rom S903 Moving Expense Adjustment 1967

US, Treasury Department
Internal Revenue Service (Attach this statement to your individual income tax return)

(See instructions before completing this form)
Name and address as shown on page 1 of Form 1040

Did you receive an allowance or reimbursement from your employer for any expenses related to this move which were not
actual travel expenses for you and members of your household, or transportation expenses of your household goods and
personal effects? (See instruction 5.) Oo Yes [j No

Dates Departed Arrived
of
move = soot UD coven = cessnereeteeteenerteeety 19
(a) What is the distance from your former residence to you! (b) What is the distance from your former residence to

new business location?  ... . miles your former business location? . miles

NOTE: The moving expense deduction is not allowed unless distance (a) is 20 or more miles farther than distance (b). However, any reimburse:
ment must be included in income reported on your return (see instruction 1).

Name and address of employer at old location

Name and address of employer at new location

Address of old residence

Period of employment in new location (see instruction 7) Total number of weeks

SCHEDULE OF EXPENSES

1 Travel expenses:
(a) Railroad, airplane, boat, etc., fares . 2 ee 2 ee ee ee

(b) Meals and lodgingen route. . 1 6 © © ee ee ee

(c) Automobile expenses (attach schedule) . . 6 6 «© 6 © ee

Total travel expenses . - 2 - + © # © © ee ee
2 Transportation of household and personal property (see instruction3) 2. 2. 6 2 8 we ew ee
3 Total moving expenses (addlinesland2) © 6 ee ew ee ee we Prtteeeeeeeenenteeteetentectes
4 Reimbursement for this move (other than amounts included on Form W-2) (see instruction 6) . .

5 If employer's payments (line 4) are less than moving expenses (line 3), enter the excess expenses
here and on page 2, Part Ill, line2,Form1040  . . ee 7 ee ee ee ee

6 If employer's payments (line 4) are larger than moving expenses (line 3), enter the excess pay-
ments here and on page 2, Part Il, line 7, Form 1040 as ‘‘Excess moving reimbursement” .

5916797041


INSTRUCTIONS

1. Who May Deduct Moving Expenses.—Employees,
including new employees, can deduct moving expenses which
include the cost of moving household goods, personal prop-
erty, the cost of traveling from the taxpayer's former residence
to his new residence, and the moving of an employee's per-
sonal automobile to his new place of residence.

The deduction is allowed only if (a) the change in job
location would have added at least 20 miles to the distance
to work if the taxpayer had not moved to a new residence, or,
if (b) he had no former principal place of work, his new
place of work is at least 20 miles from his former residence.
In either case, during the 12-month period immediately fol-
lowing his arrival in the general location of his new principal
place of work, the taxpayer must be a full-time employee, in
such general location, during at least 39 weeks.

2. “Reasonableness” of Moving Expenses.—The term
“moving expenses” includes only those expenses which are
reasonable under the circumstances of the particular move.
Generally, expenses are reasonable only if they are paid or
incurred for movement by the shortest and most direct route
available from the taxpayer's former residence to his new
residence by the conventional mode or modes of transporta-
tion actually used and in the shortest period of time commonly
required to travel the distance involved by such mode.

3. Household Goods and Personal Effects.—Ex-
penses of moving household goods and personal effects owned
by the taxpayer or a member of his houschold from the tax-
payer's former residence to his new residence includes the
actual cost of transportation or hauling, packing and crating,
in-transit storage, and insurance.

4. Traveling Expenses.—Expenses of traveling from the
taxpayer's former residence to his new residence include the
cost of transportation and of meals and lodging en route
(including the date of arrival) of both the taxpayer and mem-
bers of his household, who have both the taxpayer’s former
residence and his new residence as their principal place of
abode. The deduction for traveling expenses is allowable
for only one trip made by the taxpayer and members of his
household; however, it is not necessary that the taxpayer and
all members of his household travel together or at the same
time. Members of the taxpayer's household do not include,
for example, an individual such as a servant, governess, chauf-
feur, nurse, valet, or personal attendant.

If the taxpayer uses his own automobile as the mode of
transportation he can compute the transportation expenses in
either of two ways: (1) the actual out-of-pocket expenses, for
example, gasoline, oil, repairs, etc., or, (2) at a rate of 5 cents
per mile. If you claim out-of-pocket expenses you must keep
adequate records to verify the amount. If you use the op-
tional method of 5 cents per mile you need only verify the
mileage used in the computation, (Attach schedule.)

‘YE U.S, GOVERNMENT PRINTING OFFICE: 1967~O-260-102

5. Nondeductible Expenses.—Moving expenses do not
include such items as costs incurred in the purchase or sale
of property, losses arising from the sale of property, penalties
for breaking leases, mortgage penalties, expenses of refitting
tugs or draperies, expenses of connecting or disconnecting
utilities, losses arising from the disposal of memberships in
clubs, tuition fees, and similar items.

Travel expenses do not include, for example, living or other
expenses of the taxpayer and members of his household fol-
lowing their date of arrival at the new place of residence and
while they are waiting to enter the new residence or waiting
for their household goods to arrive; expenses in connection
with house or apartment hunting; living expenses preceding
the date of departure for the new place of residence; expenses
of trips for purposes of selling property; expenses of trips to
the former residence by the taxpayer pending the move by his
family to the new place of residence; ot any allowance for
depreciation.

6. Reimbursements and Allowances.—Include on
line 4 of this form, all payments (allowances or reimburse-
ments) received from your employer for expenses incurred
in connection with your moving unless they have been in-
cluded on your Form W-2. Any such amounts shown on
your Form W-2 must be reported on line 5, page 1, Form
1040. Check with your employer if you are in doubt as to
whether or not the payments are included in your Form W-2.

7. The 39-Week and 12-Month Period.—The 39-week
and 12-month period begin on the date you arrive in the
general location of your new principal place of work. Gen-
erally, this is the date on which you arrive in the new area, im-
mediately before you commence regular work on the new job,
regardless of when your family arrives or when you move into
the new residence. It is not necessary that you actually have
employment on the date you arrive at the new location. It
is not necessary that you work for one employer for the 39
weeks, nor that the weeks be consecutive. It is necessary
only that you be employed on a full-time basis, and within
the general commuting area of such place of employment
for at least 39 weeks during the 12-month period following
your arrival in the new area.

If, on or before the due date of your return, you have not
met the 39-week full-time employment test, but it appears that
by the end of the 12-month period that this requirement will
be met, you may claim these moving expenses on your 1967
return. However, you may claim this adjustment after you
meet the test in 1968 by filing either an amended 1967 return
or a claim for refund on Form 843 based upon the allowable
moving expenses. If you choose to claim this adjustment on
your 1967 return before meeting the 39-week test but then
fail to meet the test in 1968, you must cither include the
amount as income on your 1968 return or file an amended
1967 return eliminating the adjustment claimed.

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