OMB No. 1545-0121 Foreign Tax Credit Form 1116 (Individual, Estate, or Trust)

Department of the Treasury

Internal Revenue Service

 Attach to Form 1040, 1040NR, 1041, or 990-T. Attachment

 See separate instructions. Sequence No. 19

Name Identifying number as shown on page 1 of your tax return

Passive income Lump-sum distributions

High withholding tax Dividends from a DISC or former DISC

interest

Financial services income General limitation income

Certain distributions from a foreign

sales corporation (FSC) or former

FSC

Resident of (name of country) 

Note: If you paid taxes to only one foreign country or U.S. possession, use column A in Part I and line A in Part II. If you paid taxes to

more than one foreign country or U.S. possession, use a separate column and line for each country or possession.

Taxable Income or Loss From Sources Outside the United States (for Category Checked Above)

Foreign Country or U.S. Possession Total

A B C (Add cols. A, B, and C.)

Enter the name of the foreign country or U.S.

possession 

Gross income from sources within country

shown above and of the type checked above (see

page 7 of the instructions):

1

1

Deductions and losses (Caution: See pages 9, 11, and

12 of the instructions):

2 Expenses definitely related to the income on

line 1 (attach statement)

3 Pro rata share of other deductions not definitely

related:

Certain itemized deductions or standard

deduction (see instructions)

a

b Other deductions (attach statement)

c Add lines 3a and 3b

d Gross foreign source income (see instructions)

e Gross income from all sources (see instructions)

f Divide line 3d by line 3e (see instructions)

g Multiply line 3c by line 3f

4 Pro rata share of interest expense (see instructions):

a Home mortgage interest (use worksheet on

page 12 of the instructions)

b Other interest expense

5 Losses from foreign sources

6 Add lines 2, 3g, 4a, 4b, and 5 6

7 Subtract line 6 from line 1. Enter the result here and on line 14, page 2  7

Foreign Taxes Paid or Accrued (see page 12 of the instructions)

Credit is claimed Foreign taxes paid or accrued for taxes

(you must check one) In foreign currency In U.S. dollars

Paid (s) Other

foreign taxes

paid or

accrued

(w) Other

foreign taxes

paid or

accrued

(x) Total foreign

taxes paid or

accrued (add cols.

(t) through (w))

Taxes withheld at source on: Taxes withheld at source on: Accrued

Country

(q) Rents

and royalties

(u) Rents

and royalties

(o) Date paid

or accrued (p) Dividends (r) Interest (t) Dividends (v) Interest

A

B

C

8 Add lines A through C, column (x). Enter the total here and on line 9, page 2  8

For Paperwork Reduction Act Notice, see page 16 of the instructions. Form 1116 (2003)

Shipping income

Cat. No. 11440U

Part I

Part II

a

b

c

d

e

g

h

i

k

(m)

(n)

l

Use a separate Form 1116 for each category of income listed below. See Categories of Income on page 3 of the instructions. Check only one

box on each Form 1116. Report all amounts in U.S. dollars except where specified in Part II below.

f

Section 901(j) income

j

Certain income re-sourced by treaty

(99)

2003
Form 1116 (2003) Page 2

Figuring the Credit

9 Enter the amount from line 8. These are your total foreign taxes paid

or accrued for the category of income checked above Part I 9

10 Carryback or carryover (attach detailed computation) 10

11 Add lines 9 and 10 11

12 Reduction in foreign taxes (see page 13 of the instructions) 12

13 Subtract line 12 from line 11. This is the total amount of foreign taxes available for credit 13

14 Enter the amount from line 7. This is your taxable income or (loss) from

sources outside the United States (before adjustments) for the category

of income checked above Part I (see page 14 of the instructions) 14

15 Adjustments to line 14 (see page 14 of the instructions) 15

16 Combine the amounts on lines 14 and 15. This is your net foreign

source taxable income. (If the result is zero or less, you have no foreign

tax credit for the category of income you checked above Part I. Skip

lines 17 through 21. However, if you are filing more than one Form

1116, you must complete line 19.)

Individuals: Enter the amount from Form 1040, line 38. If you are a

nonresident alien, enter the amount from Form 1040NR, line 36.

Estates and trusts: Enter your taxable income without the deduction

for your exemption

17

17

18 Divide line 16 by line 17. If line 16 is more than line 17, enter “1” 18

Individuals: Enter the amount from Form 1040, line 41. If you are a nonresident alien, enter the

amount from Form 1040NR, line 39.

19

19

20 Multiply line 19 by line 18 (maximum amount of credit) 20

Enter the smaller of line 13 or line 20. If this is the only Form 1116 you are filing, skip lines 22 through

30 and enter this amount on line 31. Otherwise, complete the appropriate line in Part IV (see 

page 16 of the instructions) 

21

21

Summary of Credits From Separate Parts III (see page 16 of the instructions)

22 Credit for taxes on passive income 22

23 Credit for taxes on high withholding tax interest 23

24 Credit for taxes on financial services income 24

25 Credit for taxes on shipping income 25

26

Credit for taxes on dividends from a DISC or former DISC and certain

distributions from a FSC or former FSC

26

27

Credit for taxes on certain income re-sourced by treaty

27

28

Credit for taxes on lump-sum distributions

28

29 Credit for taxes on general limitation income 29

30 Add lines 22 through 29 30

32 Reduction of credit for international boycott operations. See instructions for line 12 on page 14 32

33 Subtract line 32 from line 31. This is your foreign tax credit. Enter here and on Form 1040, line 44;

Form 1040NR, line 42; Form 1041, Schedule G, line 2a; or Form 990-T, line 40a  33

Part IV

Part III

Caution: If you figured your tax using the lower rates on qualified dividends or capital gains, see page

15 of the instructions.

16

Estates and trusts: Enter the amount from Form 1041, Schedule G, line 1a, or the total of Form 990-T,

lines 36 and 37

Form 1116 (2003)

31 Enter the smaller of line 19 or line 30 31

Caution: If you are completing line 19 for separate category g (lump-sum distributions), see page 16 of the instructions.