Form 5074 Allocation of Individual Income Tax To Guam or the Commo

Form

5074

Department of the Treasury
Internal Revenue Service

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

Information about Form 5074 and its instructions is at www.irs.gov/form5074.
▶ Attach to Form 1040.

Wages, salaries, tips, etc. . . . . . . . . . . . . . . . .
Taxable interest . . . . . . . . . . . . . . . . . . .
Ordinary dividends . . . . . . . . . . . . . . . . . .
Taxable refunds, credits, or offsets of local Guam or CNMI income taxes
Alimony received . . . . . . . . . . . . . . . . . . .
Business income or (loss) . . . . . . . . . . . . . . . .
Capital gain or (loss) . . . . . . . . . . . . . . . . . .
Other gains or (losses) . . . . . . . . . . . . . . . . .
IRA distributions (taxable amount) . . . . . . . . . . . . .
Pensions and annuities (taxable amount) . . . . . . . . . . .
Rental real estate, royalties, partnerships, S corporations, trusts, etc. . .
Farm income or (loss) . . . . . . . . . . . . . . . . .
Unemployment compensation . . . . . . . . . . . . . .
Social security benefits (taxable amount) . . . . . . . . . . .
Other income. List type and amount ▶
Total income. Add lines 1 through 15 . . . . . . . . . . . ▶

Part II

CNMI

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Adjusted Gross Income From Guam or the CNMI Reported on Form 1040

17 Educator expenses . . . . . . . . . . . . . . .
18 Certain business expenses of reservists, performing artists, and
government officials . . . . . . . . . . . . . . .
19 Health savings account deduction . . . . . . . . . .
20 Moving expenses . . . . . . . . . . . . . . . .
21 Deductible part of self-employment tax . . . . . . . . .
22 Self-employed SEP, SIMPLE, and qualified plans . . . . .
23 Self-employed health insurance deduction. . . . . . . .
24 Penalty on early withdrawal of savings . . . . . . . . .
25 IRA deduction . . . . . . . . . . . . . . . . .
26 Student loan interest deduction . . . . . . . . . . .
27 Tuition and fees . . . . . . . . . . . . . . . .
28 Add lines 17 through 27 . . . . . . . . . . . . . .
29 Adjusted gross income. Subtract line 28 from line 16 . . . .

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fee-basis
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30 Payments on estimated tax return filed with Guam or the CNMI . . . .
31 Income tax withheld from your wages while employed by the U.S.
Government as a civilian in Guam or the CNMI . . . . . . . . .
32 Income tax withheld from your wages while employed as a member of the
U.S. Armed Forces in Guam or the CNMI . . . . . . . . . . .
33 Income tax withheld from your wages earned in Guam or the CNMI other
than amounts on lines 30 through 32 . . . . . . . . . . . .
34 Total payments. Add lines 30 through 33. . . . . . . . . . ▶

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Part III

Attachment
Sequence No. 168

Income From Guam or the CNMI Reported on Form 1040
Guam

1
2
3
4
5
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16

2012

Your social security number

Name(s) shown on Form 1040

Part I

OMB No. 1545-0074

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28
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Payments of Income Tax to Guam or the CNMI

Section references are to the Internal Revenue Code unless
otherwise noted.

Instructions
Purpose of form. Form 5074 provides information to the United
States so the IRS can figure the individual income tax that is due to
Guam or the CNMI.

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32
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Who must file. If you were a U.S. citizen or resident alien (other
than a bona fide resident of Guam or the CNMI), you may need to
file Form 5074. Complete this form if all of the following apply to you
(and to your spouse if filing a joint return).
• You file a U.S. income tax return.
• You report AGI of $50,000 or more.
• At least $5,000 of the gross income on your return is from either
Guam or CNMI sources.
(Continued on back)

For Paperwork Reduction Act Notice, see Form 1040 instructions.

Cat. No. 42243X

Form 5074 (2012)

Page 2

Form 5074 (2012)

Do not use this form if you were a bona fide resident of
Guam or the CNMI during the entire tax year, or were
considered a bona fide resident of Guam or the CNMI for
CAUTION the entire tax year under the special rules for the year
of a move (see chapter 1 of Pub. 570, Tax Guide for Individuals With
Income From U.S. Possessions).
Joint returns. If you file jointly and only one spouse is a bona fide
resident of Guam or the CNMI for the entire tax year, the resident status
for both spouses and subsequent tax treatment is determined by the
spouse with the higher adjusted gross income (AGI) (disregarding
community property laws). File Form 5074 only if the spouse with the
higher AGI is not a bona fide resident of Guam or the CNMI for the entire
tax year.
Where to file. If you are not enclosing a check or money order, file your
Form 1040 (including Form 5074) with the Department of the Treasury,
Internal Revenue Service Center, Austin, TX 73301-0215 USA.
If you are including a check or money order, file your return with the
Internal Revenue Service, P.O. Box 1303, Charlotte, NC 28201-1303
USA.
Additional information. Pub. 570 has more information and an example
of how to complete Form 5074. To get Pub. 570, see Quick and Easy
Access to Tax Help and Tax Products in the Instructions for Form 1040.

