(Form 1040)
SCHEDULE 5
(Form 1040)
Deparbnent of the Treasury
Internal Revenue &nice
Nameis) sham) on Fomi 1040 Other Payments and Refundable Credits
P Attach to Form 1040.
► Go to www.irs.gov/Form1040 for instructions and the latest information. OMB No. 1545-0074
2018 Attachment
Sequence No. 05
Your social security number
Other 65 Reserved
Payments 66 2018 estimated tax payments and amount applied from 2017 return 66
67a and 67a
b Reserved
Reserved 67b
Refundable 68-69 Reserved 68-69
Credits 70 Net premium tax credit. Attach Form 8962 70
71 Amount paid with request for extension to file (see instructions) 71
72 Excess social security and tier 1 RRTA tax withheld 72
73 Credit for federal tax on fuels. Attach Form 4136 73
74 Credits from Form: a O2439 b ❑ Reserved c O8885 d ❑ 74
75 Add the amounts in the far right column. These are your total other payments
and refundable credits. Enter here and include on Form 1040. line 17. . . . 75
For Paperwork Reduction Act Notice, see your tax return instructions. Schedule 5 (Form 1040)2018
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