Header
Taxpayer's name and address, an "In reply refer to" box, the tax year and the last four digits of the Social Security number.
9249
Questionnaire - Housing Exclusion
Form 9249, Questionnaire - Housing Exclusion, is an Internal Revenue Service form used in the examination of a tax return. The form says: "To assist us in the examination of your tax return, provide the following requested information and documentation for the tax year shown above." It also says to write "N/A" where a question does not apply.
Its 14 numbered questions cover the dates the taxpayer lived in a foreign country, the foreign address for which expenses are claimed, the type of accommodation, who owned or rented it, what the employer paid or reimbursed, any U.S. Government housing allowance, a second foreign household, an itemized list of housing expenses with proof of payment, employer income earned in another year, moves, and carryover housing costs for the self-employed.
The taxpayer signs a certification under penalty of perjury. You can fill out the PDF free in your browser on this page and download it without an account.

Taxpayer's name and address, an "In reply refer to" box, the tax year and the last four digits of the Social Security number.
Dates lived in a foreign country, the foreign address for which expenses are claimed, and the type of accommodation: house, apartment, mobile home or other.
Own or rent, employer-owned or employer-rented housing, amounts paid by the taxpayer, paid by the employer and reimbursed by the employer, any U.S. Government housing allowance, and a second foreign household.
A table of each kind of housing expense and its amount, with proof of payment attached.
Employer income received in one year but earned in another, any move in the tax year or the year before, the move date, moving deduction and reimbursement, and carryover housing costs for the self-employed.
A remarks space, then the certification under penalty of perjury with the taxpayer's signature and date.
Confirm the header. The form says to write "N/A" for any question that does not apply.
Enter the dates lived in a foreign country for the tax year and the foreign address for which expenses are claimed, then check the type of accommodation and explain Other.
Answer Yes or No about owning or renting, employer-owned or employer-rented housing, employer payments and reimbursements, a U.S. Government housing allowance and a second household. Enter dollar amounts where the form asks.
Itemize each kind of housing expense with its amount and attach proof of payment.
Give amounts and years for employer income tied to another year. For a move, give the date, deduction and reimbursement; if it was not in the year shown, attach Form 2555 for the year of the move. Question 14 asks for the prior year's return and verification for carryover costs.
Add remarks if needed, then sign and date the certification.
You get the real form, filled in a browser tab, with nothing standing between you and the finished PDF.
The form says it is to assist the IRS ("us") in the examination of your tax return. It prints no mailing address.
The form prints no due date.
Proof of payment for the itemized housing expenses, Form 2555, Foreign Earned Income, for a move year other than the year shown, and the preceding year's return and verification for carryover housing costs.
The form says original documentation, if submitted, will be returned at the conclusion of the examination.
2555
160 fields, 3 pages
9212
27 fields, 2 pages
9214
25 fields, 1 page
9210
76 fields, 2 pages
9250
55 fields, 2 pages
9368
49 fields, 1 page
The header holds the taxpayer's name and address, the tax year and the last four digits of the Social Security number.
Questions 1 to 9 ask about the foreign residence for which housing expenses are claimed and who paid for it.
Questions 8, 9, 11 and 12 also cover a spouse's U.S. Government housing allowance and income, and a second foreign household kept for a spouse or dependents due to adverse living conditions.
Question 14 asks a self-employed taxpayer about carryover housing costs from the preceding tax year.
The form has one signature line, for the taxpayer, and no spouse or employer signature line.
The form is addressed to the taxpayer whose return is being examined. The taxpayer completes it and returns it with the documentation it asks for to the IRS, which the form calls "us".
The agency’s own page for Form 9249.
The official blank form, to print or fill by hand.
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An IRS questionnaire about the housing exclusion. The form says it is to assist in the examination of your tax return for the tax year shown at the top.
The form says to write "N/A."
Yes. Questions 5 to 7 ask whether the employer owned or rented the residence, and how much it paid or reimbursed.
If the move was not during the year shown at the top, question 13 asks for a copy of Form 2555, Foreign Earned Income, for the year of the move.
The form says original documentation, if submitted, will be returned at the conclusion of the examination.
The taxpayer. The form has one signature line, under a certification made under penalty of perjury.