2555- EZ

OMB No. 1545-1326

Form

See separate instructions.

Attach to Form 1040.

Foreign Earned Income Exclusion

Attachment

2002

Department of the Treasury

Internal Revenue Service

(99)

Sequence No. 34A

Name shown on Form 1040

Your social security number

•	Are a U.S. citizen or a resident alien.

• Do not have self-employment income.
• Do not have business/moving expenses.

You May Use • Earned wages/salaries in a foreign country.

This Form

• Had total foreign earned income of

And You:

If You:

$80,000 or less.

• Do not claim the foreign housing exclusion or deduction.

•	Are filing a cal endar year return that

covers a 12-month period.

Part I

Tests To See If You Can Take the Foreign Earned Income Exclusion

1 Bona Fide Residence Test

(see page 2 of the instructions)?

Yes

No

•	If you answered “Yes,” you meet this test. Fill in line 1b and then go to line 3.
•	If you answered “No,” you do not meet this test. Go to line 2 to see if you meet the Physical Presence Test.

b Enter the date your bona fide residence began

, and ended (see instructions)

2 Physical Presence Test

a Were you physically present in a foreign country or countries for at least 330 full days during

2002 or

any other period of 12 months in a row starting or ending in 2002?

Yes

No

•	If you answered “Yes,” you meet this test. Fill in line 2b and then go to line 3.

•	If you answered “No,” you do not meet this test. You cannot take the exclusion unless you meet the

Bona Fide Residence Test above.

b The physical presence test is based on the 12-month period from

through

3 Tax Home Test. Was your tax home in a foreign country or countries throughout your period of bona fide

residence or physical presence, whichever applies?

Yes

No

•	If you answered “Yes,” you can take the exclusion. Complete Part II below and then go to page 2.

•	If you answered “No,” you cannot take the exclusion. Do not file this form.

Part II

General Information

4 Your foreign address (including country)

5 Your occupation

6 Employer’s name

7

Employer’s U.S. address (including ZIP code)

8 Employer’s foreign address

9 Employer is (check any that apply):

aA U.S. business

bA foreign business

cOther (specify)

10a If you filed Form 2555 or 2555-EZ after 1981, enter the last year you filed the form.

b If you did not file Form 2555 or 2555-EZ after 1981, check here

and go to line 11a now.

c Have you ever revoked the foreign earned income exclusion?

.	.	.

Yes

No

d If you answered “Yes,” enter the tax year for which the revocation was effective.

1 1a List your tax home(s) during 2002 and date(s) established.

b Of what country are you a citizen/national?

For Paperwork Reduction Act Notice, see page 3 of separate instructions.
ISA
STF FED4601 F .1

Form 2555-EZ (2002)

a Were you a bona fide resident of a foreign country or countries for a period that includes an entire tax year
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Form 2555-EZ (2002)

Page 2

Part III

Days Present in the United States — Complete this part if you were in the United States or its possessions during 2002.

Part IV

Figure Your Foreign Earned Income Exclusion

13 Maximum foreign earned income exclusion

13

$80,000.00

14 Enter the number of days in your qualifying period that fall within 2002

14

days

15 Did you enter 365 on line 14?

Yes. Enter “1.000.”

No. Divide line 14 by 365 and enter the result as

15

x

a decimal (rounded to at least three places).

16

16 Multiply line 13 by line 15

17 Enter, in U.S. dollars, the total foreign earned income you earned and received in 2002 (see

instructions). Be sure to include this amount on Form 1040, line 7

18 Foreign earned income exclusion. Enter the smaller of line 16 or line 17 here and in parentheses

on Form 1040, line 21. Next to the amount enter “2555-EZ.” On Form 1040, subtract this amount

from your income to arrive at total income on Form 1040, line 22

Form 2555-EZ (2002)

STF FED4601 F .2

12
(a) Date arrived in U.S.	(b	) Date left U.S.	(c) Number of days in U .S. on business	(d ) Income earned in U.S.
on business (attach computation)	

				

				

				

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