U.S. Individual Income Tax Return

2011

Instructions for Form 8839

Department of the Treasury
Internal Revenue Service

Qualified Adoption Expenses
Important Information
Documentation requirements. To claim the refundable
adoption credit, you must include one or more adoption-related
documents to support your claim for the credit. Documentation
must be provided for each eligible child claimed. See the
instructions for line 1 for the specific requirements.
Paper filing required. Because of the documentation
requirements, if you are filing Form 8839, you cannot file your
income tax return and Form 8839 electronically. You must file
paper returns. Mail your return with Form 8839 and all required
documentation to the address listed in your tax return
instructions.
Frequently asked questions. Answers to frequently asked
questions are available at www.irs.gov/individuals/article/
0,,id=231663,00.html.

What’s New
Future developments. The IRS has created a page for
information about Form 8839 and its instructions at www.irs.
gov/form8839. Information about any future developments
affecting Form 8839 (such as legislation enacted after we
release it) will be posted on that page.
Increased credit. The maximum credit and the exclusion for
employer-provided benefits have each increased to $13,360 per
eligible child. This amount begins to phase out if you have
modified adjusted gross income in excess of $185,210 and is
completely phased out for modified adjusted gross income of
$225,210 or more.
The ability to carryforward an unused adoption credit
expired in 2010 when the credit was made refundable. If
CAUTION you have a credit carryforward from a year prior to 2010,
you must file an amended 2010 income tax return and attach a
2010 Form 8839 in order to claim the credit.

!

General Instructions
Purpose of Form
Use Form 8839 to figure your adoption credit and any
employer-provided adoption benefits you can exclude from your
income. You can claim both the exclusion and the credit for
expenses of adopting an eligible child. For example, depending
on the cost of the adoption, you may be able to exclude up to
$13,360 from your income and also be able to claim a credit of
up to $13,360. But, you cannot claim both a credit and
exclusion for the same expenses. See Qualified Adoption
Expenses and Employer-Provided Adoption Benefits, later.
Adoption credit. Use Form 8839, Part II, to figure the
adoption credit you can take on Form 1040, line 71, checkbox b
or Form 1040NR, line 67, checkbox b. You may be able to take
this credit in 2011 if any of the following statements are true.
1. You paid qualified adoption expenses in connection with
the adoption of an eligible U.S. child in:
a. 2010 and the adoption was not final at the end of 2010,
or
b. 2011 and the adoption became final in or before 2011.
2. You adopted a child with special needs and the adoption
became final in 2011. (In this case, you may be able to take the
credit even if you did not pay any qualified adoption expenses.)
Dec 30, 2011

3. You paid qualified adoption expenses in connection with
the adoption of an eligible foreign child in:
a. 2011 or prior years and the adoption became final in
2011, or
b. 2011 and the adoption became final before 2011.
See the instructions for line 1, column (e), later.
Income exclusion for employer-provided adoption benefits.
Use Form 8839, Part III, to figure the employer-provided
adoption benefits you can exclude from your income on Form
1040, line 7, or Form 1040NR, line 8. You may be able to
exclude these benefits from income if your employer had a
qualified adoption assistance program (see Employer-Provided
Adoption Benefits, later) and any of the following statements
are true.
1. You received employer-provided adoption benefits in
2011. However, special rules apply for benefits received in
connection with the adoption of an eligible foreign child. See the
instructions for line 1, column (e), later.
2. You adopted a child with special needs and the adoption
became final in 2011.
3. You received employer-provided adoption benefits in
connection with the adoption of an eligible foreign child in:
a. 2011 or prior years and the adoption became final in
2011, or
b. 2011 and the adoption became final before 2011.
See the instructions for line 1, column (e), later.
For purposes of calculating the adoption credit in Part II,
qualified adoption expenses (defined later) do not include
expenses reimbursed by an employer under a qualified
adoption assistance program (see Employer Provided Adoption
Benefits, later). For this reason, you must complete Form 8839,
Part III, before you can figure the credit, if any, in Part II.
You cannot exclude employer-provided adoption
benefits if your employer is an S corporation in which
CAUTION you own more than 2% of the stock or stock with more
than 2% of the voting power.
Income limit. The income limit on the adoption credit or
exclusion is based on modified adjusted gross income (MAGI).
For 2011, use the following table to see if the income limit will
affect your credit or exclusion.

