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Form
8820
(Rev. December 2012)
Department of the Treasury
Internal Revenue Service
Orphan Drug Credit
a
Information about Form 8820 and its instructions is available at
www.irs.gov/form8820.
a
Attach to your tax return.
OMB No. 1545-1505
Attachment
Sequence No.
103
Name(s) shown on return
Identifying number
Part I
Current Year Credit
1
Qualified clinical testing expenses paid or incurred during the tax year (see instructions)
....
1
2a
Current year credit. Multiply line 1 by 50% (.50) (see instructions)
...........
2a
b
Enter the portion of the credit from Form 8932, line 2, that is attributable to wages that were also
used to figure the credit on line 2a above
...................
2b
c
Subtract line 2b from line 2a. If zero or less, enter -0-
...............
2c
3
Orphan drug credit from partnerships, S corporations, estates, or trusts
.........
3
4
Add lines 2c and 3. Estates and trusts go to line 5. Partnerships and S corporations, report this
amount on Schedule K. All others, report this amount on Form 3800, line 1h
........
4
5
Amount allocated to the beneficiaries of the estate or trust (see instructions)
........
5
6
Estates and trusts. Subtract line 5 from line 4. Report this amount on Form 3800, line 1h
....
6
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11208S
Form
8820
(Rev. 12-2012)
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Form 8820 (Rev. 12-2012)
Page
2
Part II
Orphan Drug Information
(see instructions)
(a)
(b)
Name of orphan drug
(c)
Designation application number
(d)
Date drug designated
(mm/dd/yyyy)
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Form
8820
(Rev. 12-2012)
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