Schedule J 1040 Income Averaging for Farmers and Fishermen

Caution: DRAFT FORM
This is an advance proof copy of an IRS tax form.
It is subject to change and OMB approval before it
is officially released. You can check the scheduled
release date on our web site (www.irs.gov).
If you have any comments on this draft form, you can
submit them to us on our web site. Include the word
DRAFT in your response. You may make comments
anonymously, or you may include your name and
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we receive. However, we will carefully consider
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your comments, please send them to us within 30
days from the date the draft was posted.

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Form

I.R.S. SPECIFICATIONS
TO BE REMOVED BEFORE PRINTING Action
INSTRUCTIONS TO PRINTERS
FORM 8840, PAGE 1 OF 4
O.K. to print
MARGINS; TOP 13mm (1⁄ 2 ”), CENTER SIDES.
PRINTS: HEAD TO HEAD
PAPER: WHITE WRITING, SUB. 20.
INK: BLACK
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Revised proofs
PERFORATE: ON FOLD
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8840

Department of the Treasury
Internal Revenue Service

©

beginning

Part I
1
2
3
4
5
6

f
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0
1
Last name

Address in country of residence

.

Attachment
Sequence No.

101

Your U.S. taxpayer identification number, if any

Address in the United States

Type of U.S. visa (for example, F, J, M, etc.) and date you entered the United States ©
Of what country or countries were you a citizen during the tax year?
What country or countries issued you a passport?
Enter your passport number(s) ©
Enter the number of days you were present in the United States during:
2006
2005
2004
.
During 2006, did you apply for, or take other affirmative steps to apply for, lawful permanent resident
status in the United States or have an application pending to change your status to that of a lawful
permanent resident of the United States (see instructions)?

Part II
7
8

2006

Attach to Form 1040NR or Form 1040NR-EZ.

For the year January 1—December 31, 2006, or other tax year
, 2006, and ending
, 20

General Information

Signature

OMB No. 1545-0074

Closer Connection Exception Statement for Aliens

Your first name and initial

Fill in your
addresses only if
you are filing this
form by itself and
not with your U.S.
tax return

Date

Yes

No

Closer Connection to One Foreign Country

Where was your tax home during 2006?
Enter the name of the foreign country to which you had a closer connection than to the United States during 2006
©

Next, complete Part IV on the back.

Part III

Closer Connection to Two Foreign Countries

9
10

Where was your tax home on January 1, 2006?
After changing your tax home from its location on January 1, 2006, where was your tax home for the remainder of 2006?

11

Did you have a closer connection to each foreign country listed on lines 9 and 10 than to the United
States for the period during which you maintained a tax home in that foreign country?
If “No,” attach an explanation.

Yes

No

Were you subject to tax as a resident under the internal laws of (a) either of the countries listed on lines
9 and 10 during all of 2006 or (b) both of the countries listed on lines 9 and 10 for the period during
which you maintained a tax home in each country?
Have you filed or will you file tax returns for 2006 in the countries listed on lines 9 and 10?
If “Yes” to either line 12 or line 13, attach verification.
If “No” to either line 12 or line 13, please explain ©

Yes
Yes

No
No

12

13

Next, complete Part IV on the back.
For Paperwork Reduction Act Notice, see page 4.

Cat. No. 15829P

Form

8840

(2006)

3
I.R.S. SPECIFICATIONS
TO BE REMOVED BEFORE PRINTING
INSTRUCTIONS TO PRINTERS
FORM 8840, PAGE 2 of 4
MARGINS: TOP 13 mm (1⁄ 2 "), CENTER SIDES. PRINTS: HEAD TO HEAD
PAPER: WHITE WRITING, SUB. 20.
INK: BLACK
FLAT SIZE: 432mm (17") x 279mm (11"); Fold to 216mm (8 1⁄ 2 ") x 279mm (11")
PERFORATE: NONE
DO NOT PRINT — DO NOT PRINT — DO NOT PRINT — DO NOT PRINT

Form 8840 (2006)

Part IV
14
15

Page

f
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0
1

16
17
18

Where was
If you had
explain ©
Where was
Where was
Where was

19

Where were your personal belongings, furniture, etc., located?

your regular or principal permanent home located during 2006 (see instructions)?
more than one permanent home available to you at all times during 2006, list the location of each and
your family located?
your automobile(s) located?
your automobile(s) registered?

20 Where was the bank(s) with which you conducted your routine personal banking activities located?
a
c
b
d
21 Did you conduct business activities in a location other than your tax home?
If “Yes,” where?
22a Where was your driver’s license issued?
b If you hold a second driver’s license, where was it issued?
23
24
25
a
b
c
d
26

Where were you registered to vote?
When completing official documents, forms, etc., what country do you list as your residence?
Have you ever completed:
Form W-8 or Form W-8BEN (relating to foreign status)?
Form W-9, Request for Taxpayer Identification Number and Certification?
Form 1078, Certificate of Alien Claiming Residence in the United States?
Any other U.S. official forms? If “Yes,” indicate the form(s) ©
In what country/countries did you keep your personal, financial, and legal documents?

27

From what country/countries did you derive the majority of your 2006 income?

28

Did you have any income from U.S. sources?
If “Yes,” what type?
In what country/countries were your investments located (see instructions)?

29
30

2

Significant Contacts With Foreign Country or Countries in 2006

Yes

No

Yes
Yes
Yes
Yes

No
No
No
No

Yes

No

Did you qualify for any type of government-sponsored “national” health plan?
Yes
No
If “Yes,” in what country?
If “No,” please explain ©
If you have any other information to substantiate your closer connection to a country other than the United States or you wish
to explain in more detail any of your responses to lines 14 through 30, attach a statement to this form.

Sign here
only if you
are filing
this form by
itself and
not with
your U.S.
tax return

Under penalties of perjury, I declare that I have examined this form and the accompanying attachments, and to the best of my knowledge and
belief, they are true, correct, and complete.

©

Your signature

©

Date
Form

8840

(2006)