Form 8891

Department of the Treasury

U.S. Information Return for Beneficiaries of

Certain Canadian Registered Retirement Plans

© Attach to Form 1040. © See instructions on back of form.

OMB No. 1545-0074

Attachment

Sequence No. 139

Name shown on Form 1040 Identifying number (see instructions)

1 2

3 4

5

6a

b

c

7a

8

9

10

a

b

c

d

e

7b

10a

10b

10c

10d

10e

Name of plan custodian Account number of plan

Address of plan custodian Type of plan (check one box):

Registered Retirement Savings Plan (RRSP)

Registered Retirement Income Fund (RRIF)

Check the applicable box for your status in the plan (see Definitions in the instructions):

Beneficiary

Annuitant (Complete only lines 7a, 7b, and 8.)

Have you previously made an election under Article XVIII(7) of the U.S.-Canada income tax treaty to

defer U.S. income tax on the undistributed earnings of the plan? ©

If “Yes,” enter the first year the election came into effect and go to line 7a. If “No,” go to line 6c.

If you have not previously made the election described on line 6a above, you can make an irrevocable

election for this year and subsequent years by checking this box ©

Distributions received from the plan during the year. Enter here and include on Form 1040,

line 16a 

Taxable distributions received from the plan during the year. Enter here and include on

Form 1040, line 16b 

Plan balance at the end of the year. If you checked the “Annuitant” box on line 5, the “Yes” box 

on line 6a, or the box on line 6c, stop here. Do not complete the rest of the form 

Contributions to the plan during the year 

Undistributed earnings of the plan during the year:

Interest income. Enter here and include on Form 1040, line 8a 

Qualified dividends. Enter here and include on Form 1040, line 9b 

Capital gains. Enter here and include on Form 1040, line 13 

Other income. Enter here and include on Form 1040, line 21. List type and amount ©

For Paperwork Reduction Act Notice, see page 2. Cat. No. 37699X Form 8891 (Rev. 7-2008)

Yes No

b Total ordinary dividends. Enter here and include on Form 1040, line 9a 

7a

8

9

Internal Revenue Service

(Rev. July 2008)
Form 8891 (Rev. 7-2008) Page 2

General Instructions

Purpose of Form

Who Must File

Definitions

Form 8891 is used by U.S. citizens or residents (a) to report

contributions to Canadian registered retirement savings plans

(RRSPs) and registered retirement income funds (RRIFs), (b)

to report undistributed earnings in RRSPs and RRIFs, and (c)

to report distributions received from RRSPs and RRIFs. See

Notice 2003-75, which is available at www.irs.gov.

Form 8891 must be completed and attached to Form 1040

by any U.S. citizen or resident who is a beneficiary of an

RRSP or RRIF. A U.S. citizen or resident who is an annuitant

of an RRSP or RRIF must file the form for any year in which

he or she receives a distribution from the RRSP or RRIF.

Beneficiary. A beneficiary of an RRSP or RRIF is an

individual who is subject to current U.S. income taxation on

income accrued in the RRSP or RRIF or would be subject to

current income taxation had the individual not made the

election under Article XVIII(7) of the U.S.-Canada income tax

treaty to defer U.S. income taxation of income accrued in the

RRSP or RRIF.

Paperwork Reduction Act Notice

We ask for the information on this form to carry out the

Internal Revenue laws of the United States. You are required

to give us the information. We need it to ensure that you are

complying with these laws and to allow us to figure and

collect the right amount of tax.

A separate Form 8891 must be filed for each RRSP or

RRIF for which there is a filing requirement. If you and your

spouse both must file Form 8891, you each must file a

separate Form 8891.

Record Retention

Taxpayers must retain supporting documentation relating to

the information reported on Form 8891, including Canadian

forms T4RSP, T4RIF, or NR4, and periodic or annual

statements issued by the custodian of the RRSP or RRIF.

Other Reporting Requirements

Pursuant to section 6048(d)(4), annuitants and beneficiaries

who are required to file Form 8891 will not be required to file

Form 3520 and will not be subject to the associated

penalties described in section 6677 on such RRSPs or

RRIFs.

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

Internal Revenue Code 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.

Annuitant. For purposes of this form, an annuitant of an

RRSP or RRIF is an individual who is designated pursuant to

the RRSP or RRIF as an annuitant and is not also a

beneficiary as defined above.

Specific Instructions

Identifying number

Enter your U.S. social security number (SSN) or individual

taxpayer identification number (ITIN). Do not enter a

Canadian identifying number.

Line 7(b)

For information on figuring taxable distributions, see section

72 and Pub. 939, General Rule for Pensions and Annuities.

Section references are to the Internal Revenue Code.

Form 8891 also can be used to make an election pursuant

to Article XVIII(7) of the U.S.-Canada income tax treaty to

defer U.S. income tax on income earned by an RRSP or an

RRIF that has been accrued, but not distributed. Taxpayers

who have not previously made the election can make it on

this form by checking the box on line 6c.

Name

Even if you are filing a joint Form 1040 with your spouse,

enter only your name.

Beneficiaries

A beneficiary who previously made the election to defer

income on the plan or is making it initially by checking the

box on line 6c must only complete lines 1 through 8 of the

form.

Annuitants

If you are treated as an annuitant for purposes of this form

(see Definitions), you should complete only lines 1 through 5,

7a, 7b, and 8.

Line 6

If the election you made previously was made under Rev.

Proc. 89-45, check the “No” box. If an election (other than an

election under Rev. Proc. 89-45) was made for an RRSP, and

amounts from the RRSP were rolled over tax-free to an RRIF

or another RRSP, the election is considered to have been

made for the plan which received the tax-free rollover.

You may be required to file Form TD F 90-22.1. See the

instructions for Form 1040.

All amounts listed must be in U.S. dollars.