Form 8839 (2019)
Page 2
Part III Employer-Provided Adoption Benefits
Child 1 Child 2 Child 3
17 Maximum exclusion per child. Enter $14,080 (see
instructions) . . . . . . . . . . . . . .
17
18 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
19 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
21 Add the amounts on line 20 . . . . . . . . . . . . . . . . . . . . . . . . . 21
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
23 Enter modified adjusted gross income (from the worksheet in
the instructions) . . . . . . . . . . . . . . . .
23
24 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
25
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
×
.
26 Multiply each amount on line 22 by line 25 . . . . 26
27 Excluded benefits. Subtract line 26 from line 22 . . 27
28 Add the amounts on line 27 . . . . . . . . . . . . . . . . . . . . . . . . . 28
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.
}
. . . . 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.
• 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.
TIP
Form 8839 (2019)
