Fillable Printable 2012 Form 2555
Fillable Printable 2012 Form 2555
2012 Form 2555
Form 2555
Department of the Treasury
Internal Revenue Service
Foreign Earned Income
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Attach to Form 1040.
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Information about Form 2555 and its separate instructions is at www.irs.gov/form2555.
OMB No. 1545-0074
2012
Attachment
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
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4 a
Employer’s U.S. address
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b
Employer’s foreign address
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5
Employer is (check
any that apply):
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a A foreign entity b A U.S. company c Self
d
A foreign affiliate of a U.S. company e Other (specify)
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6 a
If you previously filed Form 2555 or Form 2555-EZ, enter the last year you filed the form.
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b
If you did not previously file Form 2555 or 2555-EZ to claim either of the exclusions, check here
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and go to line 7.
c Have you ever revoked either of the exclusions? . . . . . . . . . . . . . . . . . . . .
Yes No
d
If you answered “Yes,” enter the type of exclusion and the tax year for which the revocation was effective.
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7
Of what country are you a citizen/national?
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8
a
Did you maintain a separate foreign residence for your family because of adverse living conditions at your
tax home? See Second foreign household in 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.
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9
List your tax home(s) during your tax year and date(s) established.
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Next, complete either Part II or Part III. If an item does not apply, enter “NA.” If you do not give
the information asked for, any exclusion or deduction you claim may be disallowed.
Part II
Taxpayers Qualifying Under Bona Fide Residence Test (see instructions)
10
Date bona fide residence began
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, and ended
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11 Kind of living quarters in foreign country
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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 part of the tax year? . . . . . . . . . . .
Yes No
b
If “Yes,” who and for what period?
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13
a
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.
(c) Number of
days in U.S.
on business
(d) Income earned in
U.S. on business
(attach computation)
(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)
15a
List any contractual terms or other conditions relating to the length of your employment abroad.
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b
Enter the type of visa under which you entered the foreign country.
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c Did your visa limit the length of your stay or employment in a foreign country? If “Yes,” attach explanation .
Yes No
d Did you maintain a home in the United States while living abroad? . . . . . . . . . . . . . .
Yes No
e
If “Yes,” enter address of your home, whether it was rented, the names of the occupants, and their relationship
to you.
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For Paperwork Reduction Act Notice, see the Form 1040 instructions.
Cat. No. 11900P
Form 2555 (2012)
Form 2555 (2012)
Page 2
Part III
Taxpayers Qualifying Under Physical Presence Test (see instructions)
16
The physical presence test is based on the 12-month period from
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through
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17
Enter your principal country of employment during your tax year.
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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
(d) Full days
present in
country
(e) Number of
days in U.S.
on business
(f) Income earned in U.S.
on business (attach
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 2012 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 2012, no matter when you performed
the service.
2012 Foreign Earned Income
Amount
(in U.S. dollars)
19 Total wages, salaries, bonuses, commissions, etc. . . . . . . . . . . . . . . . 19
20 Allowable share of income for personal services performed (see instructions):
a In a business (including farming) or profession . . . . . . . . . . . . . . . . .
20a
b
In a partnership. List partnership’s name and address and type of income.
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20b
21
Noncash income (market value of property or facilities furnished by employer—attach statement
showing how it was determined):
a Home (lodging) . . . . . . . . . . . . . . . . . . . . . . . . . . . 21a
b Meals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21b
c Car . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21c
d
Other property or facilities. List type and amount.
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21d
22 Allowances, reimbursements, or expenses paid on your behalf for services you performed:
a Cost of living and overseas differential . . . . . . . . .
22a
b Family . . . . . . . . . . . . . . . . . . . . 22b
c Education . . . . . . . . . . . . . . . . . . . 22c
d Home leave . . . . . . . . . . . . . . . . . . 22d
e Quarters . . . . . . . . . . . . . . . . . . . 22e
f
For any other purpose. List type and amount.
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22f
g Add lines 22a through 22f . . . . . . . . . . . . . . . . . . . . . . . 22g
23
Other foreign earned income. List type and amount.
