2441 Child and Dependent Care Expenses

Form

2441

Child and Dependent Care Expenses
▶

Department of the Treasury
Internal Revenue Service (99)

▶

1040
1040-SR
.........

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

OMB No. 1545-0074

◀

2021

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

A You can’t 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 .
B For 2021, your credit for child and dependent care expenses is refundable if you, or your spouse if married filing jointly, had a
principal place of abode in the United States for more than half of 2021. 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 three care providers, see the instructions and check this box . . . . . . . .

(a) Care provider’s
name

(d) Check here if the
(c) Identifying number care provider is your (e) Amount paid
(SSN or EIN)
household employee. (see instructions)
(see instructions)

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

No
Yes

Did you receive
dependent care benefits?

▶
▶

Complete only Part II below.
Complete Part III on page 2 next.

Caution: If the care was provided in your home, you may owe employment taxes. For details, see the instructions for Schedule H
(Form 1040). If you incurred care expenses in 2021 but didn’t pay them until 2022, or if you prepaid in 2021 for care to be provided
in 2022, don’t include these expenses in column (c) of line 2 for 2021. See the instructions.

Part II
2

Credit for Child and Dependent Care Expenses

Information about your qualifying person(s). If you have more than three qualifying persons, see the instructions and check
this box . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(a) Qualifying person’s name
First

Last

(b) Qualifying person’s social
security number

Add the amounts in column (c) of line 2. Don’t enter more than $8,000 if you had one qualifying
person or $16,000 if you had two or more persons. If you completed Part III, enter the amount
from line 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4
Enter your earned income. See instructions . . . . . . . . . . . . . . . . .
5
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
Enter the smallest of line 3, 4, or 5 . . . . . . . . . . . . . . . . . . . .
7
Enter the amount from Form 1040, 1040-SR, or 1040-NR, line 11 .
7
8
Enter on line 8 the decimal amount shown below that applies to the amount on line 7.
• If line 7 is $125,000 or less, enter .50 on line 8.
• If line 7 is over $125,000 and no more than $438,000, see the instructions for line 8 for the
amount to enter.
• If line 7 is over $438,000, don’t complete line 8. Enter zero on line 9a. You may be able to
claim a credit on line 9b.
9a Multiply line 6 by the decimal amount on line 8 . . . . . . . . . . . . . . . .
b If you paid 2020 expenses in 2021, complete Worksheet A in the instructions. Enter the amount
from line 13 of the worksheet here. Otherwise, go to line 10 . . . . . . . . . . . .
10
Add lines 9a and 9b and enter the result. If you checked the box on line B above, this is your
refundable credit for child and dependent care expenses; enter the amount from this line on
Schedule 3 (Form 1040), line 13g, and don’t complete line 11. If you didn’t check the box on line
B above, go to line 11 . . . . . . . . . . . . . . . . . . . . . . . . .
11
Nonrefundable credit for child and dependent care expenses. If you didn’t check the box on
line B above, your credit is nonrefundable and limited by the amount of your tax; see the
instructions to figure the portion of line 10 that you can claim and enter that amount here and on
Schedule 3 (Form 1040), line 2 . . . . . . . . . . . . . . . . . . . . . .

(c) Qualified expenses you
incurred and paid in 2021 for the
person listed in column (a)

3

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

Cat. No. 11862M

3
4
5
6

8
9a

X.

9b

10

11
Form 2441 (2021)

Page 2

Form 2441 (2021)

Part III
12

13
14
15
16
17
18
19

20
21

22

23
24
25
26

Dependent Care Benefits

Enter the total amount of dependent care benefits you received in 2021. 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 . . . . . . . . . . . . . . . . . . . . . . . . . . .
Enter the amount, if any, you carried over from 2020 and used in 2021. See instructions . . .
If you forfeited or carried over to 2022 any of the amounts reported on line 12 or 13, enter the
amount. See instructions . . . . . . . . . . . . . . . . . . . . . . . .
Combine lines 12 through 14. See instructions . . . . . . . . . . . . . . . .
Enter the total amount of qualified expenses incurred in 2021 for
the care of the qualifying person(s) . . . . . . . . . . . 16
Enter the smaller of line 15 or 16 . . . . . . . . . . . . 17
Enter your earned income. See instructions . . . . . . . . 18
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
. . . . . . 19
for line 5).

12
13
14 (
15

)

}

• If married filing separately, see instructions.
• All others, enter the amount from line 18.
Enter the smallest of line 17, 18, or 19 . . . . . . . . . .
Enter $10,500 ($5,250 if married filing separately and you were
required to enter your spouse’s earned income on line 19). If you
entered an amount on line 13, add it to the $10,500 or $5,250
amount you enter on line 21. However, don’t enter more than the
maximum amount allowed under your dependent care plan. See
instructions . . . . . . . . . . . . . . . . . . .

20

21

Is any amount on line 12 or 13 from your sole proprietorship or partnership?
No. Enter -0-.
Yes. Enter the amount here . . . . . . . . . . . . . . . . . . . . . .
Subtract line 22 from line 15
. . . . . . . . . . . . . 23
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 . . . . . . . . . . . . . . .
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- . . . . . .
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 1a. On the dotted line next to
Form 1040 or 1040-SR, line 1; or Form 1040-NR, line 1a, enter “DCB” . . . . . . . . .

22

24
25

26

To claim the child and dependent care credit,
complete lines 27 through 31 below.
27
28
29
30
31

Enter $8,000 ($16,000 if two or more qualifying persons) . . . . . . . . . . . . .
Add lines 24 and 25 . . . . . . . . . . . . . . . . . . . . . . . . .
Subtract line 28 from line 27. If zero or less, stop. You can’t take the credit. Exception. If you
paid 2020 expenses in 2021, see the instructions for line 9b . . . . . . . . . . . .
Complete line 2 on page 1 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 . . . . . . . .
Enter the smaller of line 29 or 30. Also, enter this amount on line 3 on page 1 of this form and
complete lines 4 through 11 . . . . . . . . . . . . . . . . . . . . . . .

27
28
29
30
31
Form 2441 (2021)