OMB No. 1545-0074
SCHEDULE 8812                            Credits for Qualifying Children                              . .1040 . . . . . . .     ◀
                                             and Other Dependents
(Form 1040)                                                                                           1040-SR. . . . . . . . .  
                                                                                                      1040-NR
                                           ▶ Attach to Form 1040, 1040-SR, or 1040-NR.                                                    2021
Department of the Treasury                                                                                                      8812      Attachment   
Internal Revenue Service (99)  ▶ Go to www.irs.gov/Schedule8812 for instructions and the latest information.                              Sequence No. 47
Name(s) shown on return                                                                                                              Your social security number 

Part I-A Child Tax Credit and Credit for Other Dependents
1   Enter the amount from line 11 of your Form 1040, 1040-SR, or 1040-NR  .          . .      . .   . .      .            .     . .  . 1
2a  Enter income from Puerto Rico that you excluded  .      .   . . .    . . .       . .      .     2a
b   Enter the amounts from lines 45 and 50 of your Form 2555  .     .    . . .       . .      .     2b
c   Enter the amount from line 15 of your Form 4563  .      .   . . .    . . .       . .      .     2c
d   Add lines 2a through 2c  .         . . . . . . . .      .   . . .    . . .       . .      . .   . .      .            .     . .  . 2d
3   Add lines 1 and 2d  .          .   . . . . . . . .      .   . . .    . . .       . .      . .   . .      .            .     . .  . 3
4a  Number of qualifying children under age 18 with the required social security number             4a
b   Number of children included on line 4a who were under age 6 at the end of 2021  .         .     4b
c   Subtract line 4b from line 4a        . . . . . . .      .   . . .    . . .       . .      .     4c
5   If line 4a is more than zero, enter the amount from the Line 5 Worksheet; otherwise, enter -0- .         .            .     . .  . 5
6   Number of other dependents, including any qualifying children who are not under age 
    18 or who do not have the required social security number     . .    . . .       . .      .     6
    Caution: Do not include yourself, your spouse, or anyone who is not a U.S. citizen, U.S. national, or U.S. resident 
    alien. Also, do not include anyone you included on line 4a.
7   Multiply line 6 by $500  .         . . . . . . . .      .   . . .    . . .       . .      . .   . .      .            .     . .  . 7
8   Add lines 5 and 7  .         . .   . . . . . . . .      .   . . .    . . .       . .      . .   . .      .            .     . .  . 8
9   Enter the amount shown below for your filing status.
    • Married filing jointly—$400,000
    • All other filing statuses—$200,000     } . . . .      .   . . .    . . .       . .      . .   . .      .            .     . .  . 9
10  Subtract line 9 from line 3.
    • If zero or less, enter -0-.
    • If more than zero and not a multiple of $1,000, enter the next multiple of $1,000. For 
    example, if the result is $425, enter $1,000; if the result is $1,025, enter $2,000, etc.   } .   .      .            .     . .  . 10
11  Multiply line 10 by 5% (0.05)  .       . . . . . .      .   . . .    . . .       . .      . .   . .      .            .     . .  . 11
12  Subtract line 11 from line 8. If zero or less, enter -0-  . . . .    . . .       . .      . .   . .      .            .     . .  . 12
13  Check all the boxes that apply to you (or your spouse if married filing jointly).
    A    Check here if you (or your spouse if married filing jointly) had a principal place of abode in the United States 
         for more than half of 2021  .     . . . . . .      .   . . .    . . .       . .      . .   . .      .            .     . .
    B    Check here if you (or your spouse if married filing jointly) were a bona fide resident of Puerto Rico for 2021
Part I-B Filers Who Check a Box on Line 13
Caution: If you did not check a box on line 13, do not complete Part I-B; instead, skip to Part I-C.
14a Enter the smaller of line 7 or line 12  .  . . . .      .   . . .    . . .       . .      . .   . .      .            .     . .  . 14a
b   Subtract line 14a from line 12  .      . . . . . .      .   . . .    . . .       . .      . .   . .      .            .     . .  . 14b
c   If line 14a is zero, enter -0-; otherwise, enter the amount from the Credit Limit Worksheet A .          .            .     . .  . 14c
d   Enter the smaller of line 14a or line 14c  . . . .      .   . . .    . . .       . .      . .   . .      .            .     . .  . 14d
e   Add lines 14b and 14d  .           . . . . . . . .      .   . . .    . . .       . .      . .   . .      .            .     . .  . 14e
f   Enter the aggregate amount of advance child tax credit payments you (and your spouse if filing jointly) received 
    for 2021. See your Letter(s) 6419 for the amounts to include on this line. If you are missing Letter 6419, see the 
    instructions before entering an amount on this line. If you didn’t receive any advance child tax credit payments 
    for 2021, enter -0-          . .   . . . . . . . .      .   . . .    . . .       . .      . .   . .      .            .     . .  . 14f
    Caution: If the amount on this line doesn’t match the aggregate amounts reported to you (and your spouse if 
    filing jointly) on your Letter(s) 6419, the processing of your return will be delayed.
