8839 Qualified Adoption Expenses

Version A, Cycle 4

Form

8839

Qualified Adoption Expenses

2022

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

Department of the Treasury
Internal Revenue Service

Attachment
Sequence No. 38
Your social security number

Name(s) shown on return

Part I

OMB No. 1545-0074

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—

1

(a)
Child’s name
First

(b)
Child’s year
of birth
Last

(c)
(d)
born before
a child
2005 and with special
disabled
needs

(e)
a foreign
child

(g)
Check if
adoption
became final in
2022 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
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Adoption Credit

Child 1
Child 2
Child 3
Maximum adoption credit per child. Enter $14,890
(see instructions) . . . . . . . . . . . .
2
Did you file Form 8839 for a prior year for the same
No. Enter -0-.
child?
Yes. See instructions for the amount to
enter.
3
Subtract line 3 from line 2 . . . . . . . . .
4
Qualified adoption expenses (see instructions) . .
5
Caution: Your qualified adoption expenses may not
be equal to the adoption expenses you paid in 2022.
Enter the smaller of line 4 or line 5 . . . . . .
6
Enter modified adjusted gross income (see instructions) . . . . . . . . .
7
Is line 7 more than $223,410?
No. Skip lines 8 and 9, and enter -0- on line 10.
Yes. Subtract $223,410 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 in the
2021 Form 8839 instructions . . . . . . . . . . . . . . . . . . . . . . . .
Add lines 12 and 13 . . . . . . . . . . . . . . . . . . . . . . . . . . .
Enter the amount from line 5 of the Credit Limit Worksheet in the instructions . . . . . . . .
Adoption Credit. Enter the smaller of line 14 or line 15 here and on Schedule 3 (Form 1040), line 6c. If
line 15 is smaller than line 14, you may have a credit carryforward (see instructions) . . . . . .

INTERNAL
} USE ONLY
DRAFT AS OF
July 12, 2022

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

Cat. No. 22843L

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×

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Form 8839 (2022)

Version A, Cycle 4
Page 2

Form 8839 (2022)

Part III
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Employer-Provided Adoption Benefits

Child 1
Child 2
Maximum exclusion per child. Enter $14,890 (see
instructions) . . . . . . . . . . . . . .
17
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
Employer-provided adoption benefits you received in
2022. This amount should be shown in box 12 of your
2022 Form(s) W-2 with code T . . . . . . . .
20
Add the amounts on line 20 . . . . . . . . . . . . . . . . . . . . .
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 2022, enter the amount from line 19 .
22
Enter modified adjusted gross income (from the worksheet in
the instructions) . . . . . . . . . . . . . . . .
23
Is line 23 more than $223,410?
No. Skip lines 24 and 25, and enter -0- on line 26.
Yes. Subtract $223,410 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 . . . . . . . . . . . . . .
25
Multiply each amount on line 22 by line 25 . . . .
26
Excluded benefits. Subtract line 26 from line 22 . .
27
Add the amounts on line 27 . . . . . . . . . . . . . . . . . . . . .
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 1f of Form 1040, 1040-SR, or 1040-NR.
. . .
Yes. Subtract line 21 from line 28. Enter the result as a negative number.
Also, enter the result on line 1f of Form 1040, 1040-SR, or 1040-NR.

Child 3

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INTERNAL USE ONLY
DRAFT AS} OF
July 12, 2022
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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 2021, those expenses were not fully reimbursed by your employer or otherwise, and
the adoption was not final by the end of 2021.
• The total adoption expenses you paid in 2022 were not fully reimbursed by your employer or otherwise, and the
adoption became final in 2022 or earlier.
• You adopted a child with special needs and the adoption became final in 2022.
Form 8839 (2022)