Schedule 3 (Form 1040A): Credit for the Elderly or the Disabled for Form 1040A Filers 2005. Summary: This is an example of Schedule 3 (Form 1040A) 2005, Page 1 with items completed per example in the text:
               
               
                  
                     | “Name(s) shown on Form 1040” field contains Jerry A. Ash | 
                  
                     | “Your social security number” field contains 123-00-1234 | 
                  
                     | Under
                        “Part I: Check the box for your filing status and age”: | 
                  
                     | 
                           
                              | In the section
                                 “Single, Head of household, or Qualifying widow(er) with dependent child”, line item
                                 “1. You were 65 or older” checkbox checked |  |