Form Ar8839 - Qualified Adoption Expenses -2002
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1
2ARKANSAS INDIVIDUAL INCOME TAX RETURN
AR8839
2002
Qualified Adoption Expenses
Name as Shown on Return
Social Security Number
Part I
Information About Your Eligible Child or Children - You must complete this part. Attach a schedule
if you need additional space.
1
Check if child was -
(a)
(b)
(c)
(d)
(e)
(f)
Child’s Name
Child’s Year of
born before
a child
a
Child’s identifying
1983 and
Birth
with special
foreign
number
was disabled
needs
child
First
Last
Child
1
Child
2
Part II
Adoption Credit
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Child 1
Child 2
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1 2 3 4 5 6 7 8 9 0 1 2 3 4 5
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5
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00
00
2
Enter $5,000 ($6,000 for a child with special needs) ............................................. 2
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1 2 3 4 5 6 7 8 9 0 1 2 3 4 5
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3
Did you file Federal Form 8839 for a prior year?
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No. Enter -0-.
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1 2 3 4 5 6 7 8 9 0 1 2 3 4 5
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5
00
00
Yes. See Instructions ................................................................................. 3
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1 2 3 4 5 6 7 8 9 0 1 2 3 4 5
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00
00
4
Subtract line 3 from 2 ............................................................................................ 4
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5
Enter the total qualified adoption expenses you paid in:
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5
• 2001 if the adoption was not final by the end of 2002.
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5
• 2001 and 2002 if the adoption was final in 2002.
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5
00
00
• 2002 if the adoption was final before 2002. ....................................................... 5
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5
00
00
6
Enter the smaller of line 4 or line 5 ........................................................................ 6
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00
7
Add the amounts on line 6. If zero, skip lines 8 - 11 and enter -0- on line 12 ................................................................................ 7
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1 2 3 4 5 6 7 8 9 0 1 2 3 4 5
00
8
Enter your federal modified adjusted gross income .................................................................................. 8
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9
Is line 8 more than $75,000?
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1 2 3 4 5 6 7 8 9 0 1 2 3 4 5
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No. Skip lines 9 and 10 and enter -0- on line 11.
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1 2 3 4 5 6 7 8 9 0 1 2 3 4 5
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5
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00
Yes. Subtract $75,000 from line 8. ................................................................................................ 9
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10
Divide line 9 by $40,000. Enter the result as a decimal (rounded to at least three places.)
00
Do not enter more than “1.000”. .................................................................................................................................................. 10
00
11.
Multipy line 7 by line 10. .............................................................................................................................................................. 11
00
12. Subtract line 11 from line 7. ......................................................................................................................................................... 12
00
13. Carryforward of adoption credit from prior years (see instructions). ............................................................................................ 13
14.
Add lines 12 and 13. Then, see instructions for the amount of credit allowable and
00
enter amount here. ...................................................................................................................................................................... 14
00
15. Arkansas credit: Multiple amount in line 14 by 20% (.20). ........................................................................................................... 15
AR8839 (R 11/02)
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