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Get IRS 8379 2021-2023

Form Rev. November 2016 Department of the Treasury Internal Revenue Service Part I Injured Spouse Allocation OMB No. 1545-0074 Information about Form 8379 and its separate instructions is at www.irs.gov/form8379. Number and street For Paperwork Reduction Act Notice see separate instructions. Yes No City town or post office state and ZIP code Cat. No. 62474Q Form 8379 Rev. 11-2016 Page 2 Allocation Between Spouses of Items on the Joint Tax Return See the separate Form 8379 instructions for Part III. Complete this part only if you are filing Form 8379 by itself and not with your tax return. Under penalties of perjury I declare that I have examined this form and any accompanying schedules or statements and to the best of my knowledge and belief they are true correct and complete. 4 Are you legally obligated to pay this past-due amount Yes. Stop here. Do not file this form. You are not an injured spouse. Allocated Items Column a must equal columns b c Income a Amount shown on joint return b Allocated to injured spouse other spouse a. Income reported on Form s W-2 b. Keep a copy of Injured spouse s signature this form for your records Print/Type preparer s name Paid Preparer Use Only Date Preparer s signature Phone number Check if self-employed Firm s name Firm s EIN Firm s address PTIN Phone no. Go to line 3. No. Stop here. Do not file this form. You are not an injured spouse. 3 Did or will the IRS use the joint overpayment to pay any of the following legally enforceable past-due debt s owed only by your spouse see instructions Federal tax State income tax State unemployment compensation Child support Spousal support Federal nontax debt such as a student loan Note If the past-due amount is for a federal tax liability owed by both you and your spouse you may qualify for innocent spouse relief for the year to which the joint overpayment was or will be applied. See Innocent Spouse Relief in the instructions. Skip line 9 and go to Part II and complete the rest of this form. Yes. Go to Part II and complete the rest of this form. 10 Enter the following information exactly as it is shown on the tax return for which you are filing this form. The spouse s name and social security number shown first on that tax return must also be shown first below. First name initial and last name shown first on the return Social security number shown first check here 11 Check this box only if you want your refund issued in both names. Otherwise separate refunds will be issued for each spouse if applicable. 12 Do you want any injured spouse refund mailed to an address different from the one on your joint return If Yes enter the address. Attachment Sequence No* 104 Should You File This Form You must complete this part. Answer the following questions for that year. 1 Enter the tax year for which you are filing this form* 2 Did you or will you file a joint return Yes. 5a b No* Go to line 5a* Were you a resident of a community property state at any time during the tax year entered on line 1 see instructions.

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