OMB No, 1545-0121

1987

som 1 1 1 6 Computation of Foreign Tax Credit

Individual, Fiduciary, or Nonresident Alien Individual
Department af the Treasury > Attach to Form 1040, 1040NR, 1041, or 990-T.

Attachment
Internal Revenue Service > See separate Instructions. Sequence No. 21
Name Identifying number as shown on page 1 of your tax return

Use a separate Form 1116 for each type of income. Check only one box. This form is being completed for credit for taxes on:

0 Passive income CO Shipping income (J Dividends from each noncontrolled section
C1 High withholding tax interest 1 Dividends from an IC-DISC or former DISC 902 corporation
: - C) General limitation income—ali other income from
C1 Financial services income C0 Distributions from a foreign sales sources outside the United States (including
corporation (FSC) or former FSC. income from sources within U.S. possessions)

Resident of (name of country) >
Note: /f you paid taxes to one foreign country, use column A in Part | and line A in Part Il. If you paid taxes to more than one foreign
country, use a separate column and line for each country.
GEM Taxable income From Sources Outside the United States
Foreign Country or U.S. Possession Total
A B Cc (Add Cols. A, B, and C)

Write the name of the foreign country or U.S.
possession. .. . . . an id

1 Gross income from sources within country shown
above and of the type checked above (see
instructions): ]/ 1] 1 7
:’ 7

2 Applicable deductions and losses (see instructions): fh
a Expenses directly allocable to the income on line 1
(attach schedule) . See
Pro rata share of all other deductions not directly
allocable: MI
(i) Itemized deductions (attach schedule) .
(ii) Other deductions (attach schedule)
Add lines 2b(i) and 2b(ii) .
(iv) Total foreign source income see instructions)

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(v) Gross income from all sources (see
instructions)
(vi) Divide line 2b(iv) by line 2b(V) .
(vii) Multiply line 2b(iii) by line 2b(vi) _
¢ Losses from foreign sources . _ . Mh
d Add lines 2a, 2b(vii), and2c . 2d
3. Subtract line 2d from line 1. Enter the result here and in Part ili, ine 6a . . ei 3 |
Foreign Taxes Paid or Accrued (Attach receipt or copy of return.)
T. Credit is 2. Foreign Taxes Paid or Accrued

claimed for taxes
(you must check one) In Foreign Currency in US. Dollars

| Ey Paid or Taxes Withheld at Source on: (d) Other Taxes Withheld at Source on: (h) Other (Total Foreign
[) Accrued 1 orsign 7 foreign A sexes Paid or

by Rent ‘axes Paid or (fy Rents faxes Paidor | Accrued (Add Cols.

Date Paid, (a) Dividends | a Pheerties | (interest | ‘Accrued | (e) Dividends and Rcties (e)interest| “Accrued | (e), (), (@), and (h))

Country

>

B
c
3_Add lines A through C, column (i). Enterthetotalhere andonPartiilinei
For Paperwork Reduction Act Notice, see page 1 of separate Instructions. Form 1116 (1987)



Form 1116 (1987)

Page 2

sats Computation of Foreign Tax Credit

Check if you are claiming a credit for taxes paid to the Virgin Islands under section 932(b) .

|

YY
checked on page 1. Skip lines 7 through 13 to . | be ]f
7 Recapture of prior year overall foreign losses (attach computation) . .L7
Subtract line 7 from line 6c. This is your net foreign source taxable income . ow. LB
Individuals: Enter amount from Form 1040, line 34, or from Form
1040NR, line 33. Estates and trusts: Enter on this line your taxable 7]/
income without the deduction for your exemption . . . Lg | YU
|
10 Divide line 8 by line 9. (If line 8 is more than line 9, enter the figure ‘'1."’) an 10
11 Individuals: Enter amount from Form 1040, line 43, or Form 1040NR, line 40. Estates and trusts:
Enter amount from Form 1041, line 22c, or Form 990-T, line 8 . 11
12 Multiply line 11 by line 10. (Maximum amount of credit.) : woe ee. [82
13 Enter the amount from line 5 or line 12, whichever is smaller. (If this is the only Form 1116 you are
completing, skip lines 1 through 8 in Part IV and enter this amount on line 9, Part IV. Otherwise,
complete the appropriate lines in Part lV.) ee 8

Enter amount from Part Il, line 3. (This is the total foreign taxes paid

oraccrued.) 2 2 2. ee LD
Carryback or carryover (attach detailed computation). . . . . . L2
Addlinesland2. 2. 2 1 1. 2 2 ee eee 2... LB

Reduction in foreign taxes (see instructions). . . coe _L4

Subtract line 4 from line 3. (This is the total amount of foreign taxes available for credit.) .

Enter amount from Part |, line 3(see instructions). . . . . . | 6a

Enter pro rata share of allocated foreign losses (see instructions) |_6b

Reduce the amount on line 6a by the loss on line 6b. (This is your
taxable income (or loss) from sources outside the United States.) If
this is a loss, you have no foreign tax credit for the type of income you

Summary of Credits From Separate Parts III (See Instructions.)

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10

11

Credit for taxes on passive income

Credit for taxes on high withholding tax interest .

Credit for taxes on financial services income .

Credit for taxes on shipping income .

Credit for taxes on dividends from an IC- Disc. or former Disc.

oy lon | |eo [ro J

Credit for taxes on distributions from a FSC or former FSC

Credit for taxes on dividends from each noncontrolled section 902
corporation...) . woe ee LZ

Credit for taxes on general limitation income (all other income from
sources outside the U.S.) .. So ee ee LB

Add lines 1 through 8 soe . . : soe soe
Reduction of credit for international 1 boycott operations (see “Reduction of Credit for International
Boycott Operations”’ in instructions for Part Ill) .

Subtract line 10 from line 9. This is your foreign tax credit. Enter here and on 1 Form 1040, line 44;
Form 1040NR, line 41; Form 1041, line 23a; or Form 990-T, lineQa_ _ rd

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#U.S.GPO:1987-0-183-184