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Form 1116, Foreign Tax Credit

This is a foreign tax credit for an individual, estate, trust, or nonresident alien individual. The form provided here is simply a sample of what the actual Form 1116 looks like.

Form 1116
OMB No. 1545-0121

Department of the Treasury
Internal Revenue Service

Foreign Tax Credit (Individual, Estate, Trust, or Nonresident Alien Individual)
Attach to Form 1040, 1040NR, 1041, or 990-T.

See separate instructions.

Name ________________________________

Identifying number as shown on page 1 of your tax return ________________________________

Use a separate Form 1116 for each category of income listed below. See Categories of Income on page 3 of the instructions. Check only one box on each Form 1116. Report all amounts in U.S. dollars except where specified in Part II below.

a ____ Passive income

b ____ High withholding tax interest

c ____ Financial services income

d ____ Shipping income

e ____ Dividends from a DISC or former DISC

f ____ Certain distributions from a foreign sales corporation (FSC) or former FSC

g ____ Lump-sum distributions

h ____ Section 901(j) income

i ____ Income re-sourced by treaty

j ____ General limitation income

k ____ Resident of (name of country)

Note: If you paid taxes to only one foreign country or U.S. possession, use column A in Part I and line A in Part II. If you paid taxes to more than one foreign country or U.S. possession, use a separate column and line for each country or possession.

Part I Taxable Income or Loss From Sources Outside the United States (for Category Checked Above)

l Enter the name of the foreign country or U.S. possession

1 Gross income from sources within country shown above and of the type checked above. See page 7 of the instructions: ______________________

Foreign Country or U.S. Possession

A ___________________ B ___________________ C ___________________

Total (Add cols. A, B, and C.) 1 ______________________

Deductions and losses (Caution: See pages 7 through 9 of the instructions):

2 Expenses definitely related to the income on line 1 (attach statement)

Foreign Country or U.S. Possession

A ___________________ B ___________________ C ___________________

3 Pro rata share of other deductions not definitely related:

a. Certain itemized deductions or standard deduction. See instructions

Foreign Country or U.S. Possession

A ___________________ B ___________________ C ___________________

b Other deductions (attach statement)

Foreign Country or U.S. Possession

A ___________________ B ___________________ C ___________________

c Add lines 3a and 3b

d Gross foreign source income. See instructions

Foreign Country or U.S. Possession

A ___________________ B ___________________ C ___________________

e Gross income from all sources. See instructions

Foreign Country or U.S. Possession

A ___________________ B ___________________ C ___________________

f Divide line 3d by line 3e. See instructions

g Multiply line 3c by line 3f

4 Pro rata share of interest expense. See instructions:

a Home mortgage interest (use worksheet on page 9 of the instructions)

Foreign Country or U.S. Possession

A ___________________ B ___________________ C ___________________

b Other interest expense

Foreign Country or U.S. Possession

A ___________________ B ___________________ C ___________________

5 Losses from foreign sources

Foreign Country or U.S. Possession

A ___________________ B ___________________ C ___________________

6 Add lines 2, 3g, 4a, 4b, and 5 6 ______________________

Foreign Country or U.S. Possession

A ___________________ B ___________________ C ___________________

7 Subtract line 6 from line 1. Enter the result here and on line 14, page 2 7 ______________________

Part II Foreign Taxes Paid or Accrued (See page 9 of the instructions.)

Credit is claimed for taxes (you must check one)

(m) ____ Paid (n) ____ Accrued

A

(o) Date paid or accrued ______________________

Foreign taxes paid or accrued

In foreign currency

Taxes withheld at source on:

(p) Dividends _______________

(q) Rents and royalties _______________

(r) Interest _______________

(s) Other foreign taxes paid or accrued ______________________

In U.S. dollars

Taxes withheld at source on:

(t) Dividends _______________

(u) Rents and royalties _______________

(v) Interest _______________

(x) Total foreign taxes paid or accrued (add cols. (t) through (w) ______________________

B

(o) Date paid or accrued ______________________

Foreign taxes paid or accrued

In foreign currency

Taxes withheld at source on:

(p) Dividends _______________

(q) Rents and royalties _______________

(r) Interest _______________

(s) Other foreign taxes paid or accrued ______________________

In U.S. dollars

Taxes withheld at source on:

