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Rochester New York Form 2848: What You Should Know

The amount you are entitled to is an amount equal to the product of: 1. Youare tax-free income before deducting any expenses. 2. Your standard deduction amount 3. The amount of the PTC you received. Taxpayers who file Forms 1040, 1040A, 1040EZ, and 1040NR are treated as having the standard deduction amount of 6,000 (6,150 if married filing separately), the amount of the PTC they received of 3,000. 4. The amount of any applicable state taxes paid to the IRS. The amount of state taxes paid will be the amount of any applicable state taxes you are responsible for paying, unless the amount is more than 2,500. The amount of your state taxes is reduced to 300. Form 8962 — Information you need to fill out 1. Taxpayer (Name and Address) 2. Number of 3. Tax Year 4. Year of first coverage 5. Name of health care provider and/or health insurance issuer 6. Number of dependent in coverage 7. Date on which your coverage began 8. Payment Information 9. Premium (Minimum monthly premium) 10. Type of health plan 11. Amount of 12. Payment Type 13. Address 1. If your Marketplace or State had a health insurance exchange through which you could enroll in a Marketplace Plan, enter that information 2. If your Marketplace or State did not have a health insurance exchange, enter “None” 3. If you have Medicare, enter “Medicare” instead of “Medicaid” 4. If you enrolled in a Marketplace Plan through a Federal, State, or Local government-sponsored program, such as Veterans Affairs or Federal Employee Health Benefits, or you enrolled in a Marketplace Plan through a Federal or State program not funded by the federal government, such as a Medicare, Medicaid, SHIP, or similar program, enter “None” 5. If you enrolled in an exchange established by a state, political subdivision, or the District of Columbia, enter the State, political subdivision, or District of Columbia, as applicable 6. You must report your total monthly advance payment of the premium tax credit, the amount of which is the PTC you are entitled to, as described in 26 CFR 1.

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