2012 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
UnderPart 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
UnderPart 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
UnderPart 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