OMB No. 15,15-0074 f 0. 2555 Department of the Treasury Internal Revenue Service Foreign Earned Income ► Attach to Form 1040. Complete the Foreign Earned Income Tax Worksheet in the Instructions for Form 1040 if you enter an amount on lines 45 or 50. ► Go to wwwirs.gov/Form2555 for Instructions and the latest information. 2017 Attachment Sequence No. 34 For Use by U.S. Citizens and Resident Aliens Only Name shown on Form 1040 Your social security number Part I General Information 1 Your foreign address (including country) 2 Your occupation 3 Employer's name ► 4a Employer's U.S. address P b Employer's foreign address P 5 Employer is (check a 0 A foreign entity b 0 A U.S. company c 0 Self any that apply): d 0 A foreign affiliate of a U.S. company e 0 Other (specify) P. 8a If you previously filed Form 2555 or Form 2555-EZ, enter the last year you filed the form. ► b If you didn't previously file Form 2555 or 2555-EZ to claim either of the exclusions, check here and go to line 7. c Have you ever revoked either of the exclusions? 0 Yes 0 No d If you answered "Yes," enter the type of exclusion and the tax year for which the revocation was effective. P. 7 Of what country are you a citizen/national? ► 8a Did you maintain a separate foreign residence for your family because of adverse living conditions at your tax home? See Second foreign household in the instructions 0 Yes 0 No b If "Yes," enter city and country of the separate foreign residence. Also, enter the number of days during your tax year that you maintained a second household at that address. ► 9 List your tax home(s) during your tax year and date(s) established. ► Next, complete either Part II or Part Ill. If an item doesn't apply, enter "NA." If you don't give the information asked for, any exclusion or deduction you claim may be disallowed. Part II Taxpayers Qualifying Under Bona Fide Residence Test (see instructions) 10 Date bona fide residence began P.