g   Subtract line 14f from line 14e. If zero or less, enter -0- on lines 14g through 14i and go to Part III               .     . .  . 14g
h   Enter the smaller of line 14d or line 14g. This is your credit for other dependents. Enter this amount on line 
    19 of your Form 1040, 1040-SR, or 1040-NR      . .      .   . . .    . . .       . .      . .   . .      .            .     . .  . 14h
i   Subtract line 14h from line 14g.       This is your refundable child tax credit. Enter this amount on line 28 of 
    your Form 1040, 1040-SR, or 1040-NR .        . . .      .   . . .    . . .       . .      . .   . .      .            .     . .  . 14i
For Paperwork Reduction Act Notice, see your tax return instructions.                  Cat. No. 59761M                               Schedule 8812 (Form 1040) 2021

Schedule 8812 (Form 1040) 2021                                                                                                      Page 2
Part I-C  Filers Who Do Not Check a Box on Line 13
Caution: If you checked a box on line 13, do not complete Part I-C.
15a Enter the amount from the Credit Limit Worksheet A           . . . . .       . . .    . .     .  .   .  . .  . .         15a
b   Enter the smaller of line 12 or line 15a  .  . . .       .   . . . . .       . . .    . .     .  .   .  . .  . .         15b
    Additional child tax credit. Complete Parts II-A through II-C if you meet each of the following items.
    1.  You are not filing Form 2555.
    2.  Line 4a is more than zero.
    3.  Line 12 is more than line 15a.
c   If you completed Parts II-A through II-C, enter the amount from line 27; otherwise, enter -0-  .     .  . .  . .         15c
d   Add lines 15b and 15c  .       . . . .    .  . . .       .   . . . . .       . . .    . .     .  .   .  . .  . .         15d
e   Enter the aggregate amount of advance child tax credit payments you (and your spouse if filing jointly) received 
    for 2021. See your Letter(s) 6419 for the amounts to include on this line. If you are missing Letter 6419, see the 
    instructions before entering an amount on this line. If you didn’t receive any advance child tax credit payments 
    for 2021, enter -0-        . . . . . .    .  . . .       .   . . . .     .   . . .    . .     .  .   .  . .  . .         15e
    Caution:   If the amount on this line doesn’t match the aggregate amounts reported to you (and your spouse if 
    filing jointly) on your Letter(s) 6419, the processing of your return will be delayed.
f   Subtract line 15e from line 15d. If zero or less, enter -0- on lines 15f through 15h and go to Part III . .  . .         15f
g   Enter the smaller of line 15b or line 15f.   This is your nonrefundable child tax credit and credit for other 
    dependents. Enter this amount on line 19 of your Form 1040, 1040-SR, or 1040-NR .             .  .   .  . .  . .         15g
h   Subtract line 15g from line 15f. This is your additional child tax credit. Enter this amount on line 28 of your 
    Form 1040, 1040-SR, or 1040-NR  .         .  . . .       .   . . . .     .   . . .    . .     .  .   .  . .  . .         15h
Part II-A Additional Child Tax Credit (use only if completing Part I-C)
Caution: If you file Form 2555, do not complete Parts II-A through II-C;  you cannot claim the additional child tax credit.
Caution: If you checked a box on line 13, do not complete Parts II-A through II-C; you cannot claim the additional child tax credit.
16a Subtract line 15b from line 12. If zero, skip Parts II-A and II-B and enter -0- on line 27  . .  .   .  . .  . .         16a
b   Number of qualifying children under 18 with the required social security number:                          x $1,400. 
    Enter the result. If zero, skip Parts II-A and II-B and enter -0- on line 27 . . .    . .     .  .   .  . .  . .         16b
    TIP: The number of children you use for this line is the same as the number of children you used for line 4a.
17  Enter the smaller of line 16a or line 16b  . . . .       .   . . . . .       . . .    . .     .  .   .  . .  . .         17
18a Earned income (see instructions)  .  .    .  . . .       .   . . . . .       . . .    .       18a
b   Nontaxable combat pay (see instructions) .   . . .       .   .   18b
19  Is the amount on line 18a more than $2,500? 
          No.  Leave line 19 blank and enter -0- on line 20. 
          Yes. Subtract $2,500 from the amount on line 18a. Enter the result     . . .    .       19
20  Multiply the amount on line 19 by 15% (0.15) and enter the result  . .       . . .    . .     .  .   .  . .  . .         20
    Next. On line 16b, is the amount $4,200 or more?
