Form 2441 Child and Dependent Care Expenses

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Form

2441

Child and Dependent Care Expenses
▶

Department of the Treasury
Internal Revenue Service (99)

▶

OMB No. 1545-0074

1040

1040-SR

..........

◀

2019

1040-NR

Attach to Form 1040, 1040-SR, or 1040-NR.

2441

Go to www.irs.gov/Form2441 for instructions and the
latest information.

Attachment
Sequence No. 21
Your social security number

Name(s) shown on return

DRAFT AS OF
September 6, 2019
DO NOT FILE
You cannot claim a credit for child and dependent care expenses if your filing status is married filing separately unless you meet the
requirements listed in the instructions under “Married Persons Filing Separately.” If you meet these requirements, check this box.

Part I
1

Persons or Organizations Who Provided the Care—You must complete this part.
(If you have more than two care providers, see the instructions.)

(a) Care provider’s
name

(b) Address
(number, street, apt. no., city, state, and ZIP code)

(c) Identifying number
(SSN or EIN)

(d) Amount paid
(see instructions)

Did you receive
▶ Complete only Part II below.
No
dependent care benefits?
▶ Complete Part III on the back next.
Yes
Caution: If the care was provided in your home, you may owe employment taxes. For details, see the instructions for Schedule 2
(Form 1040 or 1040-SR), line 7a; or Form 1040-NR, line 59a.

Part II
2

Credit for Child and Dependent Care Expenses

Information about your qualifying person(s). If you have more than two qualifying persons, see the instructions.
First

(c) Qualified expenses you
incurred and paid in 2019 for the
person listed in column (a)

(b) Qualifying person’s social
security number

(a) Qualifying person’s name

Last

3

Add the amounts in column (c) of line 2. Don’t enter more than $3,000 for one qualifying person
or $6,000 for two or more persons. If you completed Part III, enter the amount from line 31 . .

4
5

Enter your earned income. See instructions . . . . . . . . . . . . . . . . .
If married filing jointly, enter your spouse’s earned income (if you or your spouse was a student
or was disabled, see the instructions); all others, enter the amount from line 4 . . . . . .

6
7

Enter the smallest of line 3, 4, or 5 . . . . . . . . . . .
Enter the amount from Form 1040 or 1040-SR, line 8b; or Form
1040-NR, line 35 . . . . . . . . . . . . . . . .

8

9
10
11

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3
4
5
6

7
Enter on line 8 the decimal amount shown below that applies to the amount on line 7
If line 7 is:

If line 7 is:
But not
over
Over

Decimal
amount is

$0—15,000
15,000—17,000
17,000—19,000
19,000—21,000
21,000—23,000
23,000—25,000
25,000—27,000
27,000—29,000

.35
.34
.33
.32
.31
.30
.29
.28

Over

But not
over

$29,000—31,000
31,000—33,000
33,000—35,000
35,000—37,000
37,000—39,000
39,000—41,000
41,000—43,000
43,000—No limit

Decimal
amount is
.27
.26
.25
.24
.23
.22
.21
.20

8

Multiply line 6 by the decimal amount on line 8. If you paid 2018 expenses in 2019, see the
instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Tax liability limit. Enter the amount from the Credit Limit Worksheet
in the instructions . . . . . . . . . . . . . . . .
10
Credit for child and dependent care expenses. Enter the smaller of line 9 or line 10 here and
on Schedule 3 (Form 1040 or 1040-SR), line 2; or Form 1040-NR, line 47 . . . . . . . .

For Paperwork Reduction Act Notice, see your tax return instructions.

Cat. No. 11862M

X.

9

11
Form 2441 (2019)

Page 2

Form 2441 (2019)

Part III

Dependent Care Benefits

12 Enter the total amount of dependent care benefits you received in 2019. Amounts you received as
an employee should be shown in box 10 of your Form(s) W-2. Don’t include amounts reported as
wages in box 1 of Form(s) W-2. If you were self-employed or a partner, include amounts you
received under a dependent care assistance program from your sole proprietorship or partnership .
13 Enter the amount, if any, you carried over from 2018 and used in 2019 during the grace period.
See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . .

12

DRAFT AS OF
September 6, 2019
}
DO NOT FILE
14 Enter the amount, if any, you forfeited or carried forward to 2020. See instructions
15 Combine lines 12 through 14. See instructions . . . . . . . . . . . .
16 Enter the total amount of qualified expenses incurred in 2019 for the
care of the qualifying person(s) . . . . . . . . . . . . . 16

17 Enter the smaller of line 15 or 16 . . . . . . .
18 Enter your earned income. See instructions . . .
19 Enter the amount shown below that applies to you.
• If married filing jointly, enter your spouse’s
earned income (if you or your spouse was
a student or was disabled, see the
. .
instructions for line 5).

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17
18

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19

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13
14 (
15

)

• If married filing separately, see
instructions.

• All others, enter the amount from line 18.
20 Enter the smallest of line 17, 18, or 19 . . . . . . . . . . .
21 Enter $5,000 ($2,500 if married filing separately and you were required
to enter your spouse’s earned income on line 19) . . . . . . .

20

21
22 Is any amount on line 12 from your sole proprietorship or partnership?
No. Enter -0-.
Yes. Enter the amount here . . . . . . . . . . . . . . . . . . . . . .
23 Subtract line 22 from line 15 . . . . . . . . . . . . . . 23
24 Deductible benefits. Enter the smallest of line 20, 21, or 22. Also, include this amount on the
appropriate line(s) of your return. See instructions . . . . . . . . . . . . . . . .
25 Excluded benefits. If you checked “No” on line 22, enter the smaller of line 20 or 21. Otherwise,
subtract line 24 from the smaller of line 20 or line 21. If zero or less, enter -0- . . . . . . .

25

26 Taxable benefits. Subtract line 25 from line 23. If zero or less, enter -0-. Also, include this amount
on Form 1040 or 1040-SR, line 1; or Form 1040-NR, line 8. On the dotted line next to Form 1040
or 1040-SR, line 1; or Form 1040-NR, line 8, enter “DCB” . . . . . . . . . . . . . .

26

22

24

To claim the child and dependent care
credit, complete lines 27 through 31 below.
27 Enter $3,000 ($6,000 if two or more qualifying persons) . . . . . . . . . . . . . .
28 Add lines 24 and 25 . . . . . . . . . . . . . . . . . . . . . . . . . .
29 Subtract line 28 from line 27. If zero or less, stop. You can’t take the credit. Exception. If you paid
2018 expenses in 2019, see the instructions for line 9 . . . . . . . . . . . . . . .
30 Complete line 2 on the front of this form. Don’t include in column (c) any benefits shown on line
28 above. Then, add the amounts in column (c) and enter the total here . . . . . . . . .
31 Enter the smaller of line 29 or 30. Also, enter this amount on line 3 on the front of this form and
complete lines 4 through 11 . . . . . . . . . . . . . . . . . . . . . . .

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28
29
30
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Form 2441 (2019)