Form 8839 2021

Qualified Adoption Expenses

Department of the Treasury 

Internal Revenue Service (99)

▶ 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

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

2004 and

disabled

(d) 

a child 

with special 

needs

(e) 

a 

foreign 

child

(f) 

Child’s 

identifying number

(g) 

Check if 

adoption 

became final in 

 First 2021 or earlier 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 $14,440 

(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) . . 5 

Caution: Your qualified adoption expenses may not 

be equal to the adoption expenses you paid in 2021.

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 $216,660?

No. Skip lines 8 and 9, and enter -0- on line 10.

Yes. Subtract $216,660 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

2020 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), line 6c. 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 (2021) 
Form 8839 (2021) Page 2 

Part III Employer-Provided Adoption Benefits

Child 1 Child 2 Child 3

17 Maximum exclusion per child. Enter $14,440 (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 

2021. This amount should be shown in box 12 of your 

2021 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 2021, 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 $216,660?

No. Skip lines 24 and 25, and enter -0- on line 26.

Yes. Subtract $216,660 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 1a of Form 1040-NR. On the dotted

line next to line 1 of Form 1040 or 1040-SR or line 1a 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 1a 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 1a 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 2020, those expenses were not fully reimbursed by your employer or otherwise, and 

the adoption was not final by the end of 2020. 

• The total adoption expenses you paid in 2021 were not fully reimbursed by your employer or otherwise, and the 

adoption became final in 2021 or earlier. 

• You adopted a child with special needs and the adoption became final in 2021.

TIP

Form 8839 (2021)