Form 150-101-198 Schedule OR-WFHDC-CL "Due Diligence Checklist for Claiming the Working Family Household and Dependent Care (Wfhdc) Credit" - Oregon

What Is Form 150-101-198 Schedule OR-WFHDC-CL?

This is a legal form that was released by the Oregon Department of Revenue - a government authority operating within Oregon.The document is a supplement to Form 150-101-198, Due Diligence Checklist for Claiming the Working Family Household and Dependent Care Credit (Wfhdc). As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on August 25, 2020;
  • The latest edition provided by the Oregon Department of Revenue;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form 150-101-198 Schedule OR-WFHDC-CL by clicking the link below or browse more documents and templates provided by the Oregon Department of Revenue.

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Download Form 150-101-198 Schedule OR-WFHDC-CL "Due Diligence Checklist for Claiming the Working Family Household and Dependent Care (Wfhdc) Credit" - Oregon

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Schedule OR-WFHDC-CL
Office use only
18980001010000
Page 1 of 2, 150-101-198
Oregon Department of Revenue
(Rev. 08-25-20 ver. 01)
Due Diligence Checklist for Claiming the Working Family Household and
Dependent Care (WFHDC) credit
Tax year
Taxpayer first name
Taxpayer last name
Last four digits of identification number
Spouse’s first name
Spouse’s last name
Last four digits of identification number
Assisting individual’s first name
Assisting individual’s last name
Assisting individual’s relationship to taxpayer
Assisting individual’s license number, if applicable
Purpose: This form is to help the assisting individual and taxpayer understand their responsibilities when submitting a WFHDC credit
claim. Anyone assisting a taxpayer in claiming the WFHDC credit is expected to review supporting documentation to verify credit
eligibility, ask clarifying questions, and inform the taxpayer a penalty may be assessed if they knowingly claim a false credit. This form
does not prevent a penalty from being imposed, nor is it mandatory.
A penalty may be charged to a taxpayer or assisting individual who knowingly claims a false WFHDC credit or knowingly assists
someone in claiming a false WFHDC credit. The penalty may be up to 25 percent of the amount claimed.
Instructions: The individual assisting the taxpayer will complete Part 1. The taxpayer claiming the credit will complete Part 2. Do not
submit this form with the return. Both parties should keep a completed copy with their records.
Part 1. Assisting individual
1. Did you calculate the WFHDC credit claim based on your review of the information provided
by the taxpayer? ...................................................................................................................................... 1.
Yes
No
2. Did you interview the taxpayer, ask adequate questions, and document the taxpayer’s responses
to determine that the taxpayer is eligible to claim the credit? ................................................................ 2.
Yes
No
3. Did you ask the taxpayer if the credit was claimed and disallowed or reduced in a previous year? .... 3.
Yes
No
4. Did any information provided to you in connection with preparing the return appear to be
incorrect, incomplete, or inconsistent? If the answer is no, skip to line 6. ............................................. 4.
Yes
No
5. Did you ask reasonable questions of the taxpayer to determine the correct or complete
information? ............................................................................................................................................. 5.
Yes
No
6. Did you explain to the taxpayer that they may receive a penalty of up to 25 percent of the
amount claimed for knowingly filing a false WFHDC credit? .................................................................. 6.
Yes
No
Under penalties of false swearing, I declare that I have:
• Examined the taxpayer’s return and accompanying documentation for the WFHDC credit claim, and
• Asked clarifying questions to ensure credit eligibility, and
• Advised the taxpayer of the WFHDC penalty for knowingly false claims.
To the best of my knowledge and belief, the taxpayer’s WFHDC credit claim and accompanying schedules and statements are true,
correct, and complete. This declaration is based on all information of which I have any knowledge.
Date
Assisting individual signature
/
/
X
Clear form
Clear this page
Schedule OR-WFHDC-CL
Office use only
18980001010000
Page 1 of 2, 150-101-198
Oregon Department of Revenue
(Rev. 08-25-20 ver. 01)
Due Diligence Checklist for Claiming the Working Family Household and
Dependent Care (WFHDC) credit
Tax year
Taxpayer first name
Taxpayer last name
Last four digits of identification number
Spouse’s first name
Spouse’s last name
Last four digits of identification number
Assisting individual’s first name
Assisting individual’s last name
Assisting individual’s relationship to taxpayer
Assisting individual’s license number, if applicable
Purpose: This form is to help the assisting individual and taxpayer understand their responsibilities when submitting a WFHDC credit
claim. Anyone assisting a taxpayer in claiming the WFHDC credit is expected to review supporting documentation to verify credit
eligibility, ask clarifying questions, and inform the taxpayer a penalty may be assessed if they knowingly claim a false credit. This form
does not prevent a penalty from being imposed, nor is it mandatory.
A penalty may be charged to a taxpayer or assisting individual who knowingly claims a false WFHDC credit or knowingly assists
someone in claiming a false WFHDC credit. The penalty may be up to 25 percent of the amount claimed.
Instructions: The individual assisting the taxpayer will complete Part 1. The taxpayer claiming the credit will complete Part 2. Do not
submit this form with the return. Both parties should keep a completed copy with their records.
Part 1. Assisting individual
1. Did you calculate the WFHDC credit claim based on your review of the information provided
by the taxpayer? ...................................................................................................................................... 1.
Yes
No
2. Did you interview the taxpayer, ask adequate questions, and document the taxpayer’s responses
to determine that the taxpayer is eligible to claim the credit? ................................................................ 2.
Yes
No
3. Did you ask the taxpayer if the credit was claimed and disallowed or reduced in a previous year? .... 3.
Yes
No
4. Did any information provided to you in connection with preparing the return appear to be
incorrect, incomplete, or inconsistent? If the answer is no, skip to line 6. ............................................. 4.
Yes
No
5. Did you ask reasonable questions of the taxpayer to determine the correct or complete
information? ............................................................................................................................................. 5.
Yes
No
6. Did you explain to the taxpayer that they may receive a penalty of up to 25 percent of the
amount claimed for knowingly filing a false WFHDC credit? .................................................................. 6.
Yes
No
Under penalties of false swearing, I declare that I have:
• Examined the taxpayer’s return and accompanying documentation for the WFHDC credit claim, and
• Asked clarifying questions to ensure credit eligibility, and
• Advised the taxpayer of the WFHDC penalty for knowingly false claims.
To the best of my knowledge and belief, the taxpayer’s WFHDC credit claim and accompanying schedules and statements are true,
correct, and complete. This declaration is based on all information of which I have any knowledge.
Date
Assisting individual signature
/
/
X
Clear form
Clear this page
Schedule OR-WFHDC-CL
18980001020000
Page 2 of 2, 150-101-198
Oregon Department of Revenue
(Rev. 08-25-20 ver. 01)
Part 2. Taxpayer
7. Did the individual listed on the prior page assist you with the filing of the WFHDC credit claim? .........7.
Yes
No
8. Did the individual listed on the prior page explain that a penalty of up to 25 percent of the amount
claimed may be assessed for knowingly filing a false WFHDC credit claim? ........................................ 8.
Yes
No
Under penalties of false swearing, I declare these statements to be true, correct, and complete.
Taxpayer signature
Date
/
/
X
Date
Spouse’s signature
/
/
X
—Keep a copy of this form with your records.—
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