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IRS 8962 2015 free printable template

For Paperwork Reduction Act Notice see your tax return instructions. Cat. No. 37784Z Form 8962 2015 Page Shared Policy Allocation Complete the following information for up to four shared policy allocations. Form OMB No* 1545-0074 Premium Tax Credit PTC Department of the Treasury Internal Revenue Service Name shown on your return Attach to Form 1040 1040A or 1040NR* Information about Form 8962 and its separate instructions is at www*irs*gov/form8962. Attachment Sequence No* 73 Your social...
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How to fill out 2015 8962 form


How to fill out 2015 8962 form:

Begin by gathering all necessary documents, including your Form 1095-A (Health Insurance Marketplace Statement), which will provide you with the necessary information to complete the form accurately.
In Part I of the form, enter your personal information, including your name, Social Security Number, and address. Make sure to double-check the accuracy of the information entered.
Move on to Part II of the form, where you will report your household's Modified Adjusted Gross Income (MAGI). This information can usually be found on your tax return for the applicable tax year.
Once you have calculated your MAGI, proceed to Part III of the form, where you will determine your allocated monthly premium amounts. This is where the information from your Form 1095-A becomes crucial, as you will need to report the premium amount and reconcile any advance payments of the premium tax credit made on your behalf.
Use the provided instructions to accurately complete each line and calculation on the form. Take your time to ensure accuracy and double-check all entries.
Review the completed form once again, making sure all necessary information has been included and that there are no errors or omissions.
Sign and date the form, and attach any required documentation, such as a copy of your Form 1095-A.
Keep a copy of the completed form for your records, and submit it to the appropriate tax authorities as instructed.

Who needs 2015 8962 form:

Individuals or families who purchased health insurance coverage through a Health Insurance Marketplace established under the Affordable Care Act (ACA) during the 2015 tax year will need to fill out the 2015 Form 8962.
Anyone who received premium tax credits to help lower their monthly health insurance premiums will also need to complete the form to reconcile any advance payments made on their behalf.
The form is especially important for those who experienced changes in circumstances or income levels throughout the year, as these changes may affect their eligibility for the premium tax credit or require adjustments to the credit amount received.
It is essential to consult the IRS guidelines or a tax professional to determine if you are required to complete the 2015 Form 8962 based on your specific circumstances.
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People Also Ask about 2015 8962 form

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Making Healthcare Affordable with IRS Form 8962

IRS Form 8962 - the Premium Tax Credit

Following on Form 8962 for those of you claiming the Premium Tax Credit.

What is the purpose of Form 8962?

The premium tax credit, or PTC, is a refundable credit that helps eligible individuals and families with low or moderate income afford health insurance purchased through a Health Insurance Marketplace.  

The purpose of the Form 8962 is for the taxpayer to figure the amount of (Premium Tax Credit) and reconcile it with advance payment of the premium tax credit (APTC).


Who needs the Form 8962?

Individuals need an 8962 Form if they filed the Form 1040, Form 1040A, or Form 1040-NR, and if either of the following conditions apply:

• The individual is taking the PTC.

• APTC (Advanced Premium Tax Credit) was paid the taxpayer or another individual in the taxpayer’s tax family.

• APTC was paid for an individual including taxpayer for whom the taxpayer told the Marketplace that he or she would claim a personal exemption, and neither the taxpayer nor anyone else claims a personal exemption for that individual.

Is the Form accompanied by other forms?

If necessary, the Form 8962 is filed with Form 1040. While the Form 1095-A does not have to be attached the tax return, information from the Form 1095-A is used to complete the Form 8962.

When is the Form 8962 due?

The Form 8962 is attached to your tax return. The general filing date for an individual tax return is April 15th. If an extension is filed, the extended filing due date is generally October 15th.

How is the Form 8962 completed?

The Form 8962 is divided into five parts. Part I, (Annual and Monthly Contribution Amount), Part II, (Premium Tax Credit Claim and Reconciliation of Advance Payment of Premium Tax Credit), Part III, (Repayment Excess Advance Payment of the Premium Tax Credit)., Part IV, (Shared Policy Allocation), Part V, (Alternative Calculation for Year of Marriage).

Part I:

Line 1: Enter the number of exemptions from your Form 1040 or Form 1040 A, (line 6d), or Form 1040 NR (line 7d).

Line 2a: Enter your modified AGI (Adjusted Gross Income).

Line 2b: Enter the combined modified AGI for your dependents who are required to file an income tax return because their income meets the income tax return filing threshold.

Line 3: Add the amounts on lines 2a and 2b.

Line 4: Check the box to indicate your state of residence for the current tax year.

Line 5: Figure your household income as a percentage of the federal poverty level guidelines.

