SWORN
DECLARATION ON WAIVER OR RIGHT TO CLAIM EXEMPTION OF DEPENDENT CHILDREN BY THE
HUSBAND
In accordance with the provisions of Section 29 (1) (2)
(A) of the National Internal Revenue Code, as amended. I, __________________________________, hereby
voluntary depose and say:
1.
That
my wife and I are both income earners;
2.
That
we file a joint income tax returns on our taxable income;
3.
That
I hereby waive my right to claim the additional exemption for all our qualified
______ dependent children in favor of my wife _________________________________
who is presently employed with ______________________________________________.
4.
That
this waiver shall be effective for the taxable year ________________ and shall
continue for the succeeding year/s unless sooner revoked.
I hereby declare under penalties of perjury that the
foregoing representations are true and correct and that the waiver of right is
voluntarily and knowingly made in accordance with the provisions of the
National Internal Revenue Code, as amended.
____________________ ______________________________
Date
Taxpayer – Husband
---------------------------------------------------------------------------------------------------------------------------------
This is to acknowledge receipt of the above waiver of Mr.
______________
_____________________ in favor
of his wife_________________________________
who shall be entitled to claim
the additional exemption of all their qualified dependent children effective
_________________ (Month/Taxable Year).
______________________________
Employer of Husband
Note: If husband is engaged in
business disregard the acknowledgement receipt portion of this form.
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