(t) Dividends _______________

(u) Rents and royalties _______________

(v) Interest _______________

(x) Total foreign taxes paid or accrued (add cols. (t) through (w)) ______________________

C

(o) Date paid or accrued ______________________

Foreign taxes paid or accrued

In foreign currency

Taxes withheld at source on:

(p) Dividends _______________

(q) Rents and royalties _______________

(r) Interest _______________

(s) Other foreign taxes paid or accrued ______________________

In U.S. dollars

Taxes withheld at source on:

(t) Dividends _______________

(u) Rents and royalties _______________

(v) Interest _______________

(x) Total foreign taxes paid or accrued (add cols. (t) through (w) ______________________

8 Add lines A through C, column (x). Enter the total here and on line 9, page 2 8 ______________________

For Paperwork Reduction Act Notice, see page 12 of the instructions. Form 1116 (1999)

Part III Figuring the Credit

9 Enter amount from line 8. These are your total foreign taxes paid or accrued for the category of income checked above Part I 9______________________

10 Carryback or carryover (attach detailed computation) 10 ______________________

11 Add lines 9 and 10 11 ______________________

12 Reduction in foreign taxes. See page 10 of the instructions 12 ______________________

13 Subtract line 12 from line 11. This is the total amount of foreign taxes available for credit 13 ______________________

14 Enter amount from line 7. This is your taxable income or (loss) from sources outside the United States (before adjustments) for the category of income checked above Part I. See page 10 of the instructions 14 ______________________

15 Adjustments to line 14. See page 10 of the instructions 15 ______________________

16 Combine the amounts on lines 14 and 15. This is your net foreign source taxable income. (If the result is zero or less, you have no foreign tax credit for the category of income you checked above Part I. Skip lines 17 through 21.) ______________________

17 Individuals: Enter amount from Form 1040, line 37. If you are a nonresident alien, enter amount from Form 1040NR, line 36. Estates and trusts: Enter your taxable income without the deduction for your exemption 17 ______________________

Estates and trusts: Enter amount from Form 1041, Schedule G, line 1c, or Form 990-T, lines 36 and 37

Caution: If you figured your tax using the special rates on capital gains, see page 12 of the instructions.

18 Divide line 16 by line 17. If line 16 is more than line 17, enter "1" 18 ______________________

19 Individuals: Enter amount from Form 1040, line 40, less any amounts on Form 1040, lines 41 through 45, and any mortgage interest credit (from Form 8396) and District of Columbia first-time homebuyer credit (from Form 8859) on line 47. If you are a nonresident alien, enter amount from Form 1040NR, line 39, less any amount on Form 1040NR, lines 40, 41, 42, and any mortgage interest credit (from Form 8396) and District of Columbia first-time homebuyer credit (from Form 8859) on line 44. 19 ______________________

20 Multiply line 19 by line 18 (maximum amount of credit) 20 ______________________

21 Enter the amount from line 13 or line 20, whichever is smaller. If this is the only Form 1116 you are completing, skip lines 22 through 29 and enter this amount on line 30. Otherwise, complete the appropriate line in Part IV. See page 12 of the instructions 21 ______________________

Part IV Summary of Credits From Separate Parts III (See page 12 of the instructions.)

22 Credit for taxes on passive income 22 ______________________

23 Credit for taxes on high withholding tax interest 23 ______________________

24 Credit for taxes on financial services income 24 ______________________

25 Credit for taxes on shipping income 25 ______________________

26 Credit for taxes on dividends from a DISC or former DISC and certain distributions from a FSC or former FSC 26 ______________________

27 Credit for taxes on income re-sourced by treaty 27 ______________________

28 Credit for taxes on lump-sum distributions 28 ______________________

29 Credit for taxes on general limitation income 29 ______________________

30 Add lines 22 through 29 30 ______________________

31 Reduction of credit for international boycott operations. See instructions for line 12 on page 10 31 ______________________

32 Subtract line 31 from line 30. This is your foreign tax credit. Enter here and on Form 1040, line 46; Form 1040NR, line 43; Form 1041, Schedule G, line 2a; or Form 990-T, line 39a 32 ______________________


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