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efta-efta01222819DOJ Data Set 9OtherForm 8689
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DOJ Data Set 9
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efta-efta01222819
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Form 8689
Department
0' IN? Treasury
Internal Revenue Service
Allocation of Individual Income Tax
to the U.S. Virgin Islands
► Attach to Form 1040.
► Go to www.ks.govIForm8689 for the latest information.
OMB No. 1545-0074
2017
Attachment
Sequence No. 85
Name(s) shown on Form 1040
Your social security number
Part I
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
Income From the U.S. Virgin Islands (USVI)
Wages, salaries, tips, etc.
1
Taxable interest
2
Ordinary dividends
3
Taxable refunds, credits, or offsets of local USVI income taxes
4
Alimony received
5
Business income or (loss)
6
Capital gain or (loss)
7
Other gains or (losses)
8
IRA distributions (taxable amount)
9
Pensions and annuities (taxable amount)
10
Rental real estate, royalties, partnerships, S corporations, trusts, etc
11
Farm income or (loss)
12
Unemployment compensation
13
Social security benefits (taxable amount)
14
Other income. List type and amount ►
15
Add lines 1 through 15. This is your total USVI income
.
►
18
Adjusted Gross Income From the USVI
17
Educator expenses
17
18
Certain business expenses of reservists, performing artists, and
fee-basis 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 deduction
27
28
Add lines 17 through 27
29
Subtract line 28 from line 16. This is your USVI adjusted gross income
►
nil
Allocation of Tax to the USVI
18
19
20
21
22
23
24
25
26
30
Enter amount from Form 1040, line 63
31
Enter the total of the amounts ham Form 1040. lines 57, 58. 60a, 66a. 67, 68, 73 (boxes c and 4. Include any uncollected social
security and Medicare or tier 1 RATA tax, tax on excess golden parachute payments, or excise tax an insider stock cornpensation
reported on line U. Also include any amount from Form 5329. Parts III, IV, V. VI. VII, VIII, a IX reported on Form 1040, line 59 .
32
Subtract line 31 from line 30
33
Enter amount from Form 1040, line 38
I 33 I
34
Divide line 29 above by Me 33. Enter the result as a decimal (rounded to at least 3 places). Do not enter mae than 1.000
35
Multiply line 32 by line 34. This is your tax allocated to the USVI
Part IV
36
Income tax withheld by the USVI
37
2017 estimated tax payments and amount applied from 2016 return
38
Amount paid with Form 4868 (extension request)
39
Add lines 36 through 38. These are your total payments to the USVI
►
40
Enter the smaller of line 35 or line 39. Include this amount in the total on Form 1040, line 74 On
the dotted line next to line 74, enter "Form 8689" and show this amount
Payments of Income Tax to the USVI
37
38
28
29
30
31
32
34
35
x
40
41
Overpayment to the USVI. If line 39 is more than line 35. subtract line 35 from line 39
42
Amount of line 41 you want refunded to you
►
43
Amount of line 41 you want applied to your 2018 estimated tax
. . 143 I
44
Amount you owe to the USVI. If line 39 is less than line 35, subtract line 39 from line 35 . . . .
45
Enter the amount from fine 44 that you will pay when you file your income tax retum. Include this amount in
the total of Forrn 1040. line 74. On the dotted line next to line 74. enter Worm 8689" and show this amount
41
42
44
45
For Paperwork Reduction Act Notice, see the Form 1040 Instructions.
Form 8689 (2017)
36
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