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

Passive income Lump-sum distributions (see instructions before

Dividends from a DISC or former completing form)

DISC

High withholding tax

interest

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. However, see the exception

under How To Complete Form 1116 on page 1 of the Instructions.

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 Gross foreign source income. See instructions

e Gross income from all sources. See instructions

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 6 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 © 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 (q) Other

foreign taxes

paid or

accrued

(u) Other

foreign taxes

paid or

accrued

(v) Total foreign

taxes paid or

accrued (add cols.

(r) through (u))

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

Country

(o) Rents

and royalties

(s) Rents

and royalties

(m) Date paid

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

A

B

C

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

For Paperwork Reduction Act Notice, see page 1 of separate instructions. Form 1116 (1994)

Shipping income

Cat. No. 11440U

Part I

Part II

a

b

c

d

e

f

g

h

i

(k)

(l)

j

Report all amounts in U.S. dollars except where specified in Part II. 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:
Form 1116 (1994) 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 category of income you checked above Part I. Skip

lines 17 through 21.)

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

nonresident alien, enter amount from Form 1040NR, line 34.

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, 42,

and any mortgage interest credit (from Form 8396) on line 44. If you are a nonresident alien, enter

amount from Form 1040NR, line 39, less any amount on Form 1040NR, line 40 and any mortgage

interest credit (from Form 8396) on line 42.

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 41; Form 1041, Schedule G, line 2a; or Form 990-T, line 38a © 32

Part IV

Part III

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

16

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Estates and trusts: Enter amount from Form 1041, Schedule G, line 1c, or Form 990-T, lines 36 and 37