rorm 1 1 16 Computation of Foreign Tax Credit

Individual, Fiduciary, or Nonresident Alien Individual

1979

Department of the Treasury Attach to Form 1040,

Internal Revenue Service For calendar year 19........, or other tax year beginning 19, and ending 19. 1041, or 1040NR
Name : Resident of (Name of country) Social security number
Address (Number and street) Citizen of (Name of country) Employer identification number

City or town, State and ZIP code or country

This form being completed for credit with respect to: J Nonbusiness (section 904(d)) interest income

Dividends fi a DISC or f DISs(
(Use a separate Form 1116 for each type Oo Fovcin - in di or former DISC
of income. See General Instruction J.) CO Foreign oil related income
[J All other income from sources outside the U.S. (including income from sources within U.S. possessions)

Schedule A—Taxable Income from Sources Outside the U.S.

2. Gross Income from Sources Outside the U.S.

NTS’ Boscesston (Use a {b) Gross (er Foreign Source (@) Wages, Salaries, | (e) Business or | (f) Gross Income (ending (hy Total (Add coh
‘separate line for each) (a) Dividends Rents and Gapital Gain and Other Employes | Profession (Sole | from Trusts and Interest) htnvoush ae
Royalties (see score, Ky ‘Compensation Proprietorship) Estates alattach,
A
B
c
o
E
FE
G

Totals (Add lines AthroughG). .

3. Applicable Deductions and Losses

Directly Allocable Deductions 4, Taxable Income or (Loss)
Tati (e) Pro rata Share of (g) Total Applicable U.S. (before recapture of
(@) Expenses (b) Depreciation (©) Repairs and Other (d) Other Expenses All Other Deductions (A Losses from Deductions and Losses | prior year overall foreign
Directly Allocable Divectly Allocabl Expenses Directly Directly Allocable to Not Directly Applicable Foreign Sources (Add columns losses) (Column 2(h)
to Business or rectly Mlocable Allocable to Rent Specific Income Items (Attach schedule) (a) through (A) less column 3(g))

Profession and Royalty Income (Attach schedule)

Royalty Income

Totals] @|-n}m)o]o} a] >

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Form 1116 (1979) Schedule B—Foreign Taxes Paid or Accrued Page 2

lL Credit is claimed 4, Foreign Taxes Paid or Accrued (Attach receipt or copy of return.) (See General Instruction H.) 2; Reduction for
3. Statute In Foreign Currency In U.S. Dollars (See instructions for Schedule B, column 4.) sect under
O Paid 0 Accrued Imposing Tax 5 Mineral Income and
| 2, Tyre | Title, number, Tax Withheld at Source on: (e) other _| @Conversion | Tax Withheld at Source on: (h) Total for Failure to
(identity in detain | ______|Forelgn Taxes] "Sth equtey Follen Taxes [Paid ee accrucd| Required under
Date Date Paid or ign Taxes | Paid or Accr cl
Paid Accrued (@) Dividends | ,P erent, | Accrued (@) Dividends | an Pareciiies Pald or Accrued) Ae ew). sees Genera
Instruction N)

A

B

c

D

E

F

G

Totals (Add lines A through G)_. oe

Schedule C—Computation of Foreign Tax Credit

1 Total foreign taxes paid or accrued (from Schedule B, column 4(h), “Totals”line) . 2 6 6 ee ee ee 1 | V/

2 Carryback or carryover (attach detailed computation) (see General InstructionL) 2 6 2. 1 ee ee ee 2

3 Reduction for taxes (from Schedule B, column 5, “Totals” line) 2 6 6 1 ee ee ee 3 V7

4 Total foreign taxes available for credit (Add lines 1 and 2, and subtract line 3 from the result). © 2 2 2 6 ee ee ee wee ee ee LA

5 Taxable income or (loss) from sources outside the U.S. (from Schedule A, column 4, “Totals” line). (If loss, skip lines 6 through 16). . . |_5_|

6 Recapture of prior year overall foreign losses (see General Instruction K) «2 1. ee ee ee le . 6 I

7 Net foreign source taxable income (Subtract line 6 from line 5) «6 6 ee ee ee ee ee ee ee wee ee ee |Z

8 Individuals: Enter amount from Form 1040, line 34, or Form LO40NR, line 39. Estates and trusts: Make no entry, skiptoline10 =... 1 we . | 8 77 V//

9 Enter $3,400 (joint return or widow(er)), $2,300 (single or head of household), or $1,700 (married filing separate return) : . Ls — 7

10 Individuals: Subtract line 9 from line 8.—Estates and trusts: Enter on this line your taxable income without the deduction for your exemption. . wee LO

11 Divide line 7 by line 10. (If line 7 is more than line 10, enterthe figure “1.") 2 6 6 1 1 ee ee ee ee wae : 41

12 Total U.S. income tax before any credits (see General InstructionD) 2... ee ee |_22 | 7/ V//

13 Credit forthe elderly. 6 5 ee ce ee ee ee ee ee 188 WV]! 7/7;

14 Subtract line 13 from tine12 . ee ee ee ee LA

15 Limitation on credit (Multiply line 14 by tine 11) . a rs oe

16 Foreign tax credit (line 4 or line 15, whichever is smaller)... + + + + + + +e ee ee eres a I

Schedule D—Summary of Credits from Separate Schedules C

1 Credit with respect to nonbusiness (section 904(d)) interest 6 6 ee ee ee +|——_|

2 Credit with respect to dividends from a DISC or former DISC. - 1 ee ee ee ee ee ee ee 2]

3 Credit with respect to foreign oil related income . 2 6 6 ee ee ee ee ee 3]

4 Credit with respect to all other income from sources outside the U.S. (including income from sources within U.S. possessions) . . 4 — —V/

5 Total (Add lines lthrough4) 2. ee ee ee ee ee eee ee ef B

6 Reduction in credit for international boycott operations (see General Instruction N). . - - 2 + + 8 ee ee ee es on

7 Foreign tax credit (Subtract line 6 from line 5). Enter here and on your tax return... + ss ss : 17

‘te US. GOVERNMENT PRINTING OFFICE : 1979—-O-283-217

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