Form 8840 Closer Connection Exception Statement for Aliens

Form

8840

Department of the Treasury
Internal Revenue Service



beginning

Part I
1
2
3
4
5
6

Last name

Address in country of residence

.

Attachment
Sequence No.

101

Your U.S. taxpayer identification number, if any

Address in the United States

General Information

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:
2009
2008
2007
.
During 2009, 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

2009

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

For the year January 1—December 31, 2009, or other tax year
, 2009, and ending
, 20

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

OMB No. 1545-0074

Closer Connection Exception Statement for Aliens

Yes

No

Closer Connection to One Foreign Country

Where was your tax home during 2009?
Enter the name of the foreign country to which you had a closer connection than to the United States during 2009


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, 2009?
After changing your tax home from its location on January 1, 2009, where was your tax home for the remainder of 2009?

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 2009 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 2009 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

(2009)

Form 8840 (2009)

Part IV
14
15

Page

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 2009 (see instructions)?
more than one permanent home available to you at all times during 2009, 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?

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 or countries did you keep your personal, financial, and legal documents?

27

From what country or countries did you derive the majority of your 2009 income?

28

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

23
24
25

29
30

2

Significant Contacts With Foreign Country or Countries in 2009

Yes

No

Yes
Yes
Yes
Yes

No
No
No
No

Yes

No

Yes
No
Did you qualify for any type of government-sponsored “national” health plan?
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

(2009)

Page

Form 8840 (2009)

General Instructions
Section references are to the U.S.
Internal Revenue Code, unless otherwise
specified.

Purpose of Form
Use Form 8840 to claim the closer
connection to a foreign country(ies)
exception to the substantial presence
test. The exception is described later and
in Regulations section 301.7701(b)-2.
Note: You are not eligible for the closer
connection exception if any of the
following apply.
● You were present in the United States
183 days or more in calendar year 2009.
● You are a lawful permanent resident of
the United States (that is, you are a green
card holder).
● You have applied for, or taken other
affirmative steps to apply for, a green
card; or have an application pending to
change your status to that of a lawful
permanent resident of the United States.
Even if you are not eligible for the
closer connection exception, you may
qualify for nonresident status by reason
of a treaty. See the instructions for line 6
for more details.

Who Must File
If you are an alien individual and you
meet the closer connection exception to
the substantial presence test, you must
file Form 8840 with the IRS to establish
your claim that you are a nonresident of
the United States by reason of that
exception.
For more details on the substantial
presence test and the closer connection
exception, see Pub. 519, U.S. Tax Guide
for Aliens.
Note: You can download forms and
publications from the IRS website at
www.irs.gov.

Substantial Presence Test
You are considered a U.S. resident if you
meet the substantial presence test for
2009. You meet this test if you were
physically present in the United States for
at least:
● 31 days during 2009 and
● 183 days during the period 2009, 2008,
and 2007, counting all the days of
physical presence in 2009 but only 1/3
the number of days of presence in 2008
and only 1/6 the number of days in 2007.
Days of presence in the United States.
Generally, you are treated as being
present in the United States on any day
that you are physically present in the
country at any time during the day.

However, you do not count the following
days of presence in the United States for
purposes of the substantial presence test.
1. Days you regularly commuted to
work in the United States from a
residence in Canada or Mexico.
2. Days you were in the United States
for less than 24 hours when you were
traveling between two places outside the
United States.
3. Days you were temporarily in the
United States as a regular crew member
of a foreign vessel engaged in
transportation between the United States
and a foreign country or a possession of
the United States unless you otherwise
engaged in trade or business on such a
day.
4. Days you were unable to leave the
United States because of a medical
condition or medical problem that arose
while you were in the United States.
5. Days you were an exempt individual.
In general, an exempt individual is a (a)
foreign government-related individual, (b)
teacher or trainee, (c) student, or (d)
professional athlete competing in a
charitable sports event. For more details,
see Pub. 519.
Note: If you qualify to exclude days of
presence in the United States because
you were an exempt individual (other
than a foreign government-related
individual) or because of a medical
condition or medical problem (see item 4
above), you must file Form 8843,
Statement for Exempt Individuals and
Individuals With a Medical Condition.

