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)
----------------Page (0) Break----------------
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)
7a
b
c
d
e
f
g
h
i
j
k
l
m
n
o
p
q
r
s
t
u
v
w
x
y
z
Form 
8820
 (Rev. 12-2012)
----------------Page (1) Break----------------