| Taxpayer's Name | |
| Tax Year | |
| Cost of Housing: | Fair Market Rental Value Actual Housing Costs |
| Total Cost of Keeping Up the Home (Total Amounts Paid by Taxpayer and Others) |
Amounts Taxpayer Paid | ||||||
| Type of Expense | Monthly Amount |
No. of Months |
Total Annual Cost |
Monthly Amount |
No. of Months |
Total Annual Cost |
|
| Property Taxes | |||||||
| Mortgage Interest Expenses | |||||||
| Property Insurance | |||||||
| Fair Market Rental Value | |||||||
| Rent | |||||||
| Utility charges | |||||||
| Food consumed on premises | |||||||
| Other | |||||||
| Total | Total | ||||||
| ANSWER | ||||
Total Cost of Upkeep |
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Does the Taxpayer meet the requirement of paying more than half the cost of keeping up the home? |
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Amount paid by others |
||||
| = | ||||
Amount paid by Taxpayer |
||||
| = | = | ? | ||