Tn reply refer to Form 9209 Department of the Treasury-Internal Revenue Senice (Rev. September 2005, | Bona Fide Residence/Physica! Presence Questionnaire Taxpayer's name and address Tax Year ‘SEN Principal place of employment Please complete this questionnaire, Part! - Bona Fide Residence Test Please furnish the following information to establish whether you would qualify @s a bona fide resident ofa foreign country during the above tax year. IF you need more space, continue on a separate sheet ‘Name of courniry in which you are claiming residence | Date you fret arived in that country. Kind of Visa used Did your Visa contain intaons on ength of siayorermployment?” Yes {-] No L] yes. please exlan Atwhat teres Via renewatle? Foreign employee's name and complete address “Kind of work performed Income eared during tax year Basis of Employriont How long did you originally intend to stay n the foreign county? | Were you under contract inthe foreign country? Did you change this intention? Yes [_] No (_] ‘Was there an option to extend the contract? Yes [] No [] tyes, when, and how ing oid you then intend to stay? IF Yes, please expain and state for how long ‘it you lean ncome tax return wih the goverinent ofthe count inwhich you Gaimed estenee?” Yes] No L] if¥es. please atach a compet copy of he retin to this qvesionnare, No please exlan, Wore you subecio al laws and esrcions govering the zen othe forsgn county? Yes] No] Ito please explain Rado ing aunts Di your Tye win you ood Garg 1 Purchased house 1 cueners tunisned by empayer any prof he tx year? 1 Rentes room 1 Rented house or apartment yes []_ No] tyes, tor wnat period? D otrer expan) Visits to the United States - Please list dates and purpose of tips. ‘ther information - Pleake list any ether information you Believe may help establish your claim o residence in a foreign county. Catalog Number 11841) ‘wwrwis gov Form 9209Part Il - Physical Presence Test Date period of 12 consecutive Please furnish the folowing information to establish whether you would qualiy 2s physically month began present in a foreign county, or countries, for @ minimum of 330 days during 12 consecutive ‘months (covenng atleast part ofthe year under eramination). Attach any evidence of physical presence you have, such as canceled airine tickets, hotel bills, expense or travel vouchers, or 2 diary. You may send copies of these documents. We will return any original documents that you send upon completion ofthe examination, Date period of 12 consecutive ‘months ended ‘Schedule of days present in the foreign, countries, and days present in the United States, during 12 consecutive months Dates and Times of departure from the foreign [country tothe United States after your inital entry to the foreign county, and purpose of tp. Date and Time of Departure from the | Date and Time of Arrival in a foreign United States. country Did you perform any series nintematonal waters oraapace, such as hate ofan ol ler, seaman, or aie pow? Yes] No] ies. pease exoiain Is theses) where the services were performed lecatd under the sovereignty ofa foreign county? Yes [] No [] IN, please explain ‘Were you required to fe a tax etum in his foreign country? Yes [-] No[] _ If Yes, please provide a copy ofthe retum and verifcation of any foreign taxes paid by you, or on your behalf If No, please expiain | am claiming the Foreign Earned Income Exclusion under [bona Fide Residence Test 1 Physica Presence Test Cortification: Under penalties of perury | declare that | have examined this statement and. to the best of my knowledge and belie, itis true, correct, and complete Your signature ‘Spouse's signature, fa joint return was fled Date Catalog Number 11841 ‘wows gov Form 9208In reply refer to Form 9214 Department of the Treasury-intemal Revenue Service (Rev. Septemeer2008)| Foreign Earned Income Exclusion Questionnaire Taxpayers name and adress Tax Year SSN To assist us in the examination of your return, please answer all of the folowing questions. Ifnot applicable, enter "N/A." ‘Dates you led ina foreign county in the year shown above | Foreign county for which expenses are claimed (address) ‘ype of accommodations uch as house, | Did you wn or ent ahora Did you ve quar proved by your finished partment, moble home) ferelgn county? employee? Yes] NoL] Own [J] Rent [] It, Yes, give dates Did your employer pay directly, or reimburse you for any housing expenses? Yes[_] NoL] if Yes, please compete the folowing Amount you paid “Amount paid by your employer ‘Amount your employer reimbursed to you $ 8 8 DDid you or your spouse receive any housing allowance from the U.S. Government? Yes] NoL] WWYes, what amount? $ Dia you maintain a separate household outside the United States for your family ata place other than your tax home because of adverse lving conditions at your tax home? Yes[_] No[] __ Ifyes, please indicate which housing expenses iste below pertain o this household Housing Expenses - Please itemizo all housing expenses and attach proof of payment Kind of Expense: Amount Did either you or your spouse receive income inthe year shown above that was eamed in another year? Yes [_] NoL] Yes, show amount, type and year earned. Did either you or your spouse receive income in another year that was eamedin the year shown above? Yes] NoL] IF Yes, show amount, type and year received Did you move during the above year or the year before? Yes(_] No[_] If Yes, please complete the following: Note: Include amounts your employer paid directly to shippers, aitines, hotels, or anyone else on your behalf Date you moved to a new location ‘Amount of moving expense deduction | Amount you were reimbursed for moving 3 8 It your move was not during the year shown at the top of this questionnaire, attach a copy of Form 2555, Exemption of Income Abroad, for the year you moved Cortification: Under penalties of perury, | declare that | have examined this statement and, to the best of my knowledge and belie, itis true, correct, and complete Your signature Date Catalog Number 11843 ‘wow irs gov Form 8211 (Rev. 9-2005)4. Did the partnership conduct business in the U S.. of receive income ftom US. sources for Yes [] No L] this tax year? If Yes, what was the percentage of the partnership's U.S. income in relation to its worldwide | ———_____ business activity. Partll_Income from A Closely Held Business. Please complete the following questions and submit the requested information on the entity that employs you 4. Do you, a member of you fay. or ny other related party, own ay slack oc havea ve O w O Conbaing hoes etter decoy, weely feu a pomersn, cpraan, ur a), o ensbucively. inthe erty which empys You? If Yes, please provide the following information: a. Name(s) ©. Relationship noise sei ©. Social security number 4d. Number of shares owned Percentage of shares owned {Type ot ares owned Common] Prefered [1] vaing FJ Nonvoting Remarks Certification. Under penalty of perury, | declare that | have examined this statement and, to the best of my knowledge and belie, it is tue, correct, and complete, Your signature ‘Spouse's signature, fa joint return was fled Date ‘Catalog Number 118440 wow rs gov Form 8212 (Rev. -2005)