Form 8839 Qualified Adoption Expenses

Form

8839

Qualified Adoption Expenses

Department of the Treasury
Internal Revenue Service (99)

▶

OMB No. 1545-0074

2019

▶ Attach to Form 1040, 1040-SR, or 1040-NR.
Go to www.irs.gov/Form8839 for instructions and the latest information.

Your social security number

Name(s) shown on return

Part I

Attachment
Sequence No. 38

Information About Your Eligible Child or Children—You must complete this part. See instructions for
details, including what to do if you need more space.
Check if child was—

(a)
Child’s name

1
First

(b)
Child’s year
of birth

(c)
(d)
born before
a child
2002 and with special
disabled
needs

Last

(e)
a
foreign
child

(g)
Check if
adoption
became final in
2019 or earlier

(f)
Child’s
identifying number

Child
1
Child
2
Child
3

Caution: If the child was a foreign child, see Special rules in the instructions for line 1, column (e), before you complete Part II or
Part III. If you received employer-provided adoption benefits, complete Part III on the back next.

Part II

Adoption Credit
Child 1

2
3

Maximum adoption credit per child. Enter $14,080
(see instructions) . . . . . . . . . . . .
Did you file Form 8839 for a prior year for the same
child?
No. Enter -0-.
Yes. See instructions for the amount to
enter.

Child 2

Child 3

2

}

3

.

4

4

Subtract line 3 from line 2

5

Qualified adoption expenses (see instructions) . .
5
Caution: Your qualified adoption expenses may not
be equal to the adoption expenses you paid in 2019.
Enter the smaller of line 4 or line 5 . . . . . .
6
Enter modified adjusted gross income (see instructions) . . . . . . . . .
7
Is line 7 more than $211,160?
No. Skip lines 8 and 9, and enter -0- on line 10.
Yes. Subtract $211,160 from line 7 . . . . . . . . . . . . . .
8
Divide line 8 by $40,000. Enter the result as a decimal (rounded to at least three places).
Do not enter more than 1.000 . . . . . . . . . . . . . . . . . . . . . .
Multiply each amount on line 6 by line 9 . . . . .
10
Subtract line 10 from line 6 . . . . . . . . .
11
Add the amounts on line 11 . . . . . . . . . . . . . . . . . . . . . . .
Credit carryforward, if any, from prior years. See your Adoption Credit Carryforward Worksheet
2018 Form 8839 instructions . . . . . . . . . . . . . . . . . . . . . .
Add lines 12 and 13 . . . . . . . . . . . . . . . . . . . . . . . . .
Enter the amount from line 5 of the Credit Limit Worksheet in the instructions . . . . . .

6
7
8

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10
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12
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14
15
16

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9

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in
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the
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12

Adoption Credit. Enter the smaller of line 14 or line 15 here and on Schedule 3 (Form 1040 or 1040SR), line 6, or Form 1040-NR, line 51. Check box c on that line and enter “8839” in the space next to
box c. If line 15 is smaller than line 14, you may have a credit carryforward (see instructions) . . .

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

Cat. No. 22843L

×

.

13
14
15

16
Form 8839 (2019)

Page 2

Form 8839 (2019)

Part III

Employer-Provided Adoption Benefits
Child 1

17
18

Maximum exclusion per child. Enter $14,080 (see
instructions) . . . . . . . . . . . . . .
Did you receive employer-provided adoption benefits
for a prior year for the same child?
No. Enter -0-.
Yes. See instructions for the amount to enter.

}

18

Subtract line 18 from line 17

.

19

20

Employer-provided adoption benefits you received in
2019. This amount should be shown in box 12 of
your 2019 Form(s) W-2 with code T . . . . . .

20

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21

Add the amounts on line 20 .

22

Enter the smaller of line 19 or line 20. But if the child
was a child with special needs and the adoption
became final in 2019, enter the amount from line 19 .
22
Enter modified adjusted gross income (from the worksheet in
the instructions) . . . . . . . . . . . . . . . .
23
Is line 23 more than $211,160?
No. Skip lines 24 and 25, and enter -0- on line 26.
Yes. Subtract $211,160 from line 23 . . . . . . .
24
Divide line 24 by $40,000. Enter the result as a decimal (rounded to at least three
places). Do not enter more than 1.000 . . . . . . . . . . . . . .

23
24

25

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Multiply each amount on line 22 by line 25 .

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26

27

Excluded benefits. Subtract line 26 from line 22 .

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27

28

Add the amounts on line 27 .

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29

Taxable benefits. Is line 28 more than line 21?
No. Subtract line 28 from line 21. Also, include this amount, if more than zero, on
line 1 of Form 1040 or 1040-SR or line 8 of Form 1040-NR. On the dotted
line next to line 1 of Form 1040 or 1040-SR or line 8 of Form 1040-NR, enter
“AB.”
Yes. Subtract line 21 from line 28. Enter the result as a negative number. Reduce
the total you would enter on line 1 of Form 1040 or 1040-SR or line 8 of
Form 1040-NR by the amount on Form 8839, line 29. Enter the result on line
1 of Form 1040 or 1040-SR or line 8 of Form 1040-NR. Enter “SNE” on the
dotted line next to the entry line.

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×

25

26

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Child 3

17

19

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Child 2

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}

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21

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28

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29

You may be able to claim the adoption credit in Part II on the front of this form if any of the following apply.

TIP

• You paid adoption expenses in 2018, those expenses were not fully reimbursed by your employer or otherwise, and
the adoption was not final by the end of 2018.
• The total adoption expenses you paid in 2019 were not fully reimbursed by your employer or otherwise, and the
adoption became final in 2019 or earlier.
• You adopted a child with special needs and the adoption became final in 2019.
Form 8839 (2019)