Form 14077 - Internal Revenue Service (Irs) Survey Of Individuals Living Abroad Form Page 3

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Section 3: U.S. Tax Forms/Laws
3.
For each U.S. tax form/law listed below, please let us know if you are aware of the form/law, and if so, how well
you understand it and whether it applies to you.
2) If yes, you are aware of it: How
3) If yes, you are
well do you understand it?
aware of it: Does
Not At All
Very well
1) Are you aware of this
this form or law
form or law?
1
2
3
4
5
apply to you?
3A. Report of Foreign Bank
O Yes O No
O Yes ➔
and Financial Accounts
O
O
O
O
O
O No (skip to 3B)
O Not sure
(FBAR)
3B. Foreign Earned Income
O Yes O No
O Yes ➔
O
O
O
O
O
(Form 2555)
O No (skip to 3C)
O Not sure
3C. Foreign Tax Credit
O Yes O No
O Yes ➔
O
O
O
O
O
(Form 1116)
O No (skip to 3D)
O Not sure
3D. Foreign Account Tax
O Yes O No
O Yes ➔
O
O
O
O
O
Compliance (FATCA)
O No (skip to 3E)
O Not sure
3F. Foreign Person’s U.S.
O Yes O No
Source Income Subject to
O Yes ➔
O Not sure
O
O
O
O
O
Withholding
O No (skip to 3F)
(Form 1042-S)
3G. Initial and Annual
O Yes O No
O Yes ➔
Expatriation Statement
O
O
O
O
O
O No (skip to 3G)
O Not sure
(Form 8854)
3H. Streamlined Filing
O Yes O No
O Yes ➔
Procedures effective
O No (skip to section 4)
O Not sure
O
O
O
O
O
September 1, 2012 for
certain U.S. taxpayers
Section 4: U.S. Federal Income Taxes
For this section, please think about filing U.S. federal income taxes while living abroad, whether you have done so before
or not. Please remember that these questions are for research purposes only and your identity will not be linked to your
responses.
4A.
To your knowledge, have you ever had a U.S. federal income tax filing requirement while living abroad (that is,
while living in a U.S. territory or a foreign country?)
Yes
O
No
O
Not sure
O
4B.
Which of the following best describes how you knew about whether or not you had a U.S. federal income tax
filing requirement while living abroad? (Please select all that apply)
I was told whether or not I had a filing requirement
O
I made a logical assumption based on my situation
O
I researched or asked others for advice
O
I found out another way (please specify): –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
O
None of the above
O
14077
3
Form
(Rev. 2-2014) Catalog Number 5329IN
Department of the Treasury - Internal Revenue Service

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