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Part I—Income From Guam or the CNMI
Reported on Form 1040
Source of income. The rules for determining the source of income are
explained in sections 861 through 865 and section 937, Regulations
section 1.937-2, and chapter 2 of Pub. 570. Some general rules are:
• The source of wages, salaries, or tips is generally where the services
are performed. If you worked both in and outside Guam or the CNMI,
include on line 1 only wages, salaries, or tips earned while you were in
Guam or the CNMI. However, certain income earned while temporarily
performing services in Guam or the CNMI will not be considered income
from Guam or the CNMI. For details, see De minimis exception on this
page.
Military spouses. If you are the civilian spouse of a member of the U.
S. Armed Forces, work in Guam or the CNMI, and retain a residence or
domicile in one of the 50 states or the District of Columbia under the
Military Spouses Residency Relief Act (MSRRA), your wages, salaries,
tips, and self-employment income will not be considered income from
Guam or the CNMI. Under MSRRA, the military spouse must be in
Guam or the CNMI solely to be with his/her servicemember spouse who
is serving in compliance with military orders. For details on MSRRA, see
Pub. 570.
• The source of interest income is generally where the payer is located.
For example, Guam or CNMI source income includes interest from a
certificate of deposit issued by a bank or branch of a U.S. bank in Guam
or the CNMI.
• Generally, dividends are sourced where the paying corporation is
created or organized.
• Taxable refunds, credits, or offsets of local Guam or CNMI income
taxes only include nonmirror code income taxes.
• Alimony received from a person who is a bona fide resident of Guam
or the CNMI is sourced in that specific possession.
• Except as provided in regulations, income earned after December 31,
2004, that is from sources within the United States or effectively
connected with the conduct of a trade or business in the United States
is not income from Guam or the CNMI.
• The source of gains, profits, or income from the sale or disposition of
real property (and any interest in real property) is generally where the
real property is located.
Personal property. The source of income from the sale of
nondepreciable personal property is generally the seller's residence. For
example, if you are a bona fide resident of Guam or the CNMI, gain from
the sale or disposition of personal property is generally from sources
within Guam or the CNMI. Income from the sale of inventory is generally
sourced where the title to the property passes. See section 865 for
details.

De minimis exception. This is an exception to the general rule for
determining the source of income earned in Guam or the CNMI.
Generally, income from Guam or the CNMI does not include
compensation for services performed in Guam or the CNMI if during
2012 you:
• Were a U.S. citizen or resident,
• Were not a bona fide resident of Guam or the CNMI,
• Were not employed by or under contract with an individual,
partnership, or corporation that is engaged in a trade or business in
Guam or the CNMI,
• Temporarily performed services in Guam or the CNMI for 90 days or
less, and
• Earned $3,000 or less from such services.
Special rules may apply to bona fide residents of U.S.
possessions who have gain from dispositions of certain
investment property within the 10-year period beginning
CAUTION when they became a bona fide resident. For details, see
Special Rules for Gains From Dispositions of Certain Property, in
chapter 2 of Pub. 570, Regulations section 1.937-2(f)(1), and Examples 1
and 2 of section 1.937-2(k).

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Part II—Adjusted Gross Income From Guam
or the CNMI Reported on Form 1040
Lines 21 through 23. If you had Guam or CNMI source selfemployment income, figure the amount to enter on each line by (1)
dividing your Guam or CNMI source self-employment income by your
total (worldwide) self-employment income and (2) multiplying the total
amount of each deduction that applies to you by the result in (1).
Line 24. Enter the amount of penalty on early withdrawals from savings
accounts in banks or branches of U.S. banks located in Guam or the
CNMI. The Form 1099-INT or Form 1099-OID you received will show the
amount of any penalty you were charged.
Line 25. Enter the total of your and your spouse’s IRA deductions
attributable to Guam or CNMI compensation or earned income. Figure
the amount to report on line 25 by (1) dividing your Guam or CNMI
compensation or earned income by your total (worldwide) compensation
or earned income and (2) multiplying the amount of your IRA deduction
by the result in (1). Figure the amount of your spouse’s IRA deduction
the same way.
Line 28. Include in the total on line 28 the amount of any other
deductions included on Form 1040, line 36, that are attributable to your
Guam or CNMI income. On the dotted line next to line 28, enter the
amount of each deduction attributable to your Guam or CNMI income
and identify it as you did on Form 1040, line 36. If you or your spouse
had an Archer MSA deduction on Form 1040, line 36, figure the amount
to report on line 28 the same way you would an IRA deduction (see Line
25, above).

Penalty for Failure To Furnish Information
If, in tax year 2001 or later, you became or ceased to be a bona fide
resident of a U.S. possession, you may be required to file Form 8898,
Statement for Individuals Who Begin or End Bona Fide Residence in a
U.S. Possession. If you fail to provide the required information, you may
have to pay a $1,000 penalty for each failure unless you can show the
failure was due to reasonable cause and not willful neglect. This penalty
is in addition to any criminal penalty provided by law. For details, see
the Instructions for Form 8898.