2555

OMB No. 1545-0067

Form

See separate instructions.

Attach to Form 1040.

Foreign Earned Income

Attachment

000

Department of the Treasury Internal Revenue Service

Sequence No. 34

For Use by U.S. Citizens and Resident Aliens Only

Name shown on Form 1040

Your social security number

Part I

General Information

1

Your foreign address (including country)

2 Your occupation

3 Employer’s name

4a Employer’s U.S. address

b Employer’s foreign address

5

Employer is (check any that apply):

a

A foreign entity

b

A U.S. company

c

Self

d

A foreign affiliate of a U.S. company

e

Other (specify)

exclusion, enter the last year you filed the form.

b If you did not file Form 2555 or 2555-EZ after 1981 to claim either of the exclusions, check here
c Have you ever revoked either of the exclusions?

and go to line 7 now.

	

Yes

No

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

7 Of what country are you a citizen/national?

8a Did you maintain a separate foreign residence for your family because of adverse living conditions at your tax home? See Second foreign household on page 3 of the instructions

	

Yes

No

b If “Yes,” enter city and country of the separate foreign residence. Also, enter the number of days during your tax year that

you maintained a second household at that address.

9

List your tax home(s) during your tax year and date(s) established.

Next, complete either Part II or Part III. If an item does not apply, enter “NA.” If you do not give

Part II

Taxpayers Qualifying Under Bona Fide Residence Test (See page 2 of the instructions.)

10

Date bona fide residence began

, and ended

11

Kind of living quarters in foreign country	a

 Purchased houseb

 Rented house or apartmentc

Rented room

d

Quarters furnished by employer

12a Did any of your family live with you abroad during any part of the tax year?

	

Yes

No

b If “Yes,” who and for what period?

1 3a Have you submitted a statement to the authorities of the foreign country where you claim bona fide residence that you are not a resident of that country? (See instructions.)

	

Yes

No

b Are you required to pay income tax to the country where you claim bona fide residence? (See instructions.)

Yes

No

If you answered “Yes” to 13a and “No” to 13b, you do not qualify as a bona fide resident. Do not complete the rest of this part.

14

If you were present in the United States or its possessions during the tax year, complete columns (a)–(d) below. Do not include the income from column (d) in Part IV, but report it on Form 1040.

(a) Date

arrived in U.S.

(b) Date left

U.S.

days in U.S.

(c) Number of

U.S. on business

(attach computation)

(d) Income earned in

(a) Date

arrived in U.S.

(b) Date left

U.S.

days in U.S.

(c) Number of

U.S. on business

(attach computation)

(d) Income earned in

on business

on business

15a List any contractual terms or other conditions relating to the length of your employment abroad.

b Enter the type of visa under which you entered the foreign country.

c Did your visa limit the length of your stay or employment in a foreign country? If “Yes,” attach explanation
d Did you maintain a home in the United States while living abroad?

Yes

No

	

Yes

No

e If “Yes,” enter address of your home, whether it was rented, the names of the occupants, and their relationship

to you.

For Paperwork Reduction Act Notice, see page 4 of separate instructions.

Cat. No. 1 1900P

Form 2555 (2000)

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6a If, after 1981, you filed Form 2555 to claim either of the exclusions or Form 2555-EZ to claim the foreign earned income
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the information asked for, any exclusion or deduction you claim may be disallowed.

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Form 2555 (2000)

Page 2

Part III

Taxpayers Qualifying Under Physical Presence Test (See page 2 of the instructions.)

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

through

17 Enter your principal country of employment during your tax year.

18 If you traveled abroad during the 12-month period entered on line 16, complete columns (a)–(f) below. Exclude travel between

foreign countries that did not involve travel on or over international waters, or in or over the United States, for 24 hours or more. If you have no travel to report during the period, enter “Physically present in a foreign country or countries for the entire 12-month period.” Do not include the income from column (f) below in Part IV, but report it on Form 1040.

(a) Name of country

(including U.S.)

(b) Date arrived

(c) Date left

present in

(d) Full days

days in U.S.

(e) Number of

(f) Income earned in U.S.

on business (attach

country

on business

computation)

Part IV

All Taxpayers

Note: Enter on lines 19 through 23 all income, including noncash income, you earned and actually or constructively received during

your 2000 tax year for services you performed in a foreign country. If any of the foreign earned income received this tax year was earned in a prior tax year, or will be earned in a later tax year (such as a bonus), see the instructions. Do not include income from line 14, column (d), or line 18, column (f). Report amounts in U.S. dollars, using the exchange rates in effect when you actually or constructively received the income.

