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Ame(s) shown on return ! CAUTION OMB No. 1545-0074 Credit for Qualified Retirement Savings Contributions 2012 Attachment Sequence No. 54 Your social security number You cannot take this credit if either of the following applies. The amount on Form 1040, line 38; Form 1040A, line 22; or Form 1040NR, line 37 is more than $28,750 ($43,125 if head of household; $57,500 if married filing jointly). The person(s) who made the qualified contribution or elective deferral (a) was born af.

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