          No.  If line 20 is zero, enter -0- on line 15c. Otherwise, skip Part II-B and enter the smaller of line 17 or line 
               20 on line 27. 
          Yes. If line 20 is equal to or more than line 17, skip Part II-B and enter the amount from line 17 on line 27. 
               Otherwise, go to line 21. 
Part II-B Certain Filers Who Have Three or More Qualifying Children
21  Withheld social security, Medicare, and Additional Medicare taxes from Form(s) W-2, 
    boxes 4 and 6. If married filing jointly, include your spouse’s amounts with yours. If 
    your employer withheld or you paid Additional Medicare Tax or tier 1 RRTA taxes, see 
    instructions .    .        . . . . . .    .  . . .       .   . . . . .       . . .    .       21
22  Enter the total of the amounts from Schedule 1 (Form 1040), line 15; Schedule 2 (Form 
    1040), line 5; Schedule 2 (Form 1040), line 6; and Schedule 2 (Form 1040), line 13  .         22
23  Add lines 21 and 22  .       . . . . .    .  . . .       .   . . . . .       . . .    .       23
24  1040 and  
    1040-SR filers: Enter the total of the amounts from Form 1040 or 1040-SR, line 27a, 
                    and Schedule 3 (Form 1040), line 11.
    1040-NR filers: Enter the amount from Schedule 3 (Form 1040), line 11.                }       24
25  Subtract line 24 from line 23. If zero or less, enter -0-  . . . . . .       . . .    . .     .  .   .  . .  . .         25
26  Enter the larger of line 20 or line 25  . .  . . .       .   . . . . .       . . .    . .     .  .   .  . .  . .         26
    Next, enter the smaller of line 17 or line 26 on line 27. 
Part II-C Additional Child Tax Credit
27  Enter this amount on line 15c  .   . .    .  . . .       .   . . . . .       . . .    . .     .  .   .  . .  . .         27
                                                                                                                   Schedule 8812 (Form 1040) 2021

Schedule 8812 (Form 1040) 2021                                                                                                Page 3
Part III Additional Tax (use only if line 14g or line 15f, whichever applies, is zero)
28a Enter the amount from line 14f or line 15e, whichever applies   . . . . . . . . .               . . . .      .   .     28a
b   Enter the amount from line 14e or line 15d, whichever applies   . . . . . . . . .               . . . .      .   .     28b
29  Excess advance child tax credit payments. Subtract line 28b from line 28a. If zero, stop; you do not owe the 
    additional tax  . .        . . . . . .     . . . .  .       . . . . . . . . . . .               . . . .      .   .     29
30  Enter  the  number  of  qualifying  children  taken  into  account  in  determining  the  annual  advance  amount  you 
    received for 2021. See your Letter 6419 for this number. If you are missing your Letter 6419, you are filing a joint 
    return, or you received more than one Letter 6419, see the instructions before entering a number on this line  . .     30
    Caution: If the amount on this line doesn’t match the number of qualifying children reported to you (and your 
    spouse if filing jointly) on your Letter(s) 6419, the processing of your return will be delayed.
31  Enter the smaller of line 4a or line 30  . . . . .  .       . . . . . . . . . . .               . . . .      .   .     31
32  Subtract line 31 from line 30. If zero, skip to line 40 and enter the amount from line 29; otherwise, continue to 
    line 33  . . .    .        . . . . . .     . . . .  .       . . . . . . . . . . .               . . . .      .   .     32
33  Enter the amount shown below for your filing status.
    • Married filing jointly or Qualifying widow(er)—$60,000
    • Head of household—$50,000
    • All other filing statuses—$40,000                         }   . . . . . . . . .               . . . .      .   .     33
34  Subtract line 33 from line 3. If zero or less, enter -0-  . . . . . . . . . . . .               . . . .      .   .     34
35  Enter the amount from line 33  .   . .     . . . .  .       . . . . . . . . . . .               . . . .      .   .     35
36  Divide line 34 by line 35. Enter the result as a decimal (rounded to at least three places). If the result is 1.000 or 
    more, enter 1.000  .       . . . . . .     . . . .  .       . . . . . . . . . . .               . . . .      .   .     36
37  Multiply line 32 by $2,000  .    . . .     . . . .  .       . . . . . . . . . . .               . . . .      .   .     37
38  Multiply line 37 by line 36  .   . . .     . . . .  .       . . . . . . . . . . .               . . . .      .   .     38
39  Subtract line 38 from line 37    . . .     . . . .  .       . . . . . . . . . . .               . . . .      .   .     39
40  Subtract line 39 from line 29. If zero or less, enter -0-.  This is your additional tax. If more than zero, enter 
    this amount on Schedule 2 (Form 1040), line 19  .   .       . . . . . . . . . . .               . . . .      .   .     40
                                                                                                                     Schedule 8812 (Form 1040) 2021