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Line 12 Enter the total amount of dependent care benefits you received in 2021. Amounts you received as an employee should be shown in box 10 of your Form(s) W-2, however, don’t include amounts reported in box 10 that exceed your plan's exclusion and are therefore reported as wages in box 1 of Form(s) W-2. The ARP permits employers to increase the maximum amount that can be excluded from an employee’s income through a dependent care assistance program. For 2021, the maximum amount is increased to $10,500 (previously $5,000). For married employees filing separate returns, the maximum amount is increased to $5,250 (previously $2,500). Line 13 If you had an employer-provided dependent care plan, your employer may have permitted you to carry forward any unused amount from 2020 to use in 2021. Enter on line 13 the amount you carried forward and used in 2021. Temporary special rules for unused amount in de- pendent care FSAs. Section 214 of the Taxpayer Certainty and Disaster Tax Relief Act of 2020 allows your employer to amend its dependent care plan to allow employees to carry over unused benefits from a plan year ending in 2020 to a plan year ending in 2021 and from a plan year ending in 2021 to a plan year ending in 2022. Alternatively, your employer may extend the claims period for a plan year ending in 2020 or 2021 to 12 months after the end of the plan year for unused benefits remaining in the dependent care FSA. Your employer can tell you whether your dependent care plan was amended. Unused amounts from 2020 are added to the maximum amount of dependent care benefits that are allowed for 2021. For more information about these rules, see Notice 2021-15, 2021-10 I.R.B. 898, available at IRS.gov/irb/ 2021-10_IRB#NOT-2021-15, and Notice 2021-26, 2021-21 I.R.B. 1157, available at IRS.gov/irb/ 2021-21_IRB#NOT-2021-26. Temporary carryforward rule for dependent care FSAs where dependent aged out during the COV- ID-19 pandemic. Section 214 of the Taxpayer Certainty and Disaster Tax Relief Act of 2020 allows your employer to amend its dependent care plan to extend the maximum age of eligible dependents from 12 to 13 for dependent care FSAs for unused amounts from the 2020 plan year carried over into the 2021 plan year. Your employer can tell you whether your dependent care plan was amended. If your employer’s plan has adopted this change, you may use unused dependent care benefits from the 2020 plan year carried over into the 2021 plan year to pay for a child under age 14 for 2021. This relief only applies to amounts received from a dependent care plan and entered on Form 2441, line 13; it does not apply to amounts you paid outside of a dependent care plan. For more information about this relief, see Notice 2021-15. Line 14 If you had an employer-provided dependent care plan, enter on line 14 the total of the following amounts included on line 12 or 13. • Any amount you forfeited. You forfeited an amount if you didn't receive it because you didn't incur the expense. Don't include amounts you expect to receive at a future date. • Any amount you didn't receive but are permitted by your employer to carry forward and use in the following year. Example. Under your employer's dependent care plan, you chose to have your employer set aside $5,000 to cover your 2021 dependent care expenses. The $5,000 is shown in box 10 of your Form W-2. In 2021, you incurred and were reimbursed for $4,950 of qualified expenses. You would enter $5,000 on line 12 and $50, the amount forfeited, on line 14. You would also enter $50 on line 14 if, instead of forfeiting the amount, your employer permitted you to carry the $50 forward to use during the grace period in 2022. Don't enter on line 14 any amounts that aren't already entered on line 12 or 13. Therefore, if you carried forward dependent care benefits from 2020 to 2021, and you didn't use the benefits in 2021 and are carrying the benefits forward to 2022, as described in Notice 2021-26, you would not enter these amounts on line 12, 13, or 14. Line 15 Add the amounts on lines 12 and 13 and subtract from that total the amount on line 14. Enter the result on line 15. Line 16 Enter the total of all qualified expenses incurred in 2021 for the care of your qualifying person(s). It doesn't matter when the expenses were paid. Example. You received $2,000 in cash under your employer's dependent care plan for 2021. The $2,000 is shown in box 10 of your Form W-2. Only $900 of qualified expenses were incurred in 2021 for the care of your 5-year-old dependent child. You would enter $2,000 on line 12 and $900 on line 16. Line 18 If filing jointly, figure your and your spouse's earned income separately. Enter your earned income on line 18 and your spouse's earned income on line 19. If your filing status is married filing separately or you or your spouse was a student or disabled, see the instructions for line 19, later. Earned income for figuring the amount of dependent care benefits you are able to exclude or deduct from your income generally includes the following amounts. 1. The amount shown on Form 1040 or 1040-SR, line 1; or Form 1040-NR, line 1a, minus any amount: a. Included for a scholarship or fellowship grant that wasn't reported to you on a Form W-2, b. Excluded as foreign earned income (including any housing exclusion) on Form 2555, line 43, c. Also reported on Schedule SE (Form 1040) because you were a member of the clergy or you received $108.28 or more of church employee income, d. Received for work performed while an inmate in a penal institution, or e. Received as a pension or annuity from a nonqualified deferred compensation plan or a CAUTION ! -8- Instructions for Form 2441 (2021)