Line 6: If the amount on 5 is at least 100%, but no more than 400%, check the box “No” on line 6 and continue to line 7.

Line 7: Enter the decimal number from Table 2 (page 8 of form instructions) that applies to the amount you entered on line 5.

Line 8a: Line 3 by line 7 and enter the result on line 8a rounded to the nearest whole dollar amount.

Line 8b: Divide line 8a by 12.0 and enter the result on line 8b, rounded to the nearest whole dollar amount.

Part II:

Line 9: Refer to form instructions.

Line 10: Refer to form instructions.

Line 11: Annual Totals (Columns A-F), refer to form instructions. If you checked the “Yes” box on line 6, or you are using the filing status, married filing separately and exception 2 – Victim of domestic abuse or spousal abandonment, earlier, does not apply to you, skip columns (a) through (e) and complete only column (f) later.

Lines 12-23: Monthly Calculation.

Refer to form instructions.

Line 24: Enter the amount from line 11 (e) or add lines 12 (e) through 23 (e) and enter the total.

Line 25: Enter the amount from line 11 (f) or add lines 12 (f) through 23 (f) and enter total.

Line 26: Net Premium Tax Credit. Refer to form instructions.

Part III:

Line 27: If line 25 is greater than line 24, subtract line 24 from line 25 and enter the result.

Line 28: Refer to form instructions.

Line 29: Enter the smaller of line 27 or line 28. If Line 28 is blank, enter the amount from line 27 on Line 29. Also the amount from Form 1040NR, line 44.

Part IV:

Lines 30-34: Refer to form instructions.

Part V:

Complete this section to elect the alternative calculation for your pre-marriage months. Electing the alternative calculation is optional, but may reduce the amount of excess APTC you must pay. Refer to form instructions for more details.

Line 35: Complete columns (a) through (d) as indicated in Publication 974 (Premium Tax Credit) under Alternative Calculation for Year of Marriage.

Line 36: Complete columns (a) through (d) as indicated in Publication 974 under Alternative Calculation for Year of Marriage.

Where do I file form 8962? 

You should send form 8962 along with your 1040 to the following mailing address: Department of the Treasury Internal Revenue Service Center Ogden, UT 84201-0027

Form 8962 or the premium tax credit is used to calculate the amount of premium tax credit you're eligible to claim if you paid premiums for health insurance purchased through the health insurance marketplace claiming the premium tax credit may reduce your tax liability for the calendar year make sure to only use secure channels to fill out and submit your form you can either download your copy from the IRS website or get the current revision of form 8962 that you can edit sign and submit electronically at pdffiller.com form 8962 is a two-page form split into five parts start by filling out your name and social security number proceed to part one to indicate your annual and monthly contribution amounts using your family size modified adjusted gross income and household income in line one enter the number of exemptions indicated in form 1040 or form 1040a use lines 2a and 2b to provide your modified AGI enter your household income in line 3 by adding the amounts stated in lines 2a and 2b select the appropriate choice and enter the value in line 4. To make the calculations needed to complete lines 5 through 8 see the IRS instructions for form 8962 in part 2 you will need to reconcile your advanced premium tax credit received with monthly premium amounts select the appropriate option in lines 9 and 10. In line 11 fill the annual totals in the table in lines 12 through 23 fill out the monthly amounts under each column indicate the total tax premium credit on line 24 and the advanced payment of PTC on line 25. Follow the instructions to calculate the net premium tax credit and indicated in line 26. In part 3 you will need to calculate any excess advanced payment of PTC based on the information you provided in part two in line 27 enter the excess advanced payment of pt center the repayment limitation in line 28 use line 29 to provide the excess advance premium tax credit repayment in part four you will need to allocate policy amounts part five is used for alternative calculations for years married use IRS form 1095-a to complete each section of the form as well as your form 1040 which shows your modified adjusted gross income once all the fields are completed and checked off you can save the resulting document to your device print it out or email it to your recipient in one click good luck and don't forget to submit your form 8962 before the due date established by the IRS.