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23
24 Add lines 19 through 21d, line 22g, and line 23 . . . . . . . . . . . . . . . . 24
25 Total amount of meals and lodging included on line 24 that is excludable (see instructions) . .
25
26
Subtract line 25 from line 24. Enter the result here and on line 27 on page 3. This is your 2012
foreign earned income
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26
Form 2555 (2012)
Form 2555 (2012)
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) . . . . . . . . . . . . 28
29a
Enter location where housing expenses incurred (see instructions)
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b Enter limit on housing expenses (see instructions) . . . . . . . . . . . . . . . 29b
30 Enter the smaller of line 28 or line 29b . . . . . . . . . . . . . . . . . . . 30
31
Number of days in your qualifying period that fall within your 2012 tax
year (see instructions) . . . . . . . . . . . . . . . .
31 days
32
Multiply $41.57 by the number of days on line 31. If 366 is entered on line 31, enter $15,216.00 here
32
33
Subtract line 32 from line 30. If the result is zero or less, do not complete the rest of this part or
any of Part IX . . . . . . . . . . . . . . . . . . . . . . . . . . .
33
34 Enter employer-provided amounts (see instructions) . . . . . . 34
35
Divide line 34 by line 27. Enter the result as a decimal (rounded to at least three places), but do
not enter more than “1.000” . . . . . . . . . . . . . . . . . . . . . . .
35
×
.
36
Housing exclusion. Multiply line 33 by line 35. Enter the result but do not enter more than the
amount on line 34. Also, complete Part VIII . . . . . . . . . . . . . . . . .
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36
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
37 Maximum foreign earned income exclusion . . . . . . . . . . . . . . . . . . . . . 37
38 • If you completed Part VI, enter the number from line 31.
• All others, enter the number of days in your qualifying period that
fall within your 2012 tax year (see the instructions for line 31).
}
38 days
39 •
If line 38 and the number of days in your 2012 tax year (usually 366) are the same, enter “1.000.”
• Otherwise, divide line 38 by the number of days in your 2012 tax year and enter the result as
a decimal (rounded to at least three places).
}
39
×
.
40 Multiply line 37 by line 39 . . . . . . . . . . . . . . . . . . . . . . .
40
41 Subtract line 36 from line 27 . . . . . . . . . . . . . . . . . . . . . . 41
42
Foreign earned income exclusion. Enter the smaller of line 40 or line 41. Also, complete Part VIII
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42
Part VIII
Taxpayers Claiming the Housing Exclusion, Foreign Earned Income Exclusion, or Both
43 Add lines 36 and 42 . . . . . . . . . . . . . . . . . . . . . . . . . 43
44
Deductions allowed in figuring your adjusted g
ross income (Form 1040, line 37) that are
allocable
to the excluded income. See instructions and attach computation . . . . . . . . . .
44
45
Subtract line 44 from line 43. 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
to arrive at total income on Form 1040, line 22 . . . . . . . . . . . . . . . .
45
Part IX
Taxpayers Claiming the Housing Deduction—Complete this part only if (a) line 33 is more than line 36 and
(b) line 27 is more than line 43.
46 Subtract line 36 from line 33 . . . . . . . . . . . . . . . . . . . . . . 46
47 Subtract line 43 from line 27 . . . . . . . . . . . . . . . . . . . . . . 47
48 Enter the smaller of line 46 or line 47 . . . . . . . . . . . . . . . . . . . 48
Note: If line 47 is more than line 48 and you could not deduct all of your 2011 housing
deduction
because of the 2011 limit, use the housing deduction carryover worksheet in the instructions to
figure the amount to enter on line 49. Otherwise, go to line 50.
49
Housing deduction carryover from 2011 (from housing deduction carryover worksheet in the
instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
49
50
Housing deduction. Add lines 48 and 49. Enter the total here and on Form 1040 to the left of
line 36. Next to the amount on Form 1040, enter “Form 2555.” Add it to the total adjustments
reported on that line
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50
Form 2555 (2012)
$95,100
00
