OMB No. 1545-1552 Qualified Adoption Expenses Form 8839

© Attach to Form 1040 or 1040A.

Department of the Treasury

Internal Revenue Service

Attachment

© See separate instructions. Sequence No. 38

Name(s) shown on return Your social security number

Information About Your Eligible Child or Children—You must complete this part. See the instructions for

details, including what to do if you need more space.

(b) 

Child’s year

of birth

(c) 

born before

1980 and

was disabled

1

(a) 

Child’s name

Adoption Credit

2

Did you file a 1997 Form 8839?

Enter $5,000 ($6,000 for a child with special

needs) 

3

3

Enter the smaller of line 4 or line 5

4

5

Add the amounts on line 6. If zero, skip lines 8-11, enter -0- on line 12, and go to line 13 7

10 3

Subtract line 11 from line 7

9

For Paperwork Reduction Act Notice, see page 4 of instructions. Form 8839 (1998)

Before you begin, you need to understand the following terms. See Definitions on page 1 of the instructions.

Cat. No. 22843L

Part I

Part II

2

.

(d)

a child

with special

needs

(f)

Child’s

identifying number

First Last

19

If line 8 is $75,000 or less, skip lines 9 and 10 and enter -0- on

line 11. If line 8 is over $75,000, subtract $75,000 from the amount

on line 8

6

9

7

Divide line 9 by $40,000. Enter the result as a decimal (rounded to at least three places). Do

not enter more than “1.000”

Multiply line 7 by line 10

8

4

Check if child was—

(e)

a

foreign

child

● Eligible Child ● Employer-Provided Adoption Benefits ● Qualified Adoption Expenses

19

Child

1

Child

2

Caution: If you received employer-provided adoption benefits, complete Part III on the back next.

10

Child 1 Child 2

Enter your modified adjusted gross income (see instructions) 8

11

Caution: If the eligible child is a foreign child, you

can take the credit only if the adoption was final in or

before 1998.

Subtract line 3 from line 2

Enter the total qualified adoption

expenses you paid in:

5

6

12

13 Enter any credit carryforward from 1997 (line 11 of your 1997 Form 8839)

Add lines 12 and 13. Then, see the instructions for the amount of credit to enter on Form 1040,

line 45, or Form 1040A, line 30

1997 credit carryforward to 1999 (see instructions)

1998 credit carryforward to 1999 (see instructions)

14

15

16

Note: If the credit you enter on Form 1040, line 45, or Form 1040A, line 30, is equal to the

total of lines 12 and 13, stop; you do not have any credit to carry forward to 1999.

15

14

13

16

11

12

1998

No. Enter -0-.

Yes. See the instructions for the amount

to enter.

● 1997 if the adoption was not final by the

end of 1998.

● 1997 and 1998 if the adoption was final

in 1998.

● 1998 if the adoption was final before

1998.

%

%
Form 8839 (1998) Page 2

Employer-Provided Adoption Benefits

Add the amounts on line 20

24

20

Enter your modified adjusted gross

income (from the worksheet in the

instructions)

If line 24 is $75,000 or less, skip

lines 25-27 and enter the amount

from line 23 on line 28. If line 24 is

over $75,000, subtract $75,000

from the amount on line 24

Excluded benefits. Enter the smaller of line 23 or line 28 29

30

Part III

27

Enter the total amount of your

employer-provided adoption benefits

received in 1998. This amount should be

shown in box 13 of your 1998 W-2 form(s)

with code T 

18 Did you receive employer-provided

adoption benefits for 1997?

Divide line 25 by $40,000. Enter the result as a decimal (rounded

to at least three places). Do not enter more than “1.000”

25

Multiply line 23 by line 26

26

Subtract line 27 from line 23

Taxable benefits. Subtract line 29 from line 21. Also, include this amount on Form 1040,

line 7, or Form 1040A, line 7. On the line next to line 7, enter “AB”

29

28

27

26 3 .

21

22 Enter the smaller of line 19 or line 20

24

28

30

25

If the total adoption expenses you paid in 1998 were not fully reimbursed by your employer AND the adoption was final in

or before 1998, you may be able to claim the adoption credit in Part II on the front of this form.

Caution: If the eligible child is a foreign child, see

Special Rules in the instructions for line 1, column

(e), before completing this part.

21

22

20

18

Child 1 Child 2

23

Add the amounts on line 22. If zero, skip lines 24-28, enter -0- on

line 29, and go to line 30

23

No. Enter -0-.

Yes. See the instructions for

the amount to enter.

Subtract line 18 from line 17. If zero or

less, enter -0-

19

19

%

17 Enter $5,000 ($6,000 for a child with

special needs) 17