Form 4563 - Exclusion Of Income For Bona Fide Residents Of American Samoa Page 2

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Form 4563 (Rev. 12-98)
Page
Physical presence.
Self-Employed Individuals
Other factors that may be considered are the nature,
If you were self-employed and your net earnings from self-
extent, and reasons for temporary absences; assumption of
employment were $400 or more, you will generally have to
economic burdens and payment of taxes to American
pay self-employment tax on those earnings even though you
Samoa; existence of other homes outside American Samoa;
may exclude them from your gross income. Use Schedule
and place of employment.
SE (Form 1040) to figure any self-employment tax due.
What Income May Be Excluded
Where To File
If you qualify, you may exclude the following:
Mail your return to the Internal Revenue Service Center,
Income received from sources in American Samoa, Guam,
Philadelphia, PA 19255, U.S.A.
and the CNMI, and
Note: If you do not qualify for the exclusion, follow the
Income effectively connected with the conduct of a trade
Instructions for For m 1040. Report all your taxable income,
or business in those possessions.
including income from U.S., foreign, and possession sources.
Mail your retur n to the address shown in the For m 1040
For details on how to determine the source of income, see
instructions.
Pub. 570, Tax Guide for Individuals With Income From U.S.
Possessions.
Paperwork Reduction Act Notice. We ask for the
Employees of the United States
information on this form to carry out the Internal Revenue
laws of the United States. You are required to give us the
You may not exclude amounts paid to you for services you
information. We need it to ensure that you are complying
performed as an employee of the U.S. Government or any of
with these laws and to allow us to figure and collect the right
its agencies. This rule applies to both civilian and military
amount of tax.
employees.
You are not required to provide the information requested
Income You Must Report on Form 1040
on a form that is subject to the Paperwork Reduction Act
unless the form displays a valid OMB control number. Books
You must report on Form 1040 your worldwide income for
or records relating to a form or its instructions must be
the tax year that does not qualify for the exclusion. The
retained as long as their contents may become material in
source of that income does not matter.
the administration of any Internal Revenue law. Generally, tax
returns and return information are confidential, as required by
Deductions and Credits You May Not Take
section 6103.
on Form 1040
The time needed to complete and file this form will vary
If you claim the exclusion, you may not take any deduction
depending on individual circumstances. The estimated
or credit on Form 1040 that is definitely related to the
average time is:
excluded income.
Recordkeeping
33 min.
Deductions and credits that are not definitely related to
Learning about the law or the form
7 min.
any particular type of income must be allocated between
Preparing the form
25 min.
your excludable income and your other income to find the
amount you may take on Form 1040. Examples of
Copying, assembling, and sending
deductions that are not definitely related to any particular
the form to the IRS
17 min.
type of income are:
If you have comments concerning the accuracy of these
The standard deduction, and
time estimates or suggestions for making this form simpler,
we would be happy to hear from you. See the Instructions
Certain itemized deductions such as medical and dental
for Form 1040.
expenses, gifts to charity, and real estate taxes and
mortgage interest on your personal residence.
For more details, including how to figure the amount
allocable to the excluded income, see Pub. 570.
Note: Generally, you may take a deduction for each
exemption you are entitled to claim. This deduction is not
considered allocable to the excluded income.

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