Form 2555 Foreign Earned Income 20087

Summary: This is an example of Form 2555 (2006) as pertains to the text. The line items are completed as follows:

“Name shown on Form 1040” field contains James M. Adams

“Your social security number” field contains 111-00-1111

Under“Part I: General Information”:

“1. Your foreign address (including country)” field contains 10 Wadi Abu Hassan, City A, Country X “2. Your occupation” field contains Engineer “3. Employer's name” field contains Pan American Oil Company “4a. Employer's United States address” field contains Not Applicable “4b. Employer's foreign address” field contains 65 Sheik Hussein Street, City A, Country X “5. Employer is (check any that apply): a. A foreign entity” checkbox checked “6a. 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 year you filed the form.” field contains 2005 “6c. Have you ever revoked either of the exclusions? No” checkbox checked “7. Of what country are you a citizen/national?” field contains United States “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” checkbox checked “8b. 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.” field contains Paris, France 366 days “9. List your tax home(s) during your tax year and date(s) established.” field contains City A, Country X 6-9-98