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Example of 8962 filled out Form: What You Should Know
For those who are eligible, they can use Part II to calculate the premium tax credit. (See also: How to Calculate If You Are Eligible or Not for an Enhanced Tax Credit) Part I: Part II: Step 1, Select a number from the list below, or type your own number in the space provided. Part II is required, and it is filled out as follows: Step 1(a): Enter the Policy Type and Policy Number (including Policy Codes) of the health plan you want to use (or enter a blank space). Step 2(a): Enter your health care services and deductible on a separate line. You only need to enter a blank to enter the amount for health care services and deductible on a different line. Step 2(b): Enter your family size, household income and household income limit. If your household income is less than the limit, enter the number minus it. Step 2(c): Enter your spouse's health service deductible on a separate line. You only need to enter a blank to enter the amount for health insurance (as opposed to self-pay health insurance) on the other line. Step 3: Enter your total premium (excludes any tax credit) on the remaining lines. Use the calculator's 'Add to Premium' option to convert the total into the dollar amount for which you want to receive a premium tax credit (PTC). Step 4: Write a brief note about why you want the premium tax credit. 4. Use the Calculator's 'Show Form 8962' option to fill out your Form 8962. Complete Part II for your total premium paid. Your name: Your SSN: The policy number (including Policy Codes) of the health plan you want to use (or enter a blank space). Your health care services and deductible of the health insurance you purchase (or enter a blank space). Your gross and net income. If your gross and net income is less than the limit, enter the number minus it. If your gross and net income is more than the limit, enter the dollar amount for which you want a premium tax credit (PTC). Your net premium (expressed as a positive number, e.g.
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