Fillable Form 8839 2019 Qualified Adoption Expenses

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Form 8839 2019 Qualified Adoption Expenses

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The Form 8839 2019 Qualified Adoption Expenses form is 2 pages long and contains:

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Form 8839
Department of the Treasury
Internal Revenue Service (99)
Qualified Adoption Expenses
▶
Attach to Form 1040, 1040-SR, or 1040-NR.
▶
Go to www.irs.gov/Form8839 for instructions and the latest information.
OMB No. 1545-0074
2019
Attachment
Sequence No.
38
Name(s) shown on return Your social security number
Part I 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.
1
(a)
Child’s name
(b)
Child’s year
of birth
Check if child was—
(c)
born before
2002 and
disabled
(d)
a child
with special
needs
(e)
a
foreign
child
(f)
Child’s
identifying number
(g)
Check if
adoption
became final in
2019 or earlier
First Last
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 Child 2 Child 3
2
Maximum adoption credit per child. Enter $14,080
(see instructions) . . . . . . . . . . . .
2
3
Did you file Form 8839 for a prior year for the same
child?
No. Enter -0-.
Yes. See instructions for the amount to
enter.
}
3
4 Subtract line 3 from line 2 . . . . . . . . . 4
5 Qualified adoption expenses (see instructions) . .
Caution: Your qualified adoption expenses may not
be equal to the adoption expenses you paid in 2019.
5
6 Enter the smaller of line 4 or line 5 . . . . . . 6
7
Enter modified adjusted gross income (see instructions) . . . . . . . . .
7
8 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
9
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 . . . . . . . . . . . . . . . . . . . . . . . .
9
×
.
10 Multiply each amount on line 6 by line 9 . . . . . 10
11 Subtract line 10 from line 6 . . . . . . . . . 11
12 Add the amounts on line 11 . . . . . . . . . . . . . . . . . . . . . . . . . 12
13 Credit carryforward, if any, from prior years. See your Adoption Credit Carryforward Worksheet in the
2018 Form 8839 instructions . . . . . . . . . . . . . . . . . . . . . . . . 13
14 Add lines 12 and 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
15 Enter the amount from line 5 of the Credit Limit Worksheet in the instructions . . . . . . . . 15
16 Adoption Credit. Enter the smaller of line 14 or line 15 here and on Schedule 3 (Form 1040 or 1040-
SR), 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) . . .
16
For Paperwork Reduction Act Notice, see your tax return instructions.
Cat. No. 22843L
Form 8839 (2019)
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.
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Form 8839 (2019)
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Form 8839 2019 Qualified Adoption Expenses

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Completed 14 May 2020

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