Form W-7 A Application for Taxpayer Identification Number for Pendi

U.S. Individual Income Tax Return

F W-7 A

U.S. Individual Income Tax Return

OMB: 1545-0074

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W-7A

Application for Taxpayer Identification Number
for Pending U.S. Adoptions

Form
(Rev. October 2011)

Department of the Treasury
Internal Revenue Service

▶

OMB No. 1545-0074

See instructions.

Note. Do not file this form if you are eligible to obtain a U.S. social security number (SSN) for your adoptive child.

1

Adoptive
parent(s)
information

1a Parent’s last name

First name

Social security number

1b Parent’s last name

First name

Social security number

(see instructions)

2

Adoptive
parent(s)
address

Street address, apartment number, or rural route number. If you have a P.O. box, see the instructions.
City or town, state, and ZIP code

(see instructions)

3
4
5

Child’s name:

3a Last name

As it will appear
▶
on your tax return
3b Last name
Birth name if different
▶
and known . .
Date of birth (month, day, year)
Child’s birth

information
Placement
agency
information

Sign
Here

Middle name

First name

Middle name

Place of birth (city or town, and state) (If foreign address, see instructions)

Male
Name

Address

Date child
was placed
with adoptive
parents

Note. Be sure to attach the required documentation to Form W-7A. See instructions.
Under penalties of perjury, I declare that I have examined this application, including accompanying documentation and statements, and to
the best of my knowledge and belief, it is true, correct, and complete.

▲

Keep a copy of this
form for your
records.

Female

First name

Signature of parent

Date (month, day, year)

Daytime phone number

Signature of parent

Date (month, day, year)

Daytime phone number

▲

General Instructions
Future developments. The IRS has created a page on IRS.gov for
information about Form W-7A, at www.irs.gov/w7a. Information
about any future developments affecting Form W-7A (such as
legislation enacted after we release it) will be posted on that page.

However, you cannot use an ATIN to claim the earned income
credit (EIC). When the adoption is final and the child has an SSN,
you can file an amended return for an earlier year if you could have
claimed the EIC in the earlier year except for the fact that the child
did not have an SSN. Use Form 1040X, Amended U.S. Individual
Income Tax Return, and Schedule EIC, Earned Income Credit.

Purpose of Form

How Long Can You Use an ATIN

Use Form W-7A to apply for an Internal Revenue Service (IRS)
adoption taxpayer identification number (ATIN) for a child who is
placed in your home for purposes of legal adoption. However, do
not use Form W-7A if you will be able to obtain a social security
number (SSN) for the child in time to file your tax return. Also, do
not use Form W-7A if the child is not a U.S. citizen or resident alien.
Use Form W-7 instead.

An ATIN issued to you for your adoptive child will expire 2 years
from the date it is issued. You will receive a notice from the IRS 3
months before the expiration date to remind you that the ATIN will
expire. The notice will explain how you can apply for an extension if
the adoption will not be final by the expiration date.
After the adoption is final, do not continue using the ATIN.
Instead, you must use an SSN. To apply for an SSN for the child, fill
in Form SS-5, Application for a Social Security Card, and return it,
with the appropriate evidence documents, to the Social Security
Administration (SSA). You can get Form SS-5 online at
www.socialsecurity.gov, from your local SSA office, or by calling the
SSA at 1-800-772-1213. It usually takes about 2 weeks to get an
SSN once the SSA has all the evidence and information it needs.
Application for SSN denied. If the SSA denies your application for
an SSN, contact the IRS to request an extension or reactivation of
the ATIN. When you request the extension or reactivation of the
ATIN, include the SSA’s denial letter or an explanation with your
correspondence.

What Is an ATIN
An ATIN is a temporary nine-digit number issued by the IRS to
individuals who are in the process of legally adopting a U.S. citizen
or resident alien child but who cannot get an SSN for that child in
time to file their tax return.
You may be able to use an ATIN on your tax return to take the
following tax benefits based on the child.
• Dependency exemption. See Pub. 501, Exemptions, Standard
Deduction, and Filing Information.
• Credit for child and dependent care expenses. See Pub. 503,
Child and Dependent Care Expenses.
• Adoption credit. See the Instructions for Form 8839, Qualified
Adoption Expenses.
• Child tax credit. See Pub. 972, Child Tax Credit.
For Privacy Act and Paperwork Reduction Act Notice, see back of form.

Cat. No. 24309E

Form W-7A (Rev. 10-2011)

Form W-7A (Rev. 10-2011)

Who Must File
File Form W-7A if all of the following apply.
• You have a child living with you who was placed in your home for
legal adoption by an authorized placement agency.
• You cannot obtain the child’s existing SSN even though you have
made a reasonable attempt to obtain it from the birth parents, the
placement agency, and other persons.
• You cannot obtain an SSN for the child from the SSA because,
for example, the adoption is not final.
• You are eligible to claim the child as a dependent on your tax
return.

!
▲
CAUTION

Do not file Form W-7A if the child is not a U.S. citizen
or resident alien. Instead, apply for an ITIN using Form
W-7, Application for IRS Individual Taxpayer
Identification Number.

