To: All International Assignees
From: International Human Resources
Re: Initial Tax Form
ALL INTERNATIONAL ASSIGNEES : COMPLETE SECTION I
Name: LMP ID:
State of Residency prior to deployment:
Marital Status: Married, Filing Jointly Married, Filing Separate
(please check one) Single Head of Household
Number of Dependents:
TAX EQUALIZED INTERNATIONAL ASSIGNEES ONLY : COMPLETE SECTION II
In order for IHR to ensure accurate calculation of your hypothetical taxes, the following information is needed:
1. Net non-company (personal) income
2. Estimated actual itemized deductions (or indicate standard deduction, if applicable)
3. Estimated actual withholding on non-company income (item #1 above)
4. 401(k) contribution data: pre-tax percentage, or estimated annual dollar amount
With this information, and by utilizing our DAF (Designated Accounting Firm) software, IHR will calculate an initial
hypothetical calculation which is both consistent with company policy and, assuming the information you provide is
accurate, should approximate the final (end-of-year) hypothetical obligation as calculated by our DAF.
IHR can assist in updating your hypothetical tax, if any of the factors above (plus base salary) were to change during the year. You
need to contact IHR as soon as any of these factors changes.
Please use the "2009 Hypothetical Tax Worksheet" below to help construct the information needed.
In return, you will receive a worksheet from IHR, which details your hypothetical tax calculation.
Any questions about your calculation, at the beginning of your assignment and at any time throughout the year, may be
directed to IHR.
Net non-company (personal) income: $ (from worksheet below)
Estimated tax payments on non-company income that you will make in addition to your hypotax:
Federal $ (from worksheet below)
State $ (from worksheet below)
401(k) contribution: % pre-tax, or $ annual amount (2009 maximum contribution is $16,500)
with an additional 5,500 for over age 50
Would you like additional hypothetical taxes (“cushion”) withheld? YES NO
If so, enter amount here: $ weekly monthly annually
ALL INTERNATIONAL ASSIGNEES : COMPLETE SECTION III
Expatriate Signature: Date:
*The Tax Set-up Worksheet is for collecting information from you that IHR needs early on in your relocation process.
Please fill out the Tax Set-up Workshee, scan and return it to IHR electronically (or via fax to 301.947.3982 if need be) within 5 business days.
Please, keep a copy of the completed Tax Set-up Worksheet for your records.
TAX EQUALIZED INTERNATIONAL ASSIGNEES ONLY : COMPLETE SECTION IV
PLEASE NOTE: DO NOT RETURN TO IHR
2010 Hypothetical Tax Worksheet
(Do not return the below section to IHR)
Estimated net non-company income & Withholding tax on non-company income
Income Federal State
Interest & Dividend Income
Capital Gains / Losses
Net Rental Income or Loss
Spousal Income (in the US)
Self Employment Net Income
Partnership Net Income
Other Income / Loss
Report total(s) –only– on above worksheet for net non-company income and estimated tax payments
on non-company income, if applicable.
* includes estimated tax payments, and income taxes withheld
Report total –only– on the above worksheet for estimated itemized deductions, if applicable.
Note: your prior year’s 1040 plus Schedule A are excellent sources for this information.