Closer Connection Exception
Even though you would otherwise meet
the substantial presence test, you will not
be treated as a U.S. resident for 2009 if:
● You were present in the United States
for fewer than 183 days during 2009,
● You establish that during 2009, you
had a tax home in a foreign country, and
● You establish that during 2009, you
had a closer connection to one foreign
country in which you had a tax home
than to the United States, unless you had
a closer connection to two foreign
countries.

Closer Connection to Two Foreign
Countries
You may demonstrate that you have a
closer connection to two foreign
countries (but not more than two) if all
five of the following apply.
1. You maintained a tax home as of
January 1, 2009, in one foreign country.

3

2. You changed your tax home during
2009 to a second foreign country.
3. You continued to maintain your tax
home in the second foreign country for
the rest of 2009.
4. You had a closer connection to each
foreign country than to the United States
for the period during which you
maintained a tax home in that foreign
country.
5. You are subject to tax as a resident
under the tax laws of either foreign
country for all of 2009 or subject to tax as
a resident in both foreign countries for the
period during which you maintained a tax
home in each foreign country.

Tax Home
Your tax home is your main place of
business, employment, or post of duty
regardless of where you maintain your
family home. If you do not have a regular
or main place of business because of the
nature of your work, then your tax home
is the place where you regularly live. If
you do not fit either of these categories,
you are considered an itinerant and your
tax home is wherever you work.

Establishing a Closer Connection
You will be considered to have a closer
connection to a foreign country than to
the United States if you or the IRS
establishes that you have maintained
more significant contacts with the foreign
country than with the United States.
Your answers to the questions in
Part IV will help establish the jurisdiction
to which you have a closer connection.

When and Where To File
If you are filing a 2009 Form 1040NR or
Form 1040NR-EZ, attach Form 8840 to it.
Mail your tax return by the due date
(including extensions) to the address
shown in your tax return instructions.
If you do not have to file a 2009 tax
return, mail Form 8840 to the Department
of the Treasury, Internal Revenue Service
Center, Austin, TX 73301-0215 by the
due date (including extensions) for filing
Form 1040NR or Form 1040NR-EZ.

Page

Form 8840 (2009)

Penalty for Not Filing Form
8840
If you do not timely file Form 8840, you
will not be eligible to claim the closer
connection exception and may be treated
as a U.S. resident.
You will not be penalized if you can
show by clear and convincing evidence
that you took reasonable actions to
become aware of the filing requirements
and significant steps to comply with
those requirements.

Specific Instructions
Line 6
If you checked the “Yes” box on line 6,
do not file Form 8840. You are not
eligible for the closer connection
exception. However, you may qualify for
nonresident status by reason of a treaty.
See Pub. 519 for details. If so, file Form
8833, Treaty-Based Return Position
Disclosure Under Section 6114 or
7701(b), with your Form 1040NR or Form
1040NR-EZ.

Line 14
A “permanent home” is a dwelling unit
(whether owned or rented, and whether a
house, an apartment, or a furnished
room) that is available at all times,
continuously and not solely for short
stays.

Line 29
For stocks and bonds, indicate the
country of origin of the stock company or
debtor. For example, if you own shares of
a U.S. publicly traded corporation, the
investment is considered located in the
United States, even though the shares of
stock are stored in a safe deposit box in a
foreign country.
Paperwork Reduction Act Notice. We
ask for the information on this form to
carry out the Internal Revenue laws of the
United States. Section 7701(b) and its
regulations require that you give us the
information. We need it to determine if you
meet the closer connection exception to
the substantial presence test.

4

You are not required to provide the
information requested on a form that is
subject to the Paperwork Reduction Act
unless the form displays a valid OMB
control number. Books or records
relating to a form or its instructions must
be retained as long as their contents may
become material in the administration of
any Internal Revenue law. Generally, tax
returns and return information are
confidential, as required by section 6103.
The average time and expenses
required to complete and file this form
will vary depending on individual
circumstances. For the estimated
averages, see the instructions for your
income tax return.
If you have suggestions for making this
form simpler, we would be happy to hear
from you. See the instructions for your
income tax return.