Publication 54: Tax Guide for U.S. Citizens and Resident Aliens Abroad;

This is archived information that pertains only to the 2004 Tax Year. If you
are looking for information for the current tax year, go to the Tax Prep Help Area.

Form 2555-EZ Foreign Earned Income Exclusion 2004. Summary: This is an example of Form 2555-EZ (2004) with items included as described in the text. Additionally, the following line items are completed:

“Name shown on Form 1040” field contains Judith E. Adams

“Your social security number” field contains 222-00-2222

Under “Part I: Tests To See If You Can Take the Foreign Earned Income Exclusion”:

1. Bona Fide Residence Test

“a. Were you a bona fide resident of a foreign country or countries for a period that includes an entire tax year (see page 2 of the instructions)? No” checkbox checked

2. Physical Presence Test

“a. Were you physically present in a foreign country or countries for at least 330 full days during 2004 or any other period of 12 months in a row starting or ending in 2004? Yes” checkbox checked

“b. The physical presence test is based on the 12-month period from” field contains 1-1-04 through 12-31-04

“3. Tax Home Test. Was your tax home in a foreign country or countries throughout your period of bona fide residence or physical presence, whichever applies? Yes” checkbox checked

Under “Part II: General Information”:

“4. Your foreign address (including country)” field contains

21 Rue Reynaud

Country Y

“5. Your occupation” field contains Secretary

“6. Employer's name” field contains A B Insurance Company, Incorporated

“7. Employer's United States address (including ZIP code)” field contains

2645 Pewter Place

Anytown, Anystate, United States of America

“8. Employer's foreign address” field contains

40 Rue Royale

Country Y

“9. Employer is (check any that apply): a. A United States business” checkbox checked

“10a. If you filed Form 2555 or 2555-EZ after 1981, enter the last year you filed the form.” field contains 2003

“10c. Have you ever revoked the foreign earned income exclusion? No” checkbox checked

“11a. List your tax home(s) during 2004 and date(s) established.” field contains Country Y 6-1-98

“11b. Of what country are you a citizen/national?” field contains United States

Under “Part IV: Figure Your Foreign Earned Income Exclusion”:

“14. Enter the number of days in your qualifying period that fall within 2004” field contains 366 days

“15. Did you enter 366 on line 14? Yes” checkbox checked “Enter 1.000” field contains 1.000

“16. Multiply line 13 by line 15” field contains 80,000