Form 1040-C - U.s. Departing Alien Income Tax Return - 2017 Page 3
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Form 1040-C (2017)
Page
Schedule A
Income (see instructions)
(b) Type of income (such as
Nonresident alien income
(c) Amount of U.S.
salary, wages, taxable
(d) Resident alien
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(e) Effectively
(f) Not effectively
(a) Payer of income
income tax paid or
interest, dividends, rents,
income
connected with a U.S.
connected with a U.S.
withheld at source
alimony received, etc.)
trade or business
trade or business
2 Net gain, if any, from Schedule D (Form 1040)
2
3 Net gain, if any, from Schedule B, line 2 .
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4 Totals .
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5 Exempt income. Do not include on line 4 .
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Schedule B
Certain Gains and Losses From Sales or Exchanges by Nonresident Aliens of Property Not
Effectively Connected With a U.S. Trade or Business (see instructions). Include any U.S. income tax
that was paid or withheld on these sales or exchanges on Schedule A, line 3, column (c).
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(a) Description of property
(b) Date acquired
(c) Date sold
(e) Cost or other
(f) Gain or (loss)
(If necessary, attach statement of
(d) Sales price
(mo., day, yr.)
(mo., day, yr.)
basis
subtract (e) from (d)
descriptive details not shown below.)
2 Net gain. Combine the gains and losses entered on line 1, column (f). If the total is greater than zero,
enter this net gain amount on Schedule A, line 3, column (f).
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Schedule C
Itemized Deductions
• If you are a resident alien reporting income on Schedule A, column (d), you may claim the same deductions allowable on
Schedule A (Form 1040).
• If you are a nonresident alien reporting income on Schedule A, column (e), you may claim only deductions that are connected to U.S.
trade or business income and not deducted elsewhere. See Schedule A (Form 1040NR). However, casualty or theft losses and
charitable contributions do not have to be related to U.S. trade or business income. You should file Form 4684, Casualties and
Thefts, to support casualty or theft losses shown below.
• If you are a nonresident alien reporting income on Schedule A, column (f), do not claim any deductions related to that income.
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(a) Type of deduction
(b) Amount
(c) Type of deduction
(d) Amount of
(such as interest, taxes, contributions, etc.)
of deduction
(such as interest, taxes, contributions, etc.)
deduction
2 Total itemized deductions. Add the amounts in columns (b) and (d) of line 1. Enter the total here and
on Schedule D, line 2 or line 10, whichever applies. Exception. If the amount on Form 1040-C, line
17, is over $313,800 ($287,650 if head of household, $261,500 if single, $156,900 if married filing
separately), see the instructions for the amount to enter .
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1040-C
Form
(2017)
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