Pennsylvania Injured Spouse Claim and Allocation

Injured Spouse Claim and Allocation
Injured Spouse Claim and Allocation (PA-8379)
PA-8379
PA-8379 (EO) 02-17

INJURED SPOUSE CLAIM AND ALLOCATION

PA Department of Revenue

Are You an Injured Spouse?
You may be an injured spouse if you file a joint return showing an overpayment of tax and all or part of the
overpayment attributable to tax payments that you made was, or is expected, to be applied (offset) against your
spouse’s past-due Pennsylvania personal income tax, child/spousal support liability(ies), court-ordered
obligations, or federal income tax debt. Complete Form PA-8379, if all three of the following apply and you want
your share of the overpayment shown on the joint return refunded to you.
1. You are not liable for the past-due amounts;
2. You reported income such as wages, taxable interest, etc. on the joint return; and
3. You made and reported payments such as Pennsylvania income tax withheld from your wages or
estimated tax payments, OR you claimed the TAX BACK/Tax Forgiveness credit on the joint return.

Do not use this form if you are requesting PA Innocent Spouse Relief. Instead, file Form PA-8857, Request
for Relief from Joint Liability.
How Do You File Form PA-8379?

Mail Form PA-8379 by itself to the department’s Taxpayers’ Rights Advocate’s Office, Lobby, Strawberry Square,
Harrisburg, PA 17128. Be sure to include copies of all W-2 forms of both spouses and any Forms 1099-R
showing income tax withheld. The processing of your claim may be delayed if you do not include these copies.
Please allow at least 8 weeks for the department to process your claim.
PART I.

Information About the Joint Tax Return for Which This Claim Is Filed

1 Enter the following information exactly as it is shown on the tax return for which you are
filing this claim. The spouse’s name and Social Security Number shown first on that tax return
must also be shown first below.
START

Social Security Number shown first

First name, initial, and last name shown second on the return

Social Security Number shown second If injured Spouse,
check here

➜

2 Enter the tax year for which you are filing this claim (for example, 1999)4
Current home address

City

4

4

If you are filing Form PA-8379 with your tax return, skip to Line 5.

3

If injured Spouse,
check here

First name, initial, and last name shown first on the return

YYYY

State

4 Is the address on your joint return different from the address shown above? . . . .

5 Check this box only if you are divorced or separated from the spouse with whom
you filed the joint return and you want your refund issued in your name only . . . .

ZIP code

Yes

No

Go to Part II on the reverse side.
Reset Entire Form

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PA-8379 (EO) 02-17

Page 2

Allocation Between Spouses of Items on Joint Tax Return

PART II.

(a) Amount shown
on joint return

Allocated Items
7 Income. Enter the separate income
that each spouse earned. Allocate joint
income, such as interest earned on a
joint bank account, as you determine.
But be sure to allocate all income
shown on the joint return.

(b) Allocated to
injured spouse

(c) Allocated to
other spouse
SSN:

SSN:

a Wages . . . . . . . . . . . . . . . . . . . . . .

b All other income. Identify the type and
amount.4

8

9

Allowable deductions. Enter each
spouse’s separate deductions, such as
employee business expenses. Allocate
other deductions as you determine . .
Credits. Allocate any SP Tax
Forgiveness credit to the spouse who
was allocated the dependent’s exemption. Allocate business credits based on
each spouse’s interest in the business.
Allocate any other credits as you determine. . . . . . . . . . . . . . . . . . . . . . .

10 Pennsylvania income tax withheld.
Enter Pennsylvania income tax withheld from each spouse’s income as
shown on Forms W-2 and 1099-R. Be
sure to attach copies of these
forms to your tax return, or to
Form PA-8379 if you are filing it by
itself. . . . . . . . . . . . . . . . . . . . . . .

11 Payments. Allocate joint estimated
tax payments as you determine. . . . .

Note: The department will figure the amount of any refund due the injured spouse.
Signature

PART III.

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 knowledge.
Keep a copy
of this form for
your records.

Paid
Preparer’s
Use Only

4

Injured spouse’s signature

Preparer’s
signature

Date MM/DD/YYYY

4

PLEASE SIGN AFTER PRINTING

Date MM/DD/YYYY Check if
self-employed

Preparer’s SSN or PTIN
EIN

Firm’s name (or yours
if self-employed) and
address

Reset Entire Form

Phone number (Daytime)

PLEASE SIGN AFTER PRINTING

ZIP code

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