!

IF your MAGI is...

THEN the income limit...

$185,210 or less

will not affect your credit or
exclusion.

Between $185,211 and $225,209 will reduce your credit or
exclusion.
$225,210 or more

will eliminate your credit or
exclusion.

Note on welfare benefits and the adoption credit. Any
refund you receive as a result of taking the adoption credit
cannot be counted as income when determining if you or
anyone else is eligible for benefits or assistance, or how much
you or anyone else can receive, under any federal program or
any state or local program financed in whole or in part with
federal funds. These programs include Temporary Assistance
for Needy Families (TANF), Medicaid, Supplemental Security
Income (SSI), and Supplemental Nutrition Assistance Program
(food stamps). In addition, when determining eligibility, the
refund cannot be counted as a resource for at least 12 months

Cat. No. 23077T

after you receive it. Check with your local benefit coordinator to
find out if your refund will affect your benefits.

meet the definition of qualified adoption expenses. As a result,
Madelyn’s maximum adoption credit is limited to $6,000
($10,000 – $4,000).

Definitions

Example 2. Haylee paid $10,000 in qualified adoption
expenses for the adoption of an eligible child. Under a qualified
adoption assistance program, Haylee’s employer paid an
additional $6,000 of qualified adoption expenses on her behalf.
Her total qualified adoption expenses are $16,000 ($10,000 +
$6,000). Because the expenses paid by Haylee were different
from the expenses paid by her employer, Haylee may exclude
the $6,000 that her employer paid from her income and may
claim a credit for the $10,000 of qualified adoption expenses
she paid.

Eligible Child
An eligible child is:
• Any child under age 18. If the child turned 18 during the year,
the child is an eligible child for the part of the year he or she
was under age 18.
• Any disabled person physically or mentally unable to take
care of himself or herself.
If you and another person (other than your spouse if
filing jointly) adopted or tried to adopt an eligible U.S.
CAUTION child, see the instructions for line 2 (or line 13, if
applicable), later, before completing Part II (or Part III).

!

Example 3. Paul paid $30,000 in qualified adoption
expenses to adopt an eligible foreign child, and the adoption
became final in 2011. Under a qualified adoption assistance
program, Paul’s employer reimbursed him for $13,360 of those
expenses. Paul may exclude the $13,360 reimbursement from
his income. The remaining $16,640 of expenses ($30,000 –
$13,360) continue to be qualified adoption expenses that are
eligible for the credit. However, Paul’s credit is dollar-limited to
$13,360. The remaining $3,280 ($30,000 – $13,360 –
$13,360) may never be claimed as a credit or excluded from
gross income.

Qualified Adoption Expenses
Qualified adoption expenses are reasonable and necessary
expenses directly related to, and for the principal purpose of,
the legal adoption of an eligible child.
Qualified adoption expenses include:
Adoption fees,
Attorney fees,
Court costs,
Travel expenses (including meals and lodging) while away
from home, and
• Re-adoption expenses relating to the adoption of a foreign
child.

•
•
•
•

Who Can Take the Adoption Credit or
Exclude Employer-Provided Adoption
Benefits?

Qualified adoption expenses do not include expenses:

You may be able to take the credit or exclusion if all three of the
following statements are true.
1. Your filing status is single, head of household, qualifying
widow(er), or married filing jointly. Generally, if you are married,
you must file a joint return to take the credit or exclusion.
However, if you are married and filing a separate return, you
may be able to take the credit or exclusion on a separate return
if you are considered unmarried because you are legally
separated or living apart from your spouse and you meet
certain other requirements. See Married Persons Filing
Separate Returns below.
2. Your modified adjusted gross income (MAGI) is less than
$225,210. To figure your MAGI, see the instructions for line 7
(for the credit) or line 19 (for the exclusion), later.
3. You report the required information about the eligible
child in Part l.

