OMB No. 1545-0121 Foreign Tax Credit Form 1116 Individual, Fiduciary, or Nonresident Alien Individual

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

Use a separate Form 1116 for each category of income listed below. Check only one box. Before you check a box, read

Categories of Income on page 3 of the instructions. Complete this form for credit for taxes on:

Passive income Lump-sum distributions (see instructions

High withholding tax interest Dividends from a DISC or former DISC before completing form)

Financial services income General limitation income—all other income from

sources outside the United States (including

income from sources within U.S. possessions)

Certain distributions from a foreign

sales corporation (FSC) or former FSC

Resident of (name of country) ©

Note: If you paid taxes to 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 Separate 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 instructions.):

1

1

Applicable deductions and losses (See instructions.):

2 Expenses directly allocable to the income on

line 1 (attach schedule)

3 Pro rata share of other deductions not directly

allocable:

Certain itemized deductions or standard

deduction. (See instructions.)

a

b Other deductions (attach schedule)

c Add lines 3a and 3b

d Total foreign source income. (See instructions.)

Gross income from all sources. (See

instructions.)

e

f Divide line 3d by line 3e

g Multiply line 3c by line 3f

4 Pro rata share of interest expense. (See instructions.):

a Home mortgage interest from line 5 of the worksheet

on page 5 of the instructions

b Other interest

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 © 7

Foreign Taxes Paid or Accrued (See instructions.)

Credit is claimed Foreign taxes paid or accrued for taxes

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

Paid (d) Other

foreign taxes

paid or

accrued

(h) Other

foreign taxes

paid or

accrued

(i) Total foreign

taxes paid or

accrued (add cols.

(e) through (h))

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

Country

(b) Rents

and royalties

(f) Rents

and royalties

Date paid

or accrued (a) Dividends (c) Interest (e) Dividends (g) Interest

A

B

C

8 Add lines A through C, column (i). Enter the total here and on line 9 © 8

For Paperwork Reduction Act Notice, see page 1 of separate instructions. Form 1116 (1991)

Shipping income

Cat. No. 11440U

Part I

Part II
Form 1116 (1991) Page 2

Figuring the Credit

9 Enter amount from line 8. This is the 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 instructions.) 12

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

14 Enter 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 instructions.) 14

15 Adjustments to line 14. (See 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 type of income you checked on

page 1. Skip lines 17 through 21.) 16

Individuals: Enter amount from Form 1040, line 35. If you are a

nonresident alien, enter amount from Form 1040NR, line 33.

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 the figure “1.”) 18

Individuals: Enter amount from Form 1040, line 40, less any amounts on Form 1040, lines 41

and 42. If you are a nonresident alien, enter amount from Form 1040NR, line 38, less any amount

on Form 1040NR, line 39. Estates and trusts: Enter amount from Form 1041, Schedule G, line

1c, or Form 990-T, line 8

19

19

20 Multiply line 19 by line 18. (Maximum amount of credit) 20

Enter the amount from line 13 or line 20, whichever is smaller. (If this is the only Form 1116 you

are completing, skip lines 22 through 29 and enter this amount on line 30. Otherwise, complete

the appropriate lines in Part IV.) ©

21

21

Summary of Credits From Separate Parts III (See 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 26

27 Credit for taxes on certain distributions from a FSC or former FSC 27

28 Credit for taxes on lump-sum distributions 28

Credit for taxes on general limitation income (all other income from

sources outside the United States)

29

29

30 Add lines 22 through 29 30

31 Reduction of credit for international boycott operations. (See instructions for line 12.) 31

32 Subtract line 31 from line 30. This is your foreign tax credit. Enter here and on Form 1040, line

43; Form 1040NR, line 40; Form 1041, Schedule G, line 2a; or Form 990-T, line 9a © 32

Part IV

Part III

Caution: If you figured your tax using the maximum tax rate on capital gains, see instructions.