Publication 570 - Tax Guide For Individuals With Income From U.s. Possessions - 2003 Page 12
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15Allocation of Individual Income Tax
8689
OMB No. 1545-1032
Form
to the Virgin Islands
2003
Attach to Form 1040.
Attachment
Department of the Treasury
85
Sequence No.
Internal Revenue Service
Your social security number
Name(s) shown on Form 1040
Gerald and Lily Smith
2 2 2 0 0 2 2 2 2
Part I
Income From the Virgin Islands
1
1
Wages, salaries, tips, etc.
500
2
2
Taxable interest
3
3
Ordinary dividends
4
4
Taxable refunds, credits, or offsets of local Virgin Islands 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
6,200
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
Add lines 1 through 15. This is your total income
6,700
16
Part II
Adjusted Gross Income From the Virgin Islands
17
17
Educator expenses
18
18
IRA deduction
19
19
Student loan interest deduction
20
20
Tuition and fees deduction
21
21
Moving expenses
22
22
One-half of self-employment tax
23
23
Self-employed health insurance deduction
24
24
Self-employed SEP, SIMPLE, and qualified plans
25
25
Penalty on early withdrawal of savings
-0-
26
26
Add lines 17 through 25
27
Subtract line 26 from line 16. This is your adjusted gross income
27
6,700
Part III
Allocation of Tax to the Virgin Islands
5,199
28
28
Enter amount from Form 1040, line 60
29
Enter the total of the amounts from Form 1040, lines 55, 56, 63, and 65; any uncollected social security
and Medicare or tier 1 RRTA tax or tax on golden parachute payments included on line 60; and any
29
amount from Form 5329, Parts III, IV, V, VI, or VII, included on line 57
5,199
30
30
Subtract line 29 from line 28
54,901
31
31
Enter amount from Form 1040, line 35
.
122
32
32
Divide line 27 above by line 31. Enter the result as a decimal (rounded to at least 3 places)
634
33
Multiply line 30 by line 32. This is your tax allocated to the Virgin Islands
33
Payments of Income Tax to the Virgin Islands
Part IV
34
34
Income tax withheld by the Virgin Islands
600
35
35
2003 estimated tax payments and amount applied from 2002 return
36
36
Amount paid with Form 4868 (extension request)
600
37
Add lines 34 through 36. These are your total payments
37
Enter the smaller of line 33 or line 37. Also, include this amount in the total on Form 1040, line 68.
38
600
On the dotted line next to line 68, enter "Form 8689" and show this amount.
38
39
If line 37 is more than line 33, subtract line 33 from line 37. This is the amount you overpaid to the
39
Virgin Islands
40
Amount of line 39 you want refunded to you
40
41
Amount of line 39 you want applied to your 2004 estimated tax
41
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If line 33 is more than line 37, subtract line 37 from line 33. This is the amount you owe to the Virgin
Islands. Include the amount on this line that you are paying with your return in the total on Form 1040,
line 68. On the dotted line next to line 68, enter “Form 8689” and the amount paid.
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34
8689
For Paperwork Reduction Act Notice, see back of form.
Form
(2003)
Cat. No. 64603D
Page 12
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