Scgedule Wv/nfa-1 - Nonfamily Adoption Credit Schedule

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*P33200601W*
Sch. WV/NFA-1
Rev. 09/06
NONFAMILY ADOPTION
CREDIT SCHEDULE
Section 1: Complete information below and attach to the current year IT-140 tax return:
Name
Last Name
Your Social Security Number
If Joint Return, Spouse's First Name
Spouse's Social Security Number
Present Home Address (number and street, including apartment number or rural route)
Your Telephone Number
City Or Town
State
Zip Code
Section 2: In order to claim the credit, the following information must be provided to the West Virginia Tax Commission:
A. Adoptive Case Number:
B. Child’s Social Security Number:
C. Name of child:
D. Date of birth:
E: Age at time of adoption:
F. Date of adoption:
G. State where adoption occurred
Section 3: Credit Option
Fully claimed $2,000 credit in the year of adoption
Claim $2,000 credit over a three (3) year period
Amount claimed in
Tax year one (1):
$
Tax year two (2):
$
Tax year three (3): $
GENERAL INSTRUCTIONS
A one-time credit is allowed against personal Income tax for nonfamily adoptions . “Nonfamily adoptions” means
adoptions of a child or children by a taxpayer or taxpayers which child or children are not related to the taxpayer or taxpayers
by blood or marriage. The credit is equal to two thousand ($2,000) dollars which may be taken in the year of the adoption of
each nonfamily child, whose age at adoption is under eighteen years. This credit may, at the option of the taxpayer, be taken
over a period of three years.

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