Tax Calendar Details

Are you aware of the Irs Form 8965? If not, you should be. This form is important for taxpayers who are claiming an exemption from the individual shared responsibility payment. Use this form to report coverage exemptions and reconcile any advance payments of the shared responsibility payment made on your behalf. In this blog post, we will go over what you need to know about Irs Form 8965 and how to fill it out.

Here is the information regarding the form you were seeking to fill out. It can tell you how much time it will take to finish irs form 8965, exactly what fields you need to fill in and a few further specific details.

QuestionAnswer
Form NameIrs Form 8965
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other names8965 form 2019 pdf, 8695 form, federal w 4, 8965 form 2020 pdf

Form Preview Example

Form 8965

Health Coverage Exemptions

OMB No. 1545-0074

 

2018

 

Attach to Form 1040.

Department of the Treasury

 

Go to WWW.IRS.GOV/FORM8965 for instructions and the latest information.

Attachment

Internal Revenue Service

Sequence No. 75

Name as shown on return

 

Your social security number

 

 

 

 

Complete this form if you have a Marketplace-granted coverage exemption or you are claiming a coverage exemption on your return.

Part I

1

2

3

4

5

6

Marketplace-Granted Coverage Exemptions for Individuals. If you and/or a member of your tax household

have an exemption granted by the Marketplace, complete Part I.

(a)

(b)

(c)

Name of Individual

SSN

Exemption Certificate Number

 

 

 

Part II Coverage Exemptions Claimed on Your Return for Your Household

7If you are claiming a coverage exemption because your household income or gross income is below the filing threshold,

check here

Part III

8

9

10

11

12

13

Coverage Exemptions Claimed on Your Return for Individuals. If you and/or a member of your tax

household are claiming an exemption on your return, complete Part III.

(a)

(b)

(c)

(d)

(e)

(f)

(g)

(h)

(i)

(j)

(k)

(l)

(m)

(n)

(o)

(p)

Exemption

Full

Name of Individual

SSN

Jan

Feb

Mar

Apr

May

June

July

Aug

Sept

Oct

Nov

Dec

Type

Year

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

For Privacy Act and Paperwork Reduction Act Notice, see your tax return instructions.

Cat. No. 37787G

Form 8965 (2018)

If you believe this page is infringing on your copyright, please familiarize yourself with and follow our DMCA notice and takedown process - click here to proceed .