Schedule R (Form 1040A or 1040), Credit for the Elderly or the Disabled 2016

Summary: This is an example of Schedule R (Form 1040A or 1040) 2016, Page 1 with items completed per example in the text:

Name(s) shown on Form 1040” field contains William M. White and Helen A. White
Your social security number” field contains 220-00-3333
Under“Part I: Check the Box for Your Filing Status and Age”:
In the section“Married filing jointly”, line item“5. Both spouses were under 65, and both retired on permanent and total disability” checkbox checked
Under“Part II: Statement of Permanent and Total Disability”:
2. Due to your continued disabled condition, you were unable to engage in any substantial gainful activity in 2016, check this box” checkbox checked and William is written above checkbox.