Purpose of Form
Use Form 2120 to:
• Identify each other eligible person (see below) who paid over 10% of the support
of your qualifying relative whom you are claiming as a dependent, and
• Indicate that you have a signed statement from each other eligible person
waiving his or her right to claim that person as a dependent.
An eligible person is someone who could have claimed a person as a dependent
except that he or she didn’t pay over half of that person’s support.
If there are more than four other eligible persons, attach a statement to your
return with the required information.
Note: The rules for multiple support agreements apply to claiming an exemption
for a qualifying relative and don’t apply to claiming an exemption for a qualifying
child. For the definitions of “qualifying relative” and “qualifying child,” see the
instructions for your tax return and Pub. 501.

Claiming a Qualifying Relative
Generally, to claim a person as a qualifying relative, you must pay over half of that
person’s support. However, even if you didn’t meet this support test, you may be
able to claim him or her as a dependent if all five of the following apply.
1. You and one or more other eligible person(s) (see above) together paid over
half of that person’s support.
2. You paid over 10% of the support.
3. No one alone paid over half of that person’s support.
4. The other dependency tests are met. See Step 4, Is Your Qualifying Relative
Your Dependent, under Who Qualifies as Your Dependent, in the Instructions for
Form 1040.
5. Each other eligible person who paid over 10% of the support agrees not to
claim that person as a dependent by giving you a signed statement. See Signed
Statement on this page.
Note: To find out what is included in support, see Pub. 501.

Signed Statement
You must have received, from each other eligible person listed above, a signed
statement waiving his or her right to claim the person as a dependent for the
calendar year indicated on this form. The statement must include:
• The calendar year the waiver applies to,
• The name of your qualifying relative the eligible person helped to support, and
• The eligible person’s name, address, and social security number.
Don’t file the signed statement with your return. You must keep it for your records
and be prepared to furnish it and any other information necessary to show that you
qualify to claim the person as your dependent.

Additional Information
See Pub. 501 for details.

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confidential, as required by Internal Revenue Code section 6103.
The average time and expenses required to complete and file this form will vary
depending on individual circumstances. For the estimated averages, see the
instructions for your income tax return.
If you have suggestions for making this form simpler, we would be happy to hear
from you. See the instructions for your income tax return.