If you are a cash basis taxpayer, report on Form 1040 all income you received in 2000, no matter when you performed the service.

2000 Foreign Earned Income

Amount

(in U.S. dollars)

19 Total wages, salaries, bonuses, commissions, etc.

20 Allowable share of income for personal services performed (see instructions): a In a business (including farming) or profession

	

b In a partnership. List partnership’s name and address and type of income.

21

Noncash income (market value of property or facilities furnished by employer—attach statement

showing how it was determined):

a Home (lodging)

	

b Meals

	

c Car

	

d	Other property or facilities. List type and amount.

22 Allowances, reimbursements, or expenses paid on your behalf for services you performed:

a Cost of living and overseas differential

b Family

	

c Education

	

d	Home leave

	

e Quarters

	

f For any other purpose. List type and amount.

g	Add lines 22a through 22f

	

22g

23 Other foreign earned income. List type and amount.

24 Add lines 19 through 21d, line 22g, and line 23

	

25 Total amount of meals and lodging included on line 24 that is excludable (see instructions)
26 Subtract line 25 from line 24. Enter the result here and on line 27 on page 3. This is your 2000

foreign earned income

	

Form 2555 (2000)

							

							

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Form 2555 (2000)

Page 3

Part V

All Taxpayers

27

Enter the amount from line 26

	

27

Are you claiming the housing exclusion or housing deduction?

Yes. Complete Part VI.

No. Go to Part VII.

Part VI

Taxpayers Claiming the Housing Exclusion and/or Deduction

28

Qualified housing expenses for the tax year (see instructions)

	

29

Number of days in your qualifying period that fall within your 2000 tax year (see instructions)

	

29

days

30

Multiply $27.79 by the number of days on line 29. If 366 is entered on line 29, enter $10,171.00 here
Subtract line 30 from line 28. If the result is zero or less, do not complete the rest of this part or any of Part IX

31

	

32

Enter employer-provided amounts (see instructions)

	

32

33

Divide line 32 by line 27. Enter the result as a decimal (rounded to at least three places), but do not enter more than “1.000”

	

33

X

34

Housing exclusion. Multiply line 31 by line 33. Enter the result but do not enter more than the

amount on line 32. Also, complete Part VIII

	

34

Note: The housing deduction is figured in Part IX. If you choose to claim the foreign earned income exclusion, complete Parts VII and VIII before Part IX.

Part VII

Taxpayers Claiming the Foreign Earned Income Exclusion

$76,000

35

Maximum foreign earned income exclusion

	

35

00

36

• If you completed Part VI, enter the number from line 29.

36

days

•	All others, enter the number of days in your qualifying period that

fall within your 2000 tax year (see the instructions for line 29).

37

• If line 36 and the number of days in your 2000 tax year (usually 366) are the same, enter “1.000.”

•	Otherwise, divide line 36 by the number of days in your 2000 tax year and enter the result

37

X

38

as a decimal (rounded to at least three places). Multiply line 35 by line 37

	

39

Subtract line 34 from line 27

	

40

Foreign earned income exclusion. Enter the smaller of line 38 or line 39. Also, complete Part VIII

Part VIII

Taxpayers Claiming the Housing Exclusion, Foreign Earned Income Exclusion, or Both

41

Add lines 34 and 40

	

Deductions allowed in figuring your adjusted gross income (Form 1040, line 33) that are allocable to the excluded income. See instructions and attach computation

	

Subtract line 42 from line 41. Enter the result here and in parentheses on Form 1040, line 21	
Next to the amount enter “Form 2555.” On Form 1040, subtract this amount from your income

42

43

to arrive at total income on Form 1040, line 22

	

Part IX

Taxpayers Claiming the Housing Deduction—Complete this part only if (a) line 31 is more than line 34 and (b) line 27 is more than line 41.

44

Subtract line 34 from line 31

	

Subtract line 41 from line 27

	

Enter the smaller of line 44 or line 45

	

Note: If line 45 is more than line 46 and you could not deduct all of your 1999 housing deduction

because of the 1999 limit, use the worksheet on page 4 of the instructions to figure the amount to enter on line 47. Otherwise, go to line 48.

Housing deduction carryover from 1999 (from worksheet on page 4 of the instructions)

Housing deduction. Add lines 46 and 47. Enter the total here and on Form 1040 to the left of line 32. Next to the amount on Form 1040, enter “Form 2555.” Add it to the total adjustments

45

46

47

48

reported on that line

Form 2555 (2000)

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