  • What is 8962 form?
    Form 8962 is a tax form used by individuals who are claiming the Premium Tax Credit (PTC). The PTC is a subsidy provided under the Affordable Care Act (ACA) to help eligible individuals and families afford health insurance purchased through the Health Insurance Marketplace. Form 8962 is used to reconcile the amount of advance premium tax credits received during the year with the actual credit the individual is eligible for based on their income and family size. It helps determine if the individual received too much or too little premium tax credit and subsequently adjust their tax liability or refund accordingly.
  • Who is required to file 8962 form?
    Individuals who have received advanced premium tax credits (APTC) through a health insurance marketplace and wish to reconcile the amount of APTC received with their actual premium tax credit (PTC) eligibility are required to file Form 8962 with their federal income tax return. Additionally, those who have their APTC suspended or terminated during the year and wish to claim the PTC have to file this form. It is used to calculate the difference between the APTC received and the PTC they are eligible for.
  • How to fill out 8962 form?
    To fill out Form 8962, you will need the following information: 1. Your personal information, including name, Social Security number, and address. 2. Information about your health insurance coverage for the year, including Form 1095-A, 1095-B, or 1095-C. 3. The number of months you, your spouse, and your dependents had healthcare coverage. 4. Adjusted Gross Income (AGI) from your tax return. 5. The Second Lowest Cost Silver Plan (SLCSP) premiums for your coverage area. Here are the steps to fill out Form 8962: 1. Start by entering your personal information at the top of the form. 2. Part I: Determine your eligibility for the Premium Tax Credit (PTC). This section involves checking boxes and entering information about your healthcare coverage. 3. Part II: Calculate your Premium Tax Credit. This section involves calculating your Modified Adjusted Gross Income (MAGI) based on your tax return and determining your household income as a percentage of the Federal Poverty Line (FPL). 4. Part III: Determine your Shared Responsibility Payment. This section is only applicable if you or someone in your household did not have health insurance coverage for the entire year. 5. Part IV: Reconcile Advance Payments of the Premium Tax Credit. This section involves comparing the Premium Tax Credit you received in advance to the amount you are actually eligible for. It may require additional calculations using Form 1095-A. 6. Part V: Additional Information. Here, you may need to provide additional details or explanations, if applicable. 7. Part VI: Sign the form, include your phone number, and indicate whether you are authorizing someone to discuss your return with the IRS. 8. Attach any required supporting documents, such as Form 1095-A. Be sure to carefully review your completed Form 8962 for accuracy and attach all necessary documents before mailing it to the specified IRS address.
  • What is the purpose of 8962 form?
    Form 8962, also known as the Premium Tax Credit (PTC) form, is used to reconcile and report the amount of premium tax credits received through the Health Insurance Marketplace. It is filed by individuals who have received advance payments of the premium tax credit to lower their monthly health insurance premiums. The purpose of Form 8962 is to calculate and verify the correct amount of premium tax credits based on the actual income reported, ensuring that the individual receives the appropriate subsidy and avoiding any overpayment or underpayment of the credit.
  • What information must be reported on 8962 form?
    The Form 8962, also known as the Premium Tax Credit (PTC) form, is used by individuals to calculate the amount of premium tax credit they are eligible for and reconcile it with the advance payments of the premium tax credit they received throughout the year. The following information must be reported on Form 8962: 1. Personal Information: Your name, social security number, and tax year for which the form is being filed. 2. Annual and Monthly Contribution: You need to report the annual and monthly share of the premium for the health insurance plan you had through the Marketplace for each household member. This information can usually be found on Form 1095-A, which you should receive from the Marketplace. 3. Adjusted Gross Income: You must provide your adjusted gross income (AGI) as reported on your tax return. 4. Federal Poverty Line (FPL): The FPL is used to determine your eligibility for the premium tax credit. You need to look up the percentage corresponding to your household size and include it on the form. 5. Household Size: Report the number of individuals included in your tax household, including yourself, spouse, and dependents. 6. Modified Adjusted Gross Income (MAGI): Calculate and report your modified adjusted gross income by adding any tax-exempt interest and foreign earned income and housing costs to your AGI. 7. Advance Payments of the Premium Tax Credit: Provide the total amount of advance payments you received throughout the year. 8. Repayment Limitation: Determine if you need to repay any excess advance payments of the premium tax credit received based on your income increase or eligibility change during the year. 9. Premium Tax Credit: Calculate the amount of premium tax credit you are eligible for based on your income, FPL, and household size. 10. Premium Tax Credit Reconciliation: Compare the premium tax credit you are eligible for (calculated in the previous step) with the advance payments you received. If there is a difference, you may need to repay some or all of the excess advance payments. If you received less than the credit you are eligible for, you may be eligible for additional credit. 11. Signature: Sign and date the form to certify its accuracy. It's important to note that this is a general overview, and you should consult the instructions provided with Form 8962 and seek professional advice if needed for specific details relating to your tax situation.
  • What is the penalty for the late filing of 8962 form?
    The penalty for late filing of Form 8962, which is used to report and reconcile advance premium tax credits, varies based on the circumstances. As of 2021, the penalty for late filing the form is $283 per month or partial month for each person in the tax household who is subject to an individual shared responsibility payment (penalty for not having health coverage). This penalty can accrue for a maximum of 5 months. However, the penalty is generally waived if the taxpayer has a reasonable cause for failing to file on time. It is important to check for updated information from the Internal Revenue Service (IRS) or consult with a tax professional for the most accurate and current penalty information related to Form 8962.
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