Fillable Form 4563 (Rev. October 2009). Exclusion of Income for Bona Fide Residents of American Samoa

Description
Form 4563 (Rev. October 2009) Department of the Treasury Internal Revenue Service Name(s) shown on Form 1040 Exclusion of Income for Bona Fide Residents of American Samoa Attach to Form 1040. See instructions below and on back. OMB No. 1545-0074 Attachment Sequence No. 68 Your social security number Part I 1 General Information Date bona fide residence began , and ended Rented room Rented house or apartment 2 Type...
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