Form    
8379
(Rev. Novermber 2012) 
Department of the Treasury  
Internal Revenue Service 
Injured Spouse Allocation
a
 
 
OMB No. 1545-0074 
Attachment   
Sequence No. 
104
Part I
Should You File This Form? 
You must complete this part.
1
Enter the tax year for which you are filing this form. 
a
Answer the following questions for that year.
2
Did you (or will you) file a joint return?
Yes.
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 y
our 
spouse? (see instructions)  
• Federal tax • State income tax • State unemployment compensation • Child support • Spousal support                           
          
• Federal nontax debt (such as a student loan) 
Yes.
Go to line 4.
No. Stop here. 
Do not file this form. You are not an injured spouse.
Note.
 If the past-due amount is for a joint federal tax, you may qualify for innocent spouse relief for the year to which
 
the 
overpayment was applied. See 
Innocent Spouse Relief, 
in the instructions for more information.
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.
Note. 
If the past-due amount is for a joint federal tax, you may qualify for innocent spouse relief for the year to which
 
the 
No.
Go to line 5.
5
Were you a resident of a community property state at any time during the tax year entered on line 1? (see instructions)
Yes.
Enter the name(s) of the community property state(s)
.
No.
Go to line 6.
6
Did you make and report payments, such as federal income tax withholding or estimated tax payments?
Yes.
No.
Go to line 7.
7
Did you have earned income, such as wages, salaries, or self-employment income?
Yes.
Go to line 8.
No.
Skip line 8 and go to line 9.
8
Did (or will) you claim the earned income credit or additional child tax credit?
Yes.
No.
Go to line 9.
9
Did (or will) you claim a refundable tax credit (see instructions)?
Part II
Information About the Joint Tax Return for Which This Form Is Filed
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 
If Injured Spouse, 
check here
 
a
First name, initial, and last name shown second on the return
Social security number shown second
If Injured Spouse, 
check here
 
a
11
Check this box only if you are divorced or legally separated from the spouse with whom you filed the joint return and 
you want your refund issued in your name only
........................ 
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.
Yes
No
Number and street                                                                                   City, town, or post office, state, and ZIP code
For Privacy Act and Paperwork Reduction Act Notice, see separate instructions.
Cat. No. 62474Q 
Form 
8379
 (Rev. 11-2012) 
Information about Form 8379 and its separate instructions is at www.irs.gov/form8379.
Skip lines 6 through 9 and go to Part II and complete the rest of this form.
Skip lines 7 through 9 and go to Part II and complete the rest of this form.
Skip line 9 and go to Part II and complete the rest of this form.
No.
Yes.
Go to Part II and complete the rest of this form.
Stop here. Do not file this form. You are not an injured spouse.
overpayment was applied. See Innocent Spouse Relief, in the instructions for more information.
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Form 8379 (Rev. 11-2012) 
Page 
2 
Part III
Allocation Between Spouses of Items on the Joint Tax Return 
(see instructions)
Allocated Items
(a) 
Amount shown 
 
on joint return
(b) 
Allocated to
 
injured spouse
(c) 
Allocated to 
 
other spouse
13
Income:
a.   
Income reported on Form W-2 
b.   
All other income
14
Adjustments to income
15
Standard deduction or Itemized deductions
16
Number of exemptions
17
Credits (
do not 
include any earned income credit)
18
Other taxes
19
Federal income tax withheld
20
Payments
Part IV
Signature. 
Complete this part only if you are filing Form 8379 by itself and not with your tax return.
knowledge.
Keep a copy of 
this form for 
your records
Injured spouse’s signature
Date
Phone number (optional)
Paid 
Preparer 
Use Only
Print/Type preparer’s name
Preparer's signature
Date
Check         if 
self-employed
PTIN
Firm’s name      
a
Firm's EIN  
a
Firm's Address  
a
Phone no.
Form 
8379
 (Rev. 11-2012) 
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. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any 
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