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Country of Residence
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Afghanistan
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Algeria
American Samoa
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Angola
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Antarctica
Antigua & Barbuda
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Armenia
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Ascension Island
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Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia & Herzegovina
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Bouvet Island
Brazil
British Indian Ocean Territory
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Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Canary Islands
Cape Verde
Caribbean Netherlands
Cayman Islands
Central African Republic
Ceuta & Melilla
Chad
Chile
China
Christmas Island
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Colombia
Comoros
Congo - Brazzaville
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Cook Islands
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Croatia
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Diego Garcia
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Germany
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Gibraltar
Greece
Greenland
Grenada
Guadeloupe
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Guinea-Bissau
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Haiti
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Hungary
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Indonesia
Iran
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Mali
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Slovenia
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Somalia
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South Korea
South Sudan
Spain
Sri Lanka
St. Barthélemy
St. Helena
St. Kitts & Nevis
St. Lucia
St. Martin
St. Pierre & Miquelon
St. Vincent & Grenadines
Sudan
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Svalbard & Jan Mayen
Sweden
Switzerland
Syria
São Tomé & Príncipe
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Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad & Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
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U.S. Outlying Islands
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Ukraine
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United Kingdom
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Vietnam
Wallis & Futuna
Western Sahara
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Zambia
Zimbabwe
Åland Islands
Email ID
Basic Tax Information
Filing Status
Single
Married
Other Description
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Number of Dependents (ages 1-17)
State Tax Return Required
Yes
No
Number of State Tax Returns to be filed
Itemized Deductions
Yes
No
Not Sure
Foreign Earned Income
Primary Taxpayer
Spouse
Dependents
Foreign Taxes Paid
Yes
No
Types of Foreign Income
Salaries and Wages
Self-Employment Income
Interest/Dividend Income
Distributions from Foreign Pension Plans
Rental Properties
Yes
No
Number of Rental properties
Stock Sales during the year
Yes
No
Number of Stock Sale Transactions
10 or less
11-25
26-100
100 or more
# of RSU/ESPP of Stock Sale Transactions
0
1-10
11-25
26-100
100 or more
# Virtual Currency Sales/Conversions/Exchanges
0
1-10
11-25
26-100
100 or more
Ownership in
Foreign Corporation
Foreign Partnership
% of Ownership in Foreign Corporation
% of Ownership in Foreign Partnership
Income from US sources
Yes
No
Income from US Sources
W2 Income
Yes
No
Number of W2s
Interest/Dividend Income
Distributions from Retirement plans, IRAs, etc.
Income from
Sole-Proprietorship
Single-member LLC
1099-MISC
1099-NEC
Other
Rental Properties
Yes
No
Number of Rental properties
Schedule K1s
S Corp
Multi-Member LLC
Partnership
Number of K1s
Stock Sales during the year
Yes
No
Number of Stock Sale Transactions
10 or less
11-25
26-100
100 or more
# of RSU/ESPP of Stock Sale Transactions
0
1-10
11-25
26-100
100 or more
# Virtual Currency Sales/Conversions/Exchanges
0
1-10
11-25
26-100
100 or more
Other Reporting Required
Other Reporting Items
Yes
No
Additional Medicare Taxes
Child Care Expenses
College Tuition Form 1098-T
IRA Contributions
Net Investment Income Tax
Self-Employed Health Insurance
Self-Employed Retirement Contribution
FATCA/FBAR
Foreign Currency Used
Maximum Value in Foreign Currency
Maximum Value of Foreign Financial Assets in Foreign Currency
Maximum Value in USD
Maximum value of foreign financial assets in USD during the year
Number of Accounts to be Reported
1-7
8-15
16-25
26 or more
Would you like us to prepare FBAR
Yes
No
Additional Reporting Required
Yes
No
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