Foreign Earned Income

2005 Foreign Earned Income

Your Email Address (required)... Taxpayer Name
Taxpayer Social Security No.

Part I - General Information
1 Your foreign address (including country)
2 Your occupation

Employer's Name

Employer's US Address

4b Employer's Foreign
Address

Employer is (check

a A foreign entity

b A US company c Self

any that apply)

d A foreign affiliate of a
US company

e Other (specify)

If after 1981, you filed Form 2555 to claim either of the exclusions or Form 2555-EZ to claim the foreign earned income exclusion, enter the last year you filed the form

If you did not file Form 2555 or 2555-EZ after 1981 to claim either of the exclusions check here and go to Line 7 now.

Have you ever revoked either of the exclusions?

Yes No

If you answered "Yes", enter the type of exclusion and the tax year for which it was effective.

Of what country are you a citizen/national?

Did you maintain a foreign residence for your family because of adverse living conditions at your tax home?
See Second Foreign household in the instructions

Yes No

If "Yes" enter city and country of the foreign residence. Also, enter the number of days during your tax year that you maintained a residence at that address.

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

Part II - Taxpayers qualifying under Bona Fide Residence Test

Date bona fide residence began

, and ended

Kind of residence in
foreign country

a Purchased house

b Rented house
or apartment

c Rented room

d Quarters furnished by employer

12a

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

Yes No

If "Yes", who and for what period

13a

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?

Yes No

Are you required to pay income tax to the country where you claim bona fide residence?

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.

If you were present in the US 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 US	(b) Date left US	(c) No days in US on business	(d) Income earned in US on business (explain below)

15a

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

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

Did your visa limit the length of your stay or employment in a foreign country?
If "Yes" enter explanation below. (Line 49)

Yes No

Did you maintain a home in the US while living abroad?

Yes No

If "Yes", enter:

Address of your home	Whether it was rented	Names of the occupants	Their relationship to you
	Yes No

Part III - Taxpayers Qualifying Under Physical Presence Test

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

through

Enter you principal country of employment during your tax year

If you traveled abroad during the 12-month period entered on line 16, complete (a)-(f) below. Exclude travel between between foreign countries that did not involve travel over international waters, or in or over the US, 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 US)	(b) Date arrived	(c) Date left	(d) Full days present in country	(e) No of days in US on Business	(f) Income earned in US on business (attach details below)

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 2005 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 US 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 2005, no matter when you performed the service.

2005 Foreign Earned Income

Amount
(in US dollars)

Total wages, salaries, bonuses, commissions, etc.

Allowable share of income for personal services performed

In a business (including farming) or profession

In a partnership (List partnership's name and address and type of income

Noncash income (market value of property or facilities furnished by employer-provide details below showing how it was determined):

Home (lodging)

Meals

Car

Other property or facilities. List type and amount

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 & amount

foreign earned income. List type & amount

Total amount of meals and lodging that is excludable

Are you claiming the housing exclusion or housing deduction?

Yes No

Part VI - Taxpayers Claiming the Housing Exclusion AND/OR Deduction

Qualified housing expenses for the tax year

Number of days in your qualifying period that fall within your 2005 tax year days

Enter employer provided amounts

Part VII - Taxpayers claiming the Foreign Earned Income Exclusion

Number of days in your qualifying period that fall within your 2005 tax year days (same as line 29)

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

Housing deduction carryover from 2004