• For which you received funds under any state, local, or

federal program,
• That violate state or federal law,
• For carrying out a surrogate parenting arrangement,
• For the adoption of your spouse’s child,
• Paid or reimbursed by your employer or any other person or
organization, or
• Allowed as a credit or deduction under any other provision of
federal income tax law.

Employer-Provided Adoption Benefits
In most cases, employer-provided adoption benefits are
amounts your employer paid directly to either you or a third
party for qualified adoption expenses under a qualified adoption
assistance program. But see Children with special needs, later.
A qualified adoption assistance program is a separate written
plan set up by an employer to provide adoption assistance to its
employees. For more details, see Pub. 15-B, Employer’s Tax
Guide to Fringe Benefits.

Married Persons Filing Separate Returns
You may be able to take the credit or exclusion if all of the
following apply.
• Statements (2) and (3) above under Who Can Take the
Adoption Credit or Exclude Employer-Provided Adoption
Benefits are true.
• You lived apart from your spouse during the last 6 months of
2011.
• The eligible child lived in your home more than half of 2011.
• You provided over half the cost of keeping up your home.

Employer-provided adoption benefits should be shown in
box 12 of your Form(s) W-2 with code T. Your salary may have
been reduced to pay these benefits. You may also be able to
exclude amounts not shown in box 12 of your Form W-2 if all of
the following apply.
• You adopted a child with special needs. See the instructions
for line 1, column (d), later, for the definition of a child with
special needs.
• The adoption became final in 2011.
• Your employer had a qualified adoption assistance program
as described above.

When To Take the Credit or Exclusion
When you can take the adoption credit or exclusion depends on
whether the eligible child is a citizen or resident of the United
States (including U.S. possessions) at the time the adoption
effort began (domestic adoption).

The following examples help illustrate how qualified adoption
expenses and employer-provided adoption benefits apply to the
maximum adoption credit allowed.
Example 1. Madelyn paid $10,000 in qualified adoption
expenses for the adoption of an eligible child. Under a qualified
adoption assistance program, Madelyn’s employer reimbursed
her for $4,000 of those expenses. Madelyn may exclude the
$4,000 reimbursement from her income. However, because of
the employer reimbursement, $4,000 of her expenses no longer

Child who is a U.S. citizen or resident (U.S. child). If the
eligible child is a U.S. citizen or resident, you can take the
adoption credit or exclusion even if the adoption never became
final. Take the credit or exclusion as shown in the following
tables.

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Form 8839 (2011)

Domestic Adoption
IF you pay
qualifying expenses in...

THEN take the credit in...

Any year before the year the
adoption becomes final

The year after the year
of the payment.

The year the adoption becomes
final

The year the adoption
becomes final.

Specific Instructions
Part I—Information About Your Eligible
Child or Children
Line 1
Complete all columns that apply to the eligible child you
adopted or tried to adopt and attach the appropriate
documentation. If you do not give correct or complete
information and attach the appropriate documentation, your
credit and any exclusion may be disallowed.
Documentation requirements. You must provide at least one
of the documents described below to support your claim for
each eligible child on line 1. Attach the documents to Form
8839 and file with your income tax return. Copies are
acceptable unless otherwise specified. You may redact
sensitive personal information from an adoption order or decree
or from a special needs determination; however, the IRS may
require you to provide an unredacted copy at a later date.
Be sure to write your name and social security number on
each document. Because of these documentation
requirements, you must file your income tax return and Form
8839 by paper only. You cannot file electronically.
After your return is received by the IRS, you may be asked
to substantiate any qualified adoption expenses you paid.
Domestic adoptions that have not been finalized. For a
domestic adoption of a U.S. child that was not finalized in 2011
or earlier, attach one or more of the following documents.

Any year after the year the adoption The year of the payment.
becomes final
IF your employer pays for
THEN take the
qualifying expenses under an
exclusion in....
adoption assistance program in...
Any year

The year of the payment.