How To File
You must complete Form W-7A at least 4 to 8 weeks before you
will need an ATIN. Sign and date the application and mail it to the
address under Where To File, below. Be sure to include the
required attachments (see What To Include With Form W-7A, next).

What To Include With Form W-7A
You must attach signed and dated documentation to Form W-7A to
prove that the child was placed with you for legal adoption (not for
foster care) by an authorized placement agency.
In general, one of the following documents will satisfy this
requirement.
• A copy of the placement agreement entered into between you
and an authorized placement agency.
• A copy of the document signed by a hospital official authorizing
the release of a newborn child from the hospital to you for legal
adoption.
• A copy of the court order or other court document ordering or
approving the placement of a child with you for legal adoption.
• An affidavit signed by the adoption attorney or government
official who placed the child with you for legal adoption pursuant to
state law.
Foreign adoptions. In addition, if you adopt a foreign child with
U.S. citizenship or resident alien status, include with your Form
W-7A a copy of your child’s:
• Permanent resident card (green card),
• Certificate of Citizenship, or
• Passport with “I-551” stamp.
If the adoption of the foreign child is final, but you are unable to get
an SSN for your child, see Application for SSN denied.

Where To File
Department of the Treasury
Internal Revenue Service
Austin, TX 73301-0066

When To Expect the ATIN
It usually takes 4-8 weeks to get an ATIN. You can check on the
status of your application if it has been at least 8 weeks from the
date you filed the application by calling 512-460-7898. This is not a
toll-free number. Be sure to have a copy of your Form W-7A
available when you call.

Specific Instructions
Complete all lines on the form. Enter N/A (not applicable) on the
lines that do not apply.
Line 1. Enter your name and SSN on line 1a. If you and another
person are adopting the child, enter the other person’s name and
SSN on line 1b. If you are married filing jointly, be sure to enter the
names and SSNs in the order shown on your tax return.

Page 2

Name change. If you changed your name after you filed your
last tax return because of marriage, divorce, or some other reason,
be sure to report this to your local Social Security Administration
office before filing your Form W-7A. This will prevent delays in
processing your ATIN request.
Line 2. Enter the address where you and the child live.
Enter your post office box number only if your post office does
not deliver mail to your home.
Address change. If you changed your mailing address after you
filed your last tax return, you should use Form 8822, Change of
Address, to notify the IRS of the change. A new address shown on
Form W-7A will not update your record. You can get Form 8822
online at IRS.gov or by calling 1-800-TAX-FORM (1-800-829-3676).
Line 3a. Enter the child’s adoptive name as it will appear on your
tax return.
Line 3b. If you know the child’s birth name, enter it on line 3b.
Line 4. Enter the child’s date of birth and sex. If you know the
child’s place of birth, enter the information on line 4.
Foreign address. Enter the information in the following order:
City, province or state, and country. Do not abbreviate the country
name.
Line 5. Enter the name and address of the authorized placement
agency that placed the child with you for legal adoption. An
authorized placement agency may include a private adoption
agency, a government agency, an adoption attorney, or any other
person authorized by state law to place a child for legal adoption.
Also, enter the date the child was placed with you.
Signature. Form W-7A must be signed and dated by the adoptive
parent(s) applying for the ATIN. If you and another person are
adopting this child, that person must also sign and date the
application.
Privacy Act and Paperwork Reduction Act Notice. We ask for
the information on this form to carry out the Internal Revenue laws
of the United States. The Internal Revenue Code sections 23, 137,
6011, and 6109 require that you furnish an identifying number on
your tax return if you are claiming certain tax benefits during the
process of adopting a U.S. citizen or resident alien child and
cannot get an SSN for that child until the adoption is final. Form
W-7A must be used to apply for the identification number, an ATIN.
Section 6109 requires that you disclose your taxpayer identification
number (SSN). Routine uses of this information include giving it to
the Department of Justice for civil and criminal litigation and to
cities, states, the District of Columbia, and U.S. commonwealths
and possessions for use in administering their tax laws. We may
also disclose this information to other countries under a tax treaty,
to federal and state agencies to enforce federal nontax criminal
laws, or to federal law enforcement and intelligence agencies to
combat terrorism. If you do not file the form, you will not be issued
an ATIN.
You are required to give us the information. We need it to ensure
that you are complying with these laws and to allow us to figure and
collect the right amount of tax.
You are not required to provide the information requested on a
form that is subject to the Paperwork Reduction Act unless the form
displays a valid OMB control number. Books or records relating to a
form or its instructions must be retained as long as their contents
may become material in the administration of any Internal Revenue
law. Generally, tax returns and return information are confidential,
as required by Internal Revenue Code section 6103.
The average time and expenses required to complete and file this
form will vary depending on individual circumstances. For the
estimated averages, see the instructions for your income tax return.
If you have suggestions for making this form simpler, we would
be happy to hear from you. See the instructions for your income tax
return.


File Typeapplication/pdf
File TitleForm W-7A (Rev. October 2011)
SubjectFillable
AuthorSE:W:CAR:MP
File Modified2011-11-04
File Created2009-01-13

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