rom +) 5 5 Foreign Earned Income 1989

Department of the Treasury > See separate Instructions. > Attach to front of Form 1040. Attachment
Internal Revenue Service Sequence No. 34

For Use by United States Citizens and Resident Aliens Only
Your name Your social security number
Foreign address (including country) Your occupation

Name of employer >

Employer's |_U.S. >

address Foreign >

Employer is (check » OA foreign entity OAUSS. company

any that apply) DA foreign affiliate of a U.S. company O Self G Other (specify) >

Enter earlier years (after 1981) that you filed Form 2555 to claim either of the exclusions >

If you chose to claim an exclusion in an earlier year (after 1981), have you revoked yourchoice?. . . . . . . . . . Yes ONo
If ‘‘Yes,"' give the type of exclusion and the tax year for which the revocation was effective >

Test under which you qualify to claim the » CO Bona fide residence test (Part |) Are youa
exclusion(s) and/or deduction O Physical presence test (Part I!) U.S. citizen? . .OYes_ CINo

Did you maintain a separate foreign residence for your family because of adverse living conditions at
yourtaxhome?. . . Le rn oe toe . Le Loe toe ... .O Yes ONo

If “Yes,” give city and country of the separate foreign residence. Also show the number of days ‘during your tax year that you maintained a
second household at that address

List your tax home(s) during your tax year and date(s) established _

Complete either Part | or Part II. If an item does not apply, write “NA.” If you do not provide
the information asked for, any exclusion or deduction you claim may be disallowed.

[| Part 1 Taxpayers Qualifying Under Bona Fide Residence Test. (See Instructions.)

1 Date bona fide residence began

2 Kind of living quarters in foreign country » LC] Purchased house O)Rented house or apartment Oi Rented room
O Quarters furnished by employer
3 Did any of your family live with you abroad during any partofthetaxyear?. . ..............0Yes CNo

If “Yes,” who and for what period? > ——
4a Have you submitted a statement to the authorities of the foreign country where you claim bona fide residence that
you are not a resident of that country? (See Instructions.) . . . . . : ... .OYes ONo
b Are you required to pay income tax to the country where you claim bona fide residence? Gee | Instructions. ) ... Yes ONo
If “Yes” to 4a and “No” to 4b, you do not qualify as a bona fide resident. Do not complete the rest of Part I.

5 Complete the following for days present in the United States or its possessions during the tax year. (Do not include this income in Part
U1, but report it on Form 1040.) _

Numberof ] Income earned n US. Numberof ] Income eamed n US.
Date arived Date left days in US. ‘on business (attach pare Date left daysin U.S. | on business (attach
s. s. on business computation) . . on business computation)

b State the type of visa under which you entered the foreign country _

¢ Did your visa limit the length of your stay or employment in a foreign country? . . wee ee ee ee. Ves OF No-
If “Yes,”’ attach explanation.
d Did you maintain a home in the United States while living abroad? : . . Yes [INo

If Yes,” show address of your home, whether it was rented, and the names’and relationships of the ‘occupants.

For Paperwork Reduction Act Notice, see page 1 of separate Instructions. Form 2555 (1989)


Form 2555 (1989)

Page 2

[eels Taxpayers Qualifying Under Physical Presence Test. (See Instructions.)

7
8

The physical presence test is based on the 12-month period from __
Enter your principal country of employment during your tax year > _

Enter all travel abroad during the 12-month period shown on line 7, except travel between foreign countries that did not involve travel
on, or over, international waters, or in, or over, the United States, for 24 hours or more. If the last entry is an arrival in a foreign
country, enter the number of full days to the end of the 12-month period. If you have no travel to report during the period, write in the
schedule below that you were physically present in a foreign country or countries during the entire 12-month period. (Do not include

in Part Ill the income that you list here, but report it on Form 1040.)

Fulldays | Number of
vem of country Date arrived Date left presentin | days in U.S.
including U.S.) country _| on business

Income earned in U.S. on
business (attach
computation)

iclagug All Taxpayers

Not

te: On lines 10 through 14 enter all income, including noncash income, that you earned and actually or constructively received during
your 1989 tax year for services you performed in a foreign country. If any of the foreign earned income received this tax year was
earned in a prior tax year, or will be earned in a later tax year (such as a bonus), see the Instructions. Do not include income from
Part |, line 5, or Part Il, line 9. Report amounts in U.S. dollars, using the exchange rates in effect when you actually or constructively

received the income.

If you are a cash basis taxpayer, report on Form 1040 all income you received during 1989, no matter when you performed

the service.

1989 Foreign Earned Income

‘Amount
(in U.S. dollars)

10
11

12

13

g Add the amounts on lines 13a through 13f and enter the total . [13g
14 Other foreign earned income (specify) -

_ (44

15 Add the amounts on lines 10 through 12d, line 13g, and line 14 and enter the total 15

16 Total amount of meals and lodging included on line 15 that is excludable. (See Instructions.) 16

17 Subtract line 16 from line 15 and enter the result. This is your foreignearnedincome . . . . . . ® | 17

Total wages, salaries, bonuses, commissions, etc. .
Allowable share of income for personal services performed (see Instructions ‘for Part ul, line 1D:
In a business (including farming) or profession . .