Children with special needs. If you adopt a U.S. child with
special needs, you may be able to exclude up to $13,360 and
claim a credit for additional expenses up to $13,360 (minus any
qualified adoption expenses claimed for the same child in a
prior year). The exclusion may be available, even if you or your
employer did not pay any qualified adoption expenses, provided
the employer has a written qualified adoption assistance
program. See the instructions for line 1, column (d), later, for
more information.
Foreign child. If the eligible child is a foreign child, you cannot
take the adoption credit or exclusion unless the adoption
becomes final. A child is a foreign child if he or she was not a
citizen or resident of the United States (including U.S.
possessions) at the time the adoption effort began. Take the
credit or exclusion as shown on the following tables.

1. An adoption taxpayer identification number, obtained by
the taxpayer for the child, included on the taxpayer’s income tax
return (instead of attaching a document).
2. A home study completed by an authorized placement
agency.
3. A placement agreement with an authorized placement
agency.
4. A document signed by a hospital official authorizing the
release of a newborn child from the hospital to the taxpayer for
legal adoption.
5. A court document (a copy showing official seal), ordering
or approving the placement of a child with the taxpayer for legal
adoption.
6. An original affidavit or notarized statement signed under
penalties of perjury from an adoption attorney, government
official, or other authorized person, stating that the signer:
a. Placed or is placing a child with the taxpayer for legal
adoption, or
b. Is facilitating the adoption process for the taxpayer in an
official capacity, with a description of the actions taken to
facilitate the process.

Foreign Adoption
IF you pay
qualifying expenses in...

THEN take the credit in...

Any year before the year the
adoption becomes final

The year the adoption
becomes final.

The year the adoption becomes
final

The year the adoption
becomes final.

Any year after the year the adoption The year of the payment.
becomes final
IF your employer pays for
qualifying expenses under an
THEN take the
adoption assistance program in... exclusion in....
Any year before the year the
adoption becomes final

The year the adoption
becomes final.

The year the adoption becomes
final

The year the adoption
becomes final.

Domestic and foreign adoptions that have been
finalized. For domestic adoptions finalized in 2011 or before,
and foreign adoptions finalized in 2011, check the box in
column (g) and attach one or more of the following documents:

Any year after the year the adoption The year of the payment.
becomes final

1. For a domestic or foreign adoption finalized in the United
States, the adoption order or decree (a copy showing official
seal).
2. For an adoption governed by the Hague Convention and
finalized in another country:
a. The Hague Adoption Certificate (Immigrating Child),
b. The IH-3 visa, or
c. A foreign adoption decree (a copy showing official seal)
translated into English.
3. For a foreign adoption from a country that is not party to
the Hague Convention:
a. A foreign adoption decree (a copy showing official seal)
translated into English or
b. An IR-2 or IR-3 visa.

If your employer makes adoption assistance payments in a
year before the adoption of a foreign child is final, you must
include the payments in your income in the year of the
payment. Then, on your return for the year the adoption
becomes final, you can make an adjustment to take the
exclusion.
Your employer is not required to withhold income tax on
payments for qualifying expenses under an adoption
CAUTION assistance program. If you must include the payments in
income in the year paid because your adoption of a foreign
child is not final, your withholding may not be enough to cover
the tax on those payments. You may need to give your
employer a new Form W-4 to adjust your withholding or make
estimated tax payments to avoid a penalty for underpayment of
estimated tax.

!

Form 8839 (2011)

Adoption of a U.S. child with special needs. For
adoption of a child with special needs, in addition to the
requirements above, you must check the box in column (d) and

-3-

Table 1.

List of Documents That Need To Be Attached To Your Return If You Are Claiming Adoption Credit

IF...

AND...

THEN attach a copy of

Domestic Adoption

In-Process

One or more of the following documents:
• A home study completed by an authorized placement agency.
• A placement agreement with an authorized placement agency.
• A document signed by a hospital official authorizing the release of a newborn child
from the hospital to you for legal adoption.
• A court document ordering or approving the placement of a child with you for legal
adoption.
• An original affidavit or notarized statement signed under penalties of perjury from
an adoption attorney, government official, or other authorized person, stating that
the signer:
1. Placed or is placing a child with you for legal adoption, or
2. Is facilitating the adoption process for you in an official capacity, with a
description of the actions taken to facilitate the process.

Domestic Adoption

Final

The adoption certificate, order judgement, or decree clearly establishing that the
adoption is final. Showing the names of the adoptive child and parent (yourself) and
signed and dated by a representative of a state or county court, showing the official
seal.

