsistent, or appear incorrect, document the answers, and verify current tax law before filing.