Form 5074 - Allocation Of Individual Income Tax To Guam Or The Commonwealth Of The Northern Mariana Islands (Cnmi) Form - Imternal Revenue Service

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OMB No. 1545-0074
5074
Allocation of Individual Income Tax to Guam or the
2006
Form
Commonwealth of the Northern Mariana Islands (CNMI)
Attachment
Department of the Treasury
Attach to Form 1040.
60
Internal Revenue Service
Sequence No.
Name(s) shown on Form 1040
Your social security number
Part I
Income From Guam or the CNMI Reported on Form 1040
Guam
CNMI
1
1
Wages, salaries, tips, etc.
2
2
Taxable interest
3
3
Ordinary dividends
4
4
Taxable refunds, credits, or offsets of local Guam or CNMI income taxes
5
5
Alimony received
6
6
Business income or (loss)
7
7
Capital gain or (loss)
8
8
Other gains or (losses)
9
9
IRA distributions (taxable amount)
10
10
Pensions and annuities (taxable amount)
11
11
Rental real estate, royalties, partnerships, S corporations, trusts, etc.
12
12
Farm income or (loss)
13
13
Unemployment compensation
14
14
Social security benefits (taxable amount)
15
15
Other income. List type and amount
16
Total income. Add lines 1 through 15
16
Part II
Adjusted Gross Income From Guam or the CNMI Reported on Form 1040
17
17
Archer MSA deduction
18
Certain business expenses of reservists, performing artists, and
18
18
fee-basis government officials
19
19
Health savings account deduction
20
20
Moving expenses
21
21
One-half of self-employment tax
22
22
Self-employed SEP, SIMPLE, and qualified plans
23
23
Self-employed health insurance deduction
24
24
Penalty on early withdrawal of savings
25
25
IRA deduction
26
26
Student loan interest deduction
27
27
Jury duty pay you gave to your employer
28
28
Add lines 17 through 27
29
Adjusted gross income. Subtract line 28 from line 16
29
Part III
Payments of Income Tax to Guam or the CNMI
30
30
Payments on estimated tax return filed with Guam or the CNMI
31
Income tax withheld from your wages while employed by the U.S.
31
Government as a civilian in Guam or the CNMI
32
Income tax withheld from your wages while employed as a member of
32
the U.S. Armed Forces in Guam or the CNMI
33
Income tax withheld from your wages earned in Guam or the CNMI other
than amounts on lines 30 through 32
33
34
Total payments. Add lines 30 through 33
34
Section references are to the Internal Revenue Code unless
Tax Guide for Individuals With Income From U.S. Possessions,
otherwise noted.
for more information.
Instructions
Reminder. If, in tax year 2001 or later, you became or ceased to
be a bona fide resident of a U.S. possession, you may be
What’s new. For tax years ending after January 31, 2006 (or
required to file Form 8898, Statement for Individuals Who Begin
beginning with tax year 2006 if a calendar year taxpayer),
or End Bona Fide Residence in a U.S. Possession. The penalty
changes have been made to the rules for determining if you are
for failure to provide the required information is $1,000. For
a bona fide resident of Guam or the Commonwealth of the
details, see the Instructions for Form 8898.
Northern Mariana Islands (CNMI). See chapter 1 of Pub. 570,
(Continued on back)
5074
For Paperwork Reduction Act Notice, see back of form.
Cat. No. 42243X
Form
(2006)

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