In a partnership (give name, address, and nature of income) - _-

oo

Noncash income (market value of property or facilities furnished by employer—attach statement showing
how determined):

Home (lodging) .

Meals

Car .

Other property or ‘facilities Gpecity)

aogce

10

lla

12a

12b
12c

Allowances, reimbursements, or expenses paid on your behalf for services you performed:
a Cost of living and overseas differential. © 2 2 2... 2. Lo. . joa
bFamiy. 2 0 ee [BD
ce Education. © 2. es [BE
d Homeleave . . . . So . . [a3
e Quartes . . . rs . . {13e
f For any other purpose se (specify)

13f

Complete Part IV next if you choose to claim the housing exclusion or are claiming the housing deduction. Otherwise, skip to Part V.



Form 2555 (1989)

Page 3

For Taxpayers Claiming Housing Exclusion AND/OR Deduction

18 Qualified housing expenses for the tax year. (See Instructions.) 18
19 Number of days in your qualifying period that fall within your 1989 tax year. (see
Instructions.) . 19
20 Multiply $21.30 by the numberof days online 19. Enter the result, but do nat enter more than $7,775.00 20
21 Subtract the amount on line 20 from the amount on line 18. (lf zero or less, do not ot complete th the rest of Part
IV or any of Part VII.). . . on 21
22 Enter employer-provided amounts. (Gee Instructions.) rs 22
23 Enter the amount from line 17 se 23
24 Divide the amount on line 22 by t the amount on ‘line 23 and enter the result asa decimal Mo two places).
(Limited to 1.00.) . 24 x
25 Housing exclusion. Muttiply the amount on line 21 ‘by the decimal amount on line 24, but do not enter: more
than the amount on line 22. Also enter this amount on line 35, Part VI & | 25

Note: /f the amount on line 21 is more than the amount on line 25, complete jine 26. Otherwise, ‘skip to Part V if you choose to claim the

foreign earned income exclusion.

26 Subtract the amount on line 25 from the amount on line 21. Enter the result here and on line 40, Part Mi

(Complete Part V before Part VII if you choose to claim the foreign earned income exclusion.) 26
For Taxpayers Claiming Foreign Earned Income Exclusion
27 Maximum foreign earned income exclusion 27 |$70, 000] 00
28 Number of days in your qualifying period t that fall within your 1989 tax year. (ee
Instructions for line 19.) . 28
29 Divide the number of days on line 28 by the number ‘of cay in your 19891 tax xyear (oval 365) and enter the
result as a decimal (to two places) . 29 x
30 Multiply the amount on line 27 by the decimal amount on tine 29 fe 30
31 Entertheamountfromline17 2 6. ee ee ee LBL
32 Enter the amount fromline25 . . . . . .. . £32
33 Subtract the amount on line 32 from the amount on line 31. “Enter the result tee ee . LBB
34 Foreign earned income exclusion. Enter here and on line 36, Part VI, the amount from line 30 or line 33,
whichever is less. woe . 2 P| 34
ix aaag For Taxpayers Claiming Housing Exclusion, Foreign Earned Income Exclusion, or Both
35 Housing exclusion fromline25.. . . . . a 2)
36 Foreign earned income exclusion from line 34 Le ee ee eee LE
37 Add the amounts on lines 35 and 36 and enter the total . 37
38 Deductions allowed in figuring your adjusted gross income (Form 1040, line st that are allocable to the
excluded income. (See Instructions and attach computation.) . 38
39 Subtract line 38 from line 37. Enter the result here and in parentheses on Form 1040, line 22. Next to the
amount write ‘‘Exclusion(s) from Form 2555." On Form 1040 subtract the amount from your income to
arrive at total income on Form 1040, line23 . . . . . _ > 139

For Taxpayers Claiming Housing Deduction

Note: Complete this part only if: (1) you entered an amount on line 26, and (2) the amount on line 17 is more than the amount on line 37.

40 Enter the amount from line 26 . Se 40
41 Entertheamountfromline17 2 2. 2 ee ee ee AD
42 Enter the amount fromline37 . . . . 142
43 Subtract the amount on line 42 from the amount on line 41 and enter the result : 43
44 Enter the amount from line 40 or line 43, whichever is less . 44

Note: /f the amount on line 43 is more than the amount on line 44 and you could not deduct all of your 1988 hou:
of the 1988 limitation, complete the worksheet on page 4 of the Instructions to figure how much of your 1988

may be carried over to 1989. Otherwise, enter a zero (—O-) on line 45.

ising deduction because

housing deduction

45 Housing deduction carryover from 1988 (from worksheet on page 4 of the Instructions)

46 Add the amounts on lines 44 and 45. Enter here and on Form 1040 to the left of line 30. Next to the amount
on Form 1040 write ‘Deduction from Form 2555." Add it to the total adjustments reported onthat line. >

45

46