Home Cost and Support Worksheet

Taxpayer Information:

Taxpayer's Name: Tax Year:
Calculation Type:

Determine if the taxpayer paid more than 50% household cost to qualify for Head of Household.
Determine if the taxpayer provided sufficient support to qualify a person as a dependent.
Home Expense Information:

Home type: Rent Own
Use Fair market rental value instead of mortgage interest, real estate taxes and property insurance. (proposed legislation)

Number of residents in the home:


Income descriptionAmount you paidTotal cost
Rent
Fair market rental value
Property taxes
Mortgage interest expenses
Renter's insurance
Property insurance
Utilities - Water
Utilities - Heat
Utilities - Electric
Home phone used by all
Home maintenance expenses
Food eaten in the home
Other home expenses
HOME EXPENSE TOTALS
The amount paid cannot exceed the cost on the line in red above.
The person's information:

Person's Name:
Check if the person owns the home.


Resources:
Total income received (taxable and nontaxable)
Amount borrowed
Amount in checking accounts at beginning of year
    Amount in checking accounts at end of year
Amount in savings accounts at beginning of year
    Amount in savings accounts at end of year
Amount available to the person for support
Amount used by the person for their own support
Amount used by the person for other purposes
Expenses:
The person's share of household expenses
The person's clothing expenses
The person's education expenses
The person's unreimbursed medical and dental expenses
The person's travel and recreation expenses
The person's other expenses
Total cost of the person's support for the year
Did the person pay half of expenses?
Half of the person's support expenses
Amount provided by the person (includes home FMV if they owned)
Did you (the taxpayer) pay half of expenses?
Amount from others, including state, local or other welfare agencies
Amount from you
There seems to be some amount of income missing. Interest perhaps? The amount used by the person for support cannot exceed the amount available.
Please send corrections and suggestions to tools@cotaxaide.org