Foreign Adoption

In-Process

The adoption credit cannot be claimed.

Foreign Adoption (from a country governed Final
by the Hague Convention)

Foreign Adoption (from a country that is
not party to the Hague Convention)

Domestic Adoption (special needs child)

Final

One or more of the following documents:
•
•
•

One or more of the following documents:
•
•

Final

The Hague Adoption Certificate (Immigrating Child)
The IH-3 visa, or
A foreign adoption decree translated into English

A foreign adoption decree translated into English, or
An IR-2 or IR-3 visa.

The following documents:
• An adoption certificate, report or final decree clearly establishing that the adoption
is final, showing the names of the adoptive child and parent (yourself) and signed
and dated by a representative of the state court, and
• A copy of the state’s determination of special needs which may include, but is not
limited to the following:
1. A signed adoption assistance or subsidy agreement issued by the state
2. Certification from the state or a county welfare agency verifying that the child
is approved to receive adoption assistance
3. Certification from the state or a county welfare agency verifying that the child
has special needs

More Than Three Eligible Children

attach a copy of the state determination of special needs to
your income tax return.
For these purposes, an order or decree (a copy showing
official seal) must include information establishing that the
taxpayer’s adoption of the eligible child has been finalized and
the date it was finalized. A special needs determination must
include information establishing that the state has made a
determination of special needs for the eligible child.
For more information and examples on a state determination
of special needs, see frequently asked questions on adoption
benefits at www.irs.gov/individuals/article/0,,id=231663,00.html.

If you adopted or tried to adopt more than three eligible
children, fill in and attach as many Forms 8839 as you need to
list them. Also, enter “See Attached” to the right of the Caution
below line 1.
For Part II, fill in lines 2 through 6 and 10 and 11 for each
child. But fill in lines 7 through 9 and 12 on only one Form 8839.
The amount on line 12 of that Form 8839 should be the
combined total of the amounts on line 11 of all the Forms 8839.
For Part III, fill in lines 13 through 16, 18, 22, and 23 for each
child. But fill in lines 17, 19 through 21, 24, and 25 on only one
Form 8839. The amount on line 17 of that Form 8839 should be
the combined total of the amounts on line 16 of all the Forms
8839. The amount on line 24 of that form should be the
combined total of the amounts on line 23.

Attempted Adoptions of U.S. Children
If you made more than one attempt to adopt one eligible U.S.
child, combine the amounts you spent and complete only the
“Child 1” line. Do not report the additional attempt(s) on the
“Child 2” or “Child 3” line. Complete the “Child 2” or “Child 3”
lines only if you adopted or tried to adopt two or three eligible
children.
Example. You planned to adopt one U.S. child. You had
one unsuccessful attempt to adopt a child and later successfully
adopted a different child. Complete only the “Child 1” line
because you made more than one attempt to adopt one eligible
child.

Column (c)
A disabled individual is an eligible child, regardless of the
individual’s age at the time of adoption, if the individual is
physically or mentally unable to take care of himself or herself.

Column (d)
A child is a child with special needs if all three of the following
statements are true.
1. The child was a citizen or resident of the United States or
its possessions at the time the adoption effort began (U.S.
child).

If you filed Form 8839 for a prior year in connection with
this adoption, enter your 2011 information on the same
CAUTION line (Child 1, Child 2, or Child 3) that you used in the
prior year.

!

-4-

Form 8839 (2011)

2. A state (including the District of Columbia) has
determined that the child cannot or should not be returned to
his or her parents’ home.
3. The state has determined that the child will not be
adopted unless assistance is provided to the adoptive parents.
Factors used by states to make this determination include:
a. The child’s ethnic background and age,
b. Whether the child is a member of a minority or sibling
group, and
c. Whether the child has a medical condition or a physical,
mental, or emotional handicap.

foreign child and use the combined totals to complete lines 4
through 9 of the worksheet.
If you check the box in column (e), you must also check
the box in column (g), indicating the adoption was
CAUTION finalized in 2011 or earlier, and attach the appropriate
documentation.

!

