Form 2555-EZ
Department of the Treasury
Internal Revenue Service
(99)
Foreign Earned Income Exclusion
▶
Attach to Form 1040. Complete the Foreign Earned Income Tax Worksheet in the
Instructions for Form 1040 if you enter an amount on line 18.
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Go to www.irs.gov/Form2555EZ for instructions and the latest information.
OMB No. 1545-0074
2017
Attachment
Sequence No.
34A
Name shown on Form 1040
Your social security number
You May Use
This Form
If You:
• Are a U.S. citizen or a resident alien.
• Earned wages/salaries in a foreign country.
• Had total foreign earned income
of $102,100 or less. See line 17.
• Are filing a calendar year return that covers
a 12-month period.
And You:
• Don't have self-employment income.
• Don't have business/moving expenses.
• Don't claim the foreign housing
exclusion or deduction.
Part I
Tests To See If You Can Take the Foreign Earned Income Exclusion
1 Bona Fide Residence Test
a Were you a bona fide resident of a foreign country or countries for a period that includes an entire tax year
(see instructions)? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes No
• If you answered “Yes,” you meet this test. Fill in line 1b and then go to line 3.
• If you answered “No,” you don't meet this test. Go to line 2 to see if you meet the Physical Presence Test.
b
Enter the date your bona fide residence began
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, and ended (see instructions)
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.
2 Physical Presence Test
a Were you physically present in a foreign country or countries for at least 330 full days during—
{
2017 or
any other period of 12 months in a row starting or ending in 2017?
}
. . . . . . . . . . . . .
Yes No
• If you answered “Yes,” you meet this test. Fill in line 2b and then go to line 3.
• If you answered “No,” you don't meet this test. You can't take the exclusion unless you meet the Bona
Fide Residence Test above.
b
The physical presence test is based on the 12-month period from
▶
through
▶
.
3 Tax Home Test. Was your tax home in a foreign country or countries throughout your period of bona fide
residence or physical presence, whichever applies? . . . . . . . . . . . . . . . . . . .
Yes No
• If you answered “Yes,” you can take the exclusion. Complete Part II below and then go to page 2.
• If you answered “No,” you can't take the exclusion. Don't file this form.
Part II
General Information
4 Your foreign address (including country) 5 Your occupation
6 Employer’s name
7
Employer’s U.S. address (including ZIP code)
8 Employer’s foreign address
9
Employer is (check any that apply):
a
A U.S. business . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
b
A foreign business . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
c
Other (specify)
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10 a
If you previously filed Form 2555 or 2555-EZ, enter the last year you filed the form.
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b
If you didn't previously file Form 2555 or 2555-EZ, check here
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and go to line 11a.
c
Have you ever revoked the foreign earned income exclusion? . . . . . . . . . . . . . . .
Yes No
d
If you answered “Yes,” enter the tax year for which the revocation was effective.
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11a
List your tax home(s) during 2017 and date(s) established.
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b Of what country are you a citizen/national?
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For Paperwork Reduction Act Notice, see the Form 1040 instructions.
Cat. No. 13272W
Form 2555-EZ (2017)
