9i25f2018 CengageNOWVZ | Online teaching and learning resource from Cengage Learning www..irs.go vgform244 . Nameis) shown on return Your social security number 123-415-6789 Paul and Karen Kent Part I Persons or Organizations Win) Provided the CareYou must complete this part. (If you have more than two care providers, see the instructions.) (a) lCare (b) Address (number, street, apt. no., (c) Identifying number (d) Amount paid (see provider's name city, state, and ZIP code} (SSN or EIN} instructions} Sunnyside Day 422 Sycamore Road lCare Center Ft. Worth, TX 76028 11-23456?8 Did you receive No I Complete only Part 11 below. dependent care benefits? Yes h~ Complete Part III on the back next. Caution: If the care was provided in your home, you may owe employment taxes. If you do, you cannot file Form 1040A. For details, see the instructions for Form 1040, line 60a, or Form 1040NR, line 59a. Part II Credit for Child and Dependent Care Expenses 1 Information about your qualifying person(s). If you have more than two qualifying persons, see the instructions. a uali in h uali in ( }Q fy g t ) Q fy g (c) Qualied expenses you incurred and paid in 2016 for the person's name person's social _ _ person listed in column (a) First Last secunty number