Year-End Tax Statement (W-10) Generator
Build the statement parents need for the child care tax credit — fill in the form, then print or save it as a PDF.
Statement details
The statement updates as you type. Everything happens in your browser — nothing is saved, stored or sent anywhere.
In the print dialog you can also choose "Save as PDF". Give statements to every family by January 31.
Child Care Payment Statement
For parents’ tax records — Form W-10 information
- Provider
- —
- Provider EIN
- —
- Parent / guardian
- —
- Child
- —
- Tax year
- 2025
- Total paid
- $0.00
This statement confirms that the total above was received as payment for child care services during the tax year shown. Parents: keep this with your tax records for Form W-10 and the Child and Dependent Care Credit.
What this statement is — and why parents need it
Parents who pay for child care so they can work may claim the Child and Dependent Care Credit, and many use a dependent care FSA at work. Both ask for three things about you: your name, your address, and your taxpayer identification number — plus the total they paid. Form W-10 is the IRS form parents can use to collect that information from you; a signed statement like this one, with the same details, does the same job and is what most home providers hand out.
Give one to every family by January 31, including families who left mid-year (their total covers only what they actually paid). Use your EIN rather than your Social Security number whenever you can — an EIN is free from the IRS. Our article on daycare tax statements for parents explains the rules, the common mistakes, and what to do if a parent asks in March. While you are at it, January is also when your own records matter most — see the record-keeping guide for what to keep and for how long.
W-10 statement questions
Is this the same as filing Form W-10 with the IRS?
No. Form W-10 is a form the parent keeps with their own tax records — nobody files it with the IRS. This statement gives parents the same information in a cleaner format. You sign it, they keep it.
What if a parent needs statements for two children?
Make one statement per child, each with that child’s own total. Parents figure the credit per child, so separate statements save them (and you) confusion later.
Should the total include registration fees or deposits?
Include what the family actually paid you during the calendar year for care and related required fees, and match the number to your deposit records. When a fee is not for care itself, many providers list it as a separate line — the generator’s single total works for the standard case.
Disclaimer: This calculator gives planning estimates based on the figures you enter. It is not tax, legal or financial advice. Confirm important numbers with the official source or a qualified professional.