Column (f)
Enter the child’s identifying number. This can be a social
security number (SSN), an adoption taxpayer identification
number (ATIN), or an individual taxpayer identification number
(ITIN).
Enter the child’s SSN if the child has an SSN or you will be
able to get an SSN in time to file your tax return. Apply for an
SSN using Form SS-5.
If you are in the process of adopting a child who is a U.S.
citizen or resident alien but you cannot get an SSN for the child
in time to file your return, apply for an ATIN using Form W-7A.
However, if the child is not a U.S. citizen or resident alien, apply
instead for an ITIN using Form W-7.

You may be able to claim an exclusion or credit for the
adoption of a U.S. child with special needs even if you did not
pay any qualified adoption expenses. See line 18 and the
instructions for line 5.

!

CAUTION

If you check the box in column (d) indicating the child
has special needs, be sure to attach a copy of the
state’s determination to Form 8839.

Column (e)

Column (g)

A child is a foreign child if he or she was not a citizen or
resident of the United States or its possessions at the time the
adoption effort began.
Special rules. If you paid qualified adoption expenses in 2011
or any prior year in connection with the adoption of a foreign
child and the adoption became final in 2011, you can use the
total expenses you paid in 2011 and all prior years in
determining the amount to enter on line 5. If you and another
person (other than your spouse if filing jointly) each paid
qualified adoption expenses to adopt the same child, the total
qualified expenses must be divided between the two of you.
You can divide it in any way you both agree.

Check the box in column (g) if the adoption for each child
became final in 2011 or earlier.

!

CAUTION

Part II—Adoption Credit
Line 2
The maximum adoption credit is $13,360 per child. If you and
another person (other than your spouse if filing jointly) each
paid qualified adoption expenses to adopt the same child, the
$13,360 limit must be divided between the two of you. You can
divide it in any way you both agree. Cross out the preprinted
entry on line 2 and enter above line 2 your share of the $13,360
limit for that child.

If the adoption did not become final by the end of 2011, you
cannot take the adoption credit for that child in 2011. If the
adoption becomes final in a later year, you may be able to take
a credit for the expenses in that year.
To find out when a foreign adoption is treated as final, see
Rev. Proc. 2005-31, 2005-26 I.R.B. 1374, available at www.irs.
gov/irb/2005-26_IRB/ar14.html, and Rev. Proc. 2010-31,
2010-40 I.R.B. 413, available at www.irs.gov/irb/2010-40_IRB/
ar10.html.

Line 3
If you filed Form 8839 for a prior year for the same child, enter
on line 3 the total of the amounts shown on lines 3 and 6 of the
last form you filed for the child.

The Hague Convention on Protection of Children and
Co-operation in Respect of Intercountry Adoption
CAUTION (Hague Adoption Convention) entered into force for the
United States on April 1, 2008. The Hague Adoption
Convention applies if you adopted a child from a country that is
party to the Hague Adoption Convention and you filed your
application and petition (Forms I-800A and I-800) with the U.S.
Citizenship and Immigration Service after March 31, 2008. See
www.adoption.state.gov for more information on the Hague
Adoption Convention, the application and petition, and a
complete list of countries that are parties to the Convention.
If you received employer-provided adoption benefits in 2011
in connection with the adoption of a foreign child and the
adoption did not become final by the end of 2011, you must
include the benefits in the total entered on Form 1040, line 7, or
Form 1040NR, line 8. Also, enter “AB” (adoption benefits) on
the dotted line next to Form 1040, line 7, or Form 1040NR, line
8. If the adoption becomes final in a later year, you may be able
to exclude the benefits from your income in that year.
Exclusion of prior year benefits. If you received
employer-provided adoption benefits before 2011 in connection
with the adoption of a foreign child and the adoption became
final in 2011, you may be able to exclude part or all of those
benefits from your 2011 income. To find out if you can,
complete the Exclusion of Prior Year Benefits Worksheet. You
also must use that worksheet to complete Form 8839, Part III,
and to figure any taxable benefits to enter on Form 8839, line
25.
If the adoption of more than one eligible foreign child
became final in 2011, complete lines 1 through 3 of the
Exclusion of Prior Year Benefits Worksheet separately for each

Line 5

!

