2015 Form 5074 Allocation of Individual Income Tax to Guam or the Commonwealth of the Northern Mariana Islands (CNMI)

Summary: This is an example of Form 5074 (2011) with these line items completed:

Name(s) shown on Form 1040” field contains Tracy Grey
Your social security number” number field contains 111-00-2222
Under“Part I: Income From Guam or the CNMI Reported on Form 1040”:
6. Business income or (loss)” Guam field contains 20,000
16. Total income. Add lines 1 through 15” Guam field contains 20,000
Under“Part II: Adjusted Gross Income From Guam or the CNMI Reported on Form 1040”:
21. One-half of self-employment tax” Guam field contains 1,413
28. Add lines 17 through 27” Guam field contains 1,413
29. Adjusted gross income. Subtract line 28 from line 16” Guam field contains 18,587
Under“Part III: Payments of Income Tax to Guam or the CNMI”:
30. Payments on estimated tax return filed with Guam or the CNMI” Guam field contains 1,409
34. Total payments. Add lines 30 through 33” Guam field contains 1,409