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Publication 54

Tax Guide for

U.S. Citizens

and

Resident Aliens

Abroad

1.

Filing

Information

2.

Withholding Tax

Form 673

(Rev. December 2007) Department of the Treasury Internal Revenue Service

Statement for Claiming Exemption From Withholding

on Foreign Earned Income Eligible for the Exclusion(s)

Provided by Section 911

OMB No. 1545-0074

The following statement, when completed and furnished by a citizen of th e United States to his or her employer, permits the employer to exclude from income tax withholding all or a part of the wag es paid for services performed outside the United

States.

Name (please print or type) Social security number Part I Qualication Information for Foreign Earned Income Exclusion I expect to qualify for the foreign earned income exclusion under either the bona ?de residence or physical presence test for calendar year or other tax year beginning and ending .

Please check applicable box:

Bona Fide Residence Test

I am a citizen of the United States. I have been a bona ?de resident of and my tax home has been located in (foreign country or countries) for an uninterrupted period which includes an entire tax year that began on (date) , 20 .

I expect to remain a bona ?de resident and retain my tax home in a foreign country (or countries) until the end of the tax year for

which this statement is made. Or, if not that period, from the date of t his statement until (date within tax year) , 20 .

I have not submitted a statement to the authorities of any foreign country named above that I am not a resident of that country.

Or, if I made such a statement, the authorities of that country thereafter made a determination to the effect that I am a resident of

that country.

Based on the facts in my case, I have good reason to believe that for this period of foreign residence I will satisfy the tax home

and the bona ?de foreign resident requirements prescribed by section 911(d)(1)(A) of the Internal Revenue Code and qualify for the

exclusion Code section 911(a) allows.

Physical Presence Test

I am a citizen of the United States. Except for occasional absences that will not disqualify me for the bene?t of section

911(a) of the Internal Revenue Code, I expect to be present in and mai

ntain my tax home in (foreign country or countries) for a 12-month period that includes the entire tax year . Or, if not the entire year, for the part of the tax year beginning on , 20 , and ending on , 20 . Based on the facts in my case, I have good reason to believe that for th is period of presence in a foreign country or countries, I will satisfy the tax home and the 330 full-day requirements within a 12-month period under section 911(d)(1)(B). Part II Estimated Housing Cost Amount for Foreign Housing Exclusion (see instructions)

1 Rent . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1

2 Utilities (other than telephone charges) . . . . . . . . . . . . . . . . . . . .2

3 Real and personal property insurance . . . . . . . . . . . . . . . . . . . .3

4 Occupancy tax not deductible under section 164 . . . . . . . . . . . . . . . . .4

5 Nonrefundable fees paid for securing a leasehold . . . . . . . . . . . . . . . .5

6 Household repairs . . . . . . . . . . . . . . . . . . . . . . . . . . .6

7 Estimated qualied housing expenses. Add lines 1 through 6 . . . . . . . . . . . .7

8 Estimated base housing amount for qualifying period . . . . . . . . . . . . . . .8

9 Subtract line 8 from line 7. This is your estimated housing cost amount

9

Part III Certication

Under penalties of perjury, I declare that I have examined the information on this form and to the best of my knowledge and

belief it is true, correct, and complete. I further certify under penalt ies of perjury that:

• The estimated housing cost amount entered in Part II, plus the amount reported on any other statements outstanding with other

employers, is not more than my total estimated housing cost amount.

• If I become disquali?ed for the exclusions, I will immediately notify my employer and advise what part, if any, of the period for

which I am quali?ed.

I understand that any exemption from income tax withholding permitted by reason of furnishing this statement is not a

determination by the Internal Revenue Service that any amount paid to me for any services performed during the tax year is

excludable from gross income under the provisions of Code section 911(a

Your Signature Date

For Paperwork Reduction Act Notice, see back of form. Cat. No. 10183Y Form 673 (Rev. 12-2007) 3.

Self-Employment

Tax 4.

Foreign Earned

Income and

Housing:

Exclusion -

Deduction

YesNoYesNoYesNo

Yes No

YesYes

NoYes NoNo

Start Here

Figure 4-A.Can I Claim Either Exclusion or the Deduction?

Do you have foreign

earned income?Is your tax home in aforeign country?Are you a U.S. citizen?Are you a U.S. residentalien?

Were you a bona fide

resident of a foreign country or countries for an uninterrupted period that includes an

entire tax year?Are you a citizen ornational of a countrywith which the UnitedStates has an incometax treaty in effect?

You CAN claim the

foreign earned income exclusion and the foreign housing exclusion or the foreign housing deduction.

Were you physically

present in a foreign country or countries for at least 330 full days during any period of 12 consecutive months? You CANNOT claim the foreign earned income exclusion, the foreign housing exclusion, or the foreign housing deduction. *Foreign housing exclusion applies only to employees. Foreign housing ded uction applies only to the self-employed. Figu re 4-B.How To Figure Overlapping 12-Month Periods First

Full 12-Month Period

Second

Full 12-Month Period

* 28-day vacation in the United States Ja "15 This ?gure illustrates Example 2 under How to figure the 12-month period. 5.

Exemptions,

Deductions, and

Credits

6.

Tax Treaty

Benefits

7.

How To Get Tax

Helpquotesdbs_dbs20.pdfusesText_26