Schedule R (Form 1040) Credit for the Elderly or the Disabled 2005. Summary: This is an example of Schedule R (Form 1040) 2005, Page 1 with items completed per example in the text:
               
               
                  
                     | “Name(s) shown on Form 1040” field contains William M. White and Helen A. White | 
                  
                     | “Your social security number” field contains 220-00-3333 | 
                  
                     | Under
                        “Part I: Check the Box for Your Filing Status and Age”: | 
                  
                     | 
                           
                              | In the section
                                 “Married filing jointly”, line item
                                 “5. Both spouses were under 65, and both retired on permanent and total disability” checkbox checked |  | 
                  
                     | Under
                        “Part II: Statement of Permanent and Total Disability”: | 
                  
                     | 
                           
                              | “2. Due to your continued disabled condition, you were unable to engage in any substantial gainful activity in 2004, check
                                    this box”
                                 checkbox checked and William written above checkbox. |  |