Form 8840

Department of the Treasury

Internal Revenue Service

Closer Connection Exception Statement for Aliens

For the year January 1—December 31, 2001, or other tax year

beginning , 2001, and ending , 20 .

OMB No. 1545-1410

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

Your U.S. taxpayer identification number, if any

General Information

1

2

3

4

5

6

7

8

Enter your U.S. visa number, if any  

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:

2001 2000 1999 .

During 2001, 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)?

Closer Connection to One Foreign Country

9

10

11

12

Where was your tax home during 2001?

Enter the name of the foreign country to which you had a closer connection than to the United States during 2001



Have you filed or will you file tax returns for 2001 in the countries listed on lines 9 and 10?

If “Yes” to either line 12 or line 13, attach verification.

Yes No

Yes No

13

Cat. No. 15829P Form 8840 (2001)

Part III

Part I

Part II

Closer Connection to Two Foreign Countries

Yes No

Next, complete Part IV on the back.

After changing your tax home from its location on January 1, 2001, where was your tax home for the remainder of 2001?

Where was your tax home on January 1, 2001?

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.

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 2001 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?

Yes No

For Paperwork Reduction Act Notice, see page 4.

Attachment

Sequence No. 101

If “No” to either line 12 or line 13, please explain 

Last name

Address in country of residence Address in the United States

Next, complete Part IV on the back.

 Attach to Form 1040NR or Form 1040NR-EZ. 2001
Form 8840 (2001) Page 2

19

20

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

27

28

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. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any

knowledge.

 Your signature Date 

List social, cultural, religious, and political organizations you currently participate in and the location of each:

Location

Location

a

b

Did you conduct business activities in a location other than your tax home?

If “Yes,” where?

Where was your driver’s license issued?

If you hold a second driver’s license, where was it issued?

Where were you registered to vote?

22 Yes No

23a

24

b

In what country/countries did you keep your personal, financial, and legal documents?

From what country/countries did you derive the majority of your 2001 income?

30 In what country/countries were your investments located (see instructions)?

c Location

d Location

e Location

21 Where was the bank(s) with which you conducted your routine personal banking activities located?

a c

b d

25 When completing official documents, forms, etc., what country do you list as your residence?

26 Have you ever completed:

Form W-8 or Form W-8BEN (relating to foreign status)? Yes No

Form W-9, Request for Taxpayer Identification Number and Certification? Yes No

Form 1078, Certificate of Alien Claiming Residence in the United States? Yes No

Any other U.S. official forms? If “Yes,” indicate the form(s)  Yes No

a

b

c

d

31 List any charitable organizations to which you made contributions and their locations:

Location

Location

a

b

c Location

d Location

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

If “Yes,” in what country?

If “No,” please explain 

29 Did you have any income from U.S. sources? Yes No

If “Yes,” what type?

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 your response to lines 14 through 32, attach a statement to this form.

Significant Contacts With Foreign Country or Countries in 2001

18 Where was your automobile(s) registered?

Part IV

14 Where was your regular or principal permanent home located during 2001 (see instructions)?

15 If you had more than one permanent home available to you at all times during 2001, list the location of each and

explain 

16 Where was your family located?

17 Where was your automobile(s) located?

Form 8840 (2001)
Purpose of Form

Form 8840 (2001) Page 3

General Instructions

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.

Section references are to the U.S.

Internal Revenue Code.

Use Form 8840 to claim the closer

connection to a foreign country(ies)

exception to the substantial

presence test. The exception is

described in Regulations section

301.7701(b)-2.

Substantial Presence Test

You are considered a U.S. resident if

you meet the substantial presence

test for 2001. You meet this test if

you were physically present in the

United States for at least:

● 31 days during 2001 and

2. Days you were in the United

States for less than 24 hours when

you were traveling between two

places outside the United States.

Closer Connection

Exception

● You were present in the United

States for fewer than 183 days

during 2001, ● 183 days during the period 2001,

2000, and 1999, counting all the

days of physical presence in 2001

but only 1/3 the number of days of

presence in 2000 and only 1/6 the

number of days in 1999.

● You establish that during 2001,

you had a tax home in a foreign

country, and

● You establish that during 2001,

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.

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.

4. Days you were unable to leave

the United States because of a

medical condition or medical

problem that developed while you

were in the United States.

5. Days you were an exempt

individual.

Closer Connection to Two Foreign

Countries

You may demonstrate that you have

a closer connection to two foreign

1. You maintained a tax home as

of January 1, 2001, in one foreign

country.

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.

Note: You are not eligible for the

closer connection exception if 

(a) you were present in the United

States 183 days or more in calendar

year 2001 or (b) you are a lawful

permanent resident of the United

States (that is, you are a green card

holder).

Even though you would otherwise

meet the substantial presence test,

you will not be treated as a U.S.

resident for 2001 if:

2. You changed your tax home

during 2001 to a second foreign

country.

3. You continued to maintain your

tax home in the second foreign

country for the rest of 2001.

5. You are subject to tax as a

resident under the tax laws of either

foreign country for all of 2001 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.

For more details on the substantial

presence test and the closer

connection exception, see Pub. 519,

U.S. Tax Guide for Aliens.

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.

Note: You can download forms and

publications from the IRS Web Site

at www.irs.gov.

When and Where To File

If you are filing a 2001 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.

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.

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.

If you do not have to file a 2001

tax return, mail Form 8840 to the

Internal Revenue Service Center,

Philadelphia, PA 19255 by the due

date (including extensions) for filing

Form 1040NR or Form 1040NR-EZ.

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.

countries (but not more than two) if

all five of the following apply.
Form 8840 (2001) Page 4

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

Line 14

Line 30

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.

A “permanent home” is a dwelling

unit (whether a house owned or

rented, an apartment, or a furnished

For intangible assets, such as

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.

The time needed to complete and

file this form will vary depending on

individual circumstances. The

estimated average time is:

Recordkeeping 13 min.

Learning about the law

or the form 10 min.

Preparing the form 1 hr., 27 min.

If you have comments concerning

the accuracy of these time

estimates or suggestions for making

this form simpler, we would be

happy to hear from you. You can

write to the Tax Forms Committee,

Western Area Distribution Center,

Rancho Cordova, CA 95743-0001.

Do not send the form to this

address. Instead, see When and

Where To File on page 3.

Copying, assembling,

and sending the

form to the IRS 35 min.

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

room) that is available at all times,

continuously and not solely for short

stays.

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.