OMB No. 1545.0074 b 2 a Sam 2555-EZ Department of the Treasury Internal Revenue Servce (99) Name shown on Form 1040 Foreign Earned Income Exclusion P 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. P Go to www.irs.gov/Form2555EZ for instructions and the latest information. 2017 Attachment Sequence No. 34A 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. I Your social security number • Don't have self-employment income. And You • 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)? • If you answered "Yes." you meet this test. Fill in line 1 b 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. Enter the date your bona fide residence began IP. . and ended (see instructions) ► ❑ Yes O No Physical Presence Test Were you physically present in a foreign country or countries for at least 330 full days during — I 2017 or l any other period of 12 months in a row starting or ending in 2017? • 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 P. through ► ❑ Yes 0 No 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? • 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. ❑ Yes O No 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 a A U.S. business b A foreign business c Other (specify) ► 10a If you previously filed Form 2555 or 2555-EZ. enter the last year you filed the form. IP. Employer is (check any that apply): b c Have you ever revoked the foreign earned income exclusion? ❑ Yes ❑ No d If you didn't previously file Form 2555 or 2555-EZ. check here I" O and go to line 11a. If you answered "Yes." enter the tax year for which the revocation was effective. IP. 11a List your tax home(s) during 2017 and date(s) established. ► b Of what country are you a citizen/national? P. For Paperwork Reduction Act Notice, see the Form 1040 instructions. Form 2555-EZ (2017) EFTA01222648 Form 2555•EZ (2017) Page 2 Partlll Days Present in the United States— Complete this part if you were in the United States or its possessions during 2017. 12 (a) Date arrived In U.S. (b) Date left U.S. (e) Number of days In U.S. on business (d) Income earned in U.S. on business (attach computation) Part IV Figure Your Foreign Earned Income Exclusion 13 Maximum foreign earned income exclusion 14 Enter the number of days in your qualifying period that fall within 2017 15 Did you enter 365 on line 14? ❑ Yes. Enter "1.000." ❑ No. Divide line 14 by 365 and enter the result as a decimal (rounded to at least three places). 16 Multiply line 13 by line 15 days 17 Enter, in U.S. dollars. the total foreign earned income you earned and received in 2017 (see instructions). Be sure to include this amount on Form 1040. line 7 Caution: If the amount on line 17 is more than $102,100. don't file this form. You must file Form 2555 instead. 18 Foreign earned income exclusion. Enter the smaller of line 16 or line 17 here and in parentheses on Form 1040, line 21. Next to the amount enter "2555-EZ." On Form 1040, subtract this amount from your income to arrive at total income on Form 1040. line 22 ► 13 i $102,100 00 16 6 17 18 Form 2555-EZ (201a EFTA01222649