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

• Legal Form Number: 5074
• Year: 2023
• Issuer: Treasury Department
• Section: Treasury Department

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)

Attach to Form 1040 or 1040-SR.

Go to www.irs.gov/Form5074 for the latest information.

OMB No. 1545-0074

2023

Attachment

Sequence No. 168

Name(s) shown on Form 1040 or 1040-SR Your social security number

Part I Income From Guam or the CNMI

Guam CNMI

1 Wages, salaries, tips, etc. . . . . . . . . . . . . . . . . . . . . 1

2 Taxable interest ....................... 2

3 Ordinary dividends ...................... 3

4 Taxable refunds, credits, or offsets of local Guam or CNMI income taxes . . . . 4

5 Alimony received ....................... 5

6 Business income or (loss) . . . . . . . . . . . . . . . . . . . . 6

7 Capital gain or (loss) . . . . . . . . . . . . . . . . . . . . . . 7

8 Other gains or (losses) . . . . . . . . . . . . . . . . . . . . . 8

9 IRA distributions (taxable amount) . . . . . . . . . . . . . . . . . 9

10 Pensions and annuities (taxable amount) . . . . . . . . . . . . . . . 10

11 Rental real estate, royalties, partnerships, S corporations, trusts, etc. . . . . . . 11

12 Farm income or (loss) . . . . . . . . . . . . . . . . . . . . . 12

13 Unemployment compensation . . . . . . . . . . . . . . . . . . 13

14 Social security benefits (taxable amount) . . . . . . . . . . . . . . . 14

15 Other income. List type and amount 15

16 Total income. Add lines 1 through 15 . . . . . . . . . . . . . . . . 16

Part II Adjustments to Income From Guam or the CNMI

17 Educator expenses ...................... 17

18 Certain business expenses of reservists, performing artists, and fee-basis government

officials .......................... 18

19 Health savings account deduction . . . . . . . . . . . . . . . . . 19

20 Moving expenses for members of the armed forces . . . . . . . . . . . 20

21 Deductible part of self-employment tax . . . . . . . . . . . . . . . 21

22 Self-employed SEP, SIMPLE, and qualified plans . . . . . . . . . . . . 22

23 Self-employed health insurance deduction . . . . . . . . . . . . . . 23

24 Penalty on early withdrawal of savings . . . . . . . . . . . . . . . . 24

25 IRA deduction ........................ 25

26 Student loan interest deduction . . . . . . . . . . . . . . . . . . 26

27 Reserved for future use . . . . . . . . . . . . . . . . . . . . . 27

28 Reserved for future use . . . . . . . . . . . . . . . . . . . . . 28

29 Add lines 17 through 28 . . . . . . . . . . . . . . . . . . . . 29

30 Adjusted gross income. Subtract line 29 from line 16 . . . . . . . . . . 30

Part III Payments of Income Tax to Guam or the CNMI

31 Payments on estimated tax return filed with Guam or the CNMI . . . . . . . 31

32 Income tax withheld from your wages while employed by the U.S. Government as a

civilian in Guam or the CNMI . . . . . . . . . . . . . . . . . . . 32

33

Income tax withheld from your wages while employed as a member of the U.S. Armed

Forces in Guam or the CNMI . . . . . . . . . . . . . . . . . . .

33

34 Income tax withheld from your wages earned in Guam or the CNMI other than

amounts on lines 31 through 33 . . . . . . . . . . . . . . . . . . 34

35 Total payments. Add lines 31 through 34 . . . . . . . . . . . . . . . 35

For Paperwork Reduction Act Notice, see the Instructions for Form 1040. Cat. No. 42243X Form 5074 (2023)