Form 8839 (2011)

Attach the appropriate documentation, listed earlier,
supporting your claim for a finalized adoption for each
child for whom you checked this box.

Special rules apply if you paid expenses in connection
with the adoption of an eligible foreign child. See the
CAUTION instructions for line 1, column (e), earlier, for details.
Enter on line 5 the total qualified adoption expenses (as
defined earlier) you paid in:
• 2010 if the adoption was not final by the end of 2011,
• 2010 and 2011 if the adoption became final in 2011, or
• 2011 if the adoption became final before 2011.

!

Expenses reimbursed by your employer under a
qualified adoption assistance program are not qualified
CAUTION adoption expenses and must not be entered on line 5.
See the examples following Employer-Provided Adoption
Benefits, earlier.
Special needs adoption. If you adopted a U.S. child with
special needs and the adoption became final in 2011, enter on
line 5:
• $13,360, minus
• Any qualified adoption expenses you used to figure any
adoption credit you claimed for the same child in a prior year.
This is the amount you entered on line 3 of Form 8839 for this
child.
If you did not claim any adoption credit for the child in a prior
year, enter $13,360 on line 5 even if your qualified adoption
expenses for the child were less than $13,360 (and even if you
did not have any qualified adoption expenses for this child).
Unsuccessful adoption. If you paid qualified adoption
expenses in an attempt to adopt a U.S. child and the attempt

!

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Exclusion of Prior Year Benefits Worksheet
(for the adoption of a foreign child that became final in 2011)

Keep for Your Records

1. Enter the total employer-provided adoption benefits you received in 2011 and all prior years for the
adoption of the foreign child . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1.

2. Enter $13,360. If you and another person (other than your spouse if filing jointly) each received
employer-provided adoption benefits in 2011 or any prior year to adopt the same child, see instructions
below. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2.

3. Enter the smaller of line 1 or line 2 here and on Form 8839, line 13. If necessary, cross out the preprinted
amount on line 13 and enter the result above the preprinted amount . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

3.

Next:

• Enter -0- on Form 8839, line 14.
• Enter the amount from line 3 above on Form 8839, line 15.
• On Form 8839, line 16, enter the total amount of employer-provided adoption benefits received in 2011

and all prior years. On the dotted line next to line 16, enter “PYAB” and the total amount of benefits you
received before 2011.
• Complete Form 8839 through line 24. Then, complete lines 4 through 9 below to figure the amount of any
prior year benefits you can exclude and the taxable benefits, if any, to enter on Form 8839, line 25.
4. Is the amount on your 2011 Form 8839, line 24, less than the amount on Form 8839, line 17?
M No. Skip lines 4 through 6 and go to line 7.
M Yes. Subtract Form 8839, line 24 from line 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

4.

5. Enter the total employer-provided adoption benefits you received before 2011 included on Form 8839, line
16, for all children . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

5.

6. Taxable benefits. Subtract line 5 from line 4. If zero or less, enter -0-. Enter the result here and on Form
8839, line 25. If more than zero, also include this amount on line 7 of Form 1040 or line 8 of Form 1040NR,
and enter “AB” on the dotted line . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6.

7. Enter the amount from Form 8839, line 24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

7.

8. Enter the total 2011 employer-provided adoption benefits included on Form 8839, line 16, for all children . . .

8.

9. Prior year excluded benefits. Subtract line 8 from line 7. If zero or less, stop; you cannot exclude any of
your prior year benefits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

9.

Next. Figure the total you would enter on line 7 of Form 1040 or line 8 of Form 1040NR before you exclude the amount from
line 9 above. Then, subtract the amount from line 9 above from that total. Enter the result on line 7 of Form 1040 or line 8 of
Form 1040NR. On the dotted line next to the line for wages, enter “PYAB” and the amount from line 9 above.
Line 2. The maximum amount of employer-provided adoption benefits that can be excluded from income is $13,360 per child. If you and
another person (other than your spouse if filing jointly) each received employer-provided adoption benefits to adopt the same child, the
$13,360 limit must be divided between the two of you. You can divide it in any way you both agree. Enter your share of the $13,360 limit on
line 2 of the worksheet above.

was unsuccessful, treat those expenses in the same manner as
expenses you paid for adoptions not final by the end of the
year. See Domestic adoptions that have not been finalized
under Documentation requirements, earlier.
Example. You paid $3,000 of qualified adoption expenses
in 2010 in an attempt to adopt a U.S. child. You paid $2,000 in
qualified adoption expenses early in 2011. However, the
adoption attempt was unsuccessful. Enter $3,000 on line 5. The
$2,000 paid in 2011 may qualify in 2012.

