Forth 8820

Forth 8820 (Rev. December 2012) Department of the Treasury Internal Revenue Service Name(s) shown on return Orphan Drug Credit ► Information about Form 8820 and its instructions Is available at wwwirs.gov/form8820. 10 Attach to your tax return. OMB No. 154S-1505 Attachment Sequence No. 103 Part I Identifying number Current Year Credit 1 Qualified clinical testing expenses paid or incurred during the tax year (see instructions) . 2a Current year credit. Multiply line 1 by 50% (.50) (see instructions) 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 c Subtract line 2b from line 2a. If zero or less, enter -0- 3 Orphan drug credit from partnerships. S corporations, estates, or trusts 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 1 h 5 Amount allocated to the beneficiaries of the estate or trust (see instructions) 6 Estates and trusts. Subtract line 5 from line 4. Report this amount on Form 3800. line 1 h . . 1 2a 21) 2c 3 4 5 6 For Paperwork Reduction Act Notice, see instructions. Form 8820 (Rev. 12-2012) EFTA01220945 Rum 8820 (Rev. 12-2012) Page 2 Orphan Drug Information (see instructions) (a) (b) Name of orphan drug (a) Designation application number Date drug esignated (mmicklAjyyy) 7a b c d a f 9 h 1 k m n 0 P Q r a t u v w x Y z Form 8820 (Rev. 12-2012) EFTA01220946