Form 4563: Exclusion Of Income For Bona Fide Residents Of American Samoa

A tax form distributed by the Internal Revenue Service (IRS) and used to determine the amount of income earned in American Samoa that can be excluded from a taxpayer's gross income. In order to qualify for this exemption, the taxpayer must be either a resident of American Samoa or conduct business there.

When determining what income can be excluded from taxpayers' claims, the IRS focuses on the source of the income. If a taxpayer earns income from outside and inside American Samoa, all wages, salaries or tips from outside are not included in Form 4563. To be considered for exclusion, income gained from interest has to be from a bank located in American Samoa. Dividend income is considered if it is from a company created or organized in American Samoa.