Line 7
Use the following chart to find your modified adjusted gross
income to enter on line 7.

IF you file. . .

THEN enter on line 7 the amount from. . .

Form 1040

Form 1040, line 38, increased by the total of
any:
• Exclusion of income from Puerto Rico and
• Amounts from –
• Form 2555, lines 45 and 50,
• Form 2555-EZ, line 18, and
• Form 4563, line 15.

Form 1040NR

Form 1040NR, line 37.

Part III—Employer-Provided
Adoption Benefits
Line 13
The maximum amount that can be excluded from income for
employer-provided adoption benefits is $13,360 per child. If you
and another person (other than your spouse if filing jointly) each
received employer-provided adoption benefits in connection

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Form 8839 (2011)

with the adoption of the same eligible child, the $13,360 limit
must be divided between the two of you. You can divide it in
any way you both agree. Cross out the preprinted entry on line
13 and enter above line 13 your share of the $13,360 limit for
that child.

employer has a qualified adoption assistance program, as
defined earlier under Employer-Provided Adoption Benefits.
This requirement applies whether or not you received any
employer-provided adoption benefits under this plan.
If your employer has no qualified adoption assistance
program, you must enter the smaller of line 15 or line 16.

Line 14

Line 19

If you received employer-provided adoption benefits in a prior
year for the same child, enter on line 14 the total of the amounts
shown on lines 14 and 18 (or corresponding lines) of the last
Form 8839 you filed for the child.

Use the worksheet below to figure your modified adjusted gross
income.
Your modified adjusted gross income (MAGI) for the
adoption credit may not be the same as the MAGI
CAUTION figured in the worksheet below. If you are taking the
credit, be sure to read the instructions for line 7 before you
enter an amount on that line.

Special rules apply if the prior year benefits were
received in connection with the adoption of a foreign
CAUTION child and the adoption became final in 2011. See
Exclusion of prior year benefits, earlier.

!

!

Line 18
If the child was a child with special needs and the adoption
became final in 2011, enter the amount from line 15 only if your

Modified Adjusted Gross Income (MAGI) Worksheet—Line 19
Before you begin:

u
u

Keep for Your Records

If you file Form 1040, complete lines 8a through 21, 23 through 32, and 36 if they apply.
If you file Form 1040NR, complete lines 9a through 21, 24 through 32, and 35 if they apply.

1. Enter the amount you would enter on line 7 of Form 1040 or line 8 of Form 1040NR if you could exclude the total
amount on Form 8839, line 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1.

2. Enter the amount from Form 8839, line 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2.

3. Form 1040 filers, enter the total of lines 8a, 9a, 10 through 14, 15b, 16b, 17 through 19, 20b, and 21. Form
1040NR filers, enter the total of lines 9a, 10a, 11 through 15, 16b, 17b, and 18 through 21 . . . . . . . . . . . . . . . .

3.

4. Add lines 1, 2, and 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

4.

5. Form 1040 filers, enter the total of lines 23 through 32, and any write-in adjustments entered on the dotted line
next to line 36. Form 1040NR filers, enter the total of lines 24 through 32 and any write-in adjustments entered on
the dotted line next to line 35. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

5.

6. Subtract line 5 from line 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6.

Form 1040 filers, increase the amount on line 6 above by the total of the following amounts. Enter the total on
Form 8839, line 19.
• Any amount from Form 2555, lines 45 and 50, Form 2555-EZ, line 18, and Form 4563, line 15, and
• Any exclusion of income from Puerto Rico.
Form 1040NR filers, enter on Form 8839, line 19, the amount from line 6 above.

Form 8839 (2011)

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