Form W-5 Earned Income Credit Advance Payment Certificate 2006. Summary: This is an example of the lower portion of Form W-5 (2006). The line items to be completed are:
               
               
                  
                     | “Print or type your full name” field | 
                  
                     | “Your social security number” field | 
                  
                     | “1. I expect to have a qualifying child and be able to claim the earned income credit for 2006 using that child. I do not have
                           another Form W-5
                           in effect with any other current employer, and I choose to get advance E.I.C. payments” | 
                  
                     | 
                           
                              | “Yes” checkbox |  
                              | “No” checkbox |  | 
                  
                     | “2. Check the box that shows your expected filing status for 2006:” | 
                  
                     | 
                           
                              | “Single, head of household, or qualifying widow(er)” checkbox |  
                              | “Married filing jointly” checkbox |  | 
                  
                     | “3. If you are married, does your spouse have a Form W-5 in effect for 2006 with any employer?” | 
                  
                     | 
                           
                              | “Yes” checkbox |  
                              | “No” checkbox |  | 
                  
                     | “Under penalties of perjury, I declare that the information I have furnished above is, to the best of my knowledge, true, correct,
                           and
                           complete.” | 
                  
                     | 
                           
                              | “Signature” field |  
                              | “Date” field |  |