Form 8833 Treaty-Based Return Position Disclosure

Under Section 6114 or 7701(b) OMB No. 1545-1354

Expires 3-31-96 (March 1993)

Department of the Treasury

Internal Revenue Service © Attach to your income tax return.

Name Identifying number

Cat. No. 14895L Form 8833 (3-93)

Address in country of residence Address in the United States

Check this box if the taxpayer is a U.S. citizen or resident (if an individual) or is incorporated in the United States (if a

corporation) ©

1

a

Article(s)

List the Internal Revenue Code provision(s) overruled or

modified by the treaty-based return position

Name, identifying number (if available to the taxpayer), and

address in the United States of the payor of the income (if

fixed, determinable, annual, or periodic). (See instructions.)

List the provision(s) of the limitation on benefits article (if any) in the treaty that the taxpayer relies on to prevent application

of that article ©

Explain the treaty-based return position taken. Include a brief summary of the facts on which it is based. Also, list the nature

and amount (or a reasonable estimate) of gross receipts, each separate gross payment, each separate gross income item,

or other item (as applicable) for which the treaty benefit is claimed

Enter the specific treaty position relied on:

Treaty country

b

2

3

4

5

Attach a separate Form 8833 for each treaty-based return position taken. Failure to disclose a treaty-based return position may

result in a penalty of $1,000 ($10,000 in the case of a C corporation) (see section 6712).

Check one or both of the following boxes as applicable:

● The taxpayer is disclosing a treaty-based return position as required by section 6114 ©

● The taxpayer is a dual resident taxpayer and is disclosing a treaty-based return position as required by 

Regulations section 301.7701(b)-7 ©

For Paperwork Reduction Act Notice, see back of form.
General Instructions

(Section references are to the Internal

Revenue Code unless otherwise noted. )

Paperwork Reduction Act Notice

Who Must File

The time needed to complete and file

this form will vary depending on

individual circumstances. The estimated

average time is:

Specific Instructions

Purpose of Form

Form 8833 may be used by taxpayers to

make the treaty-based return position

disclosure required by section 6114. The

form may also be used by dual resident

taxpayers (defined below) to make the

treaty-based return position disclosure

required by Regulations section

301.7701(b)-7. A separate form is

required for each treaty-based return

position taken by the taxpayer.

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.

Recordkeeping 3 hr., 7 min.

Learning about the

law or the form 1 hr., 29 min.

Preparing and sending

the form to the IRS 1 hr., 37 min.

If you have comments concerning the

accuracy of these time estimates or

suggestions for making this form more

simple, we would be happy to hear from

you. You can write to both the IRS and

the Office of Management and Budget

at the addresses listed in the

instructions of the tax return with which

this form is filed.

A taxpayer who takes a treaty-based

return position must disclose that

position.

A dual resident taxpayer is an

individual who is considered to be a

resident of both the United States and

another country under each country’s

tax laws. The income tax treaty between

the United States and the other country

must contain a provision for resolution of

conflicting claims of residence.

The identifying number of an individual is

his or her social security number. The

identifying number of all others is their

employer identification number.

Income that is fixed, determinable,

annual, or periodic includes interest

(other than original issue discount),

dividends, rents, premiums, annuities,

salaries, wages, and other

compensation. For more information

(including other items of income that are

fixed, determinable, annual, or periodic),

nonresident aliens and dual resident

taxpayers filing as nonresident aliens

should see section 871(a) and

Regulations section 1.871-7(b) and (c).

Foreign corporations should see section

881(a) and Regulations section

1.881-2(b) and (c).

Exceptions. See Regulations section

301.6114-1(c) for examples of

treaty-based return positions taken by

taxpayers for which they are not

required to make disclosure.

Form 8833 (3-93) Page 2

If you are a dual resident taxpayer and

you choose to claim treaty benefits, you

are treated as a nonresident alien in

figuring your U.S. income tax liability for

the part of the tax year you are

considered a dual resident taxpayer. If

this is the case, attach Form 8833 to

Form 1040NR, U.S. Nonresident Alien

Income Tax Return. Form 1040NR must

be timely filed (including extensions). For

purposes other than figuring your U.S.

income tax liability, you are treated as a

U.S. resident (see Regulations section

301.7701(b)-7(a)(3)).

When and Where To File

Attach Form 8833 to your U.S. income

tax return (i.e., Form 1040NR, Form

1120F, etc.). If you would not otherwise

be required to file a tax return, you must

file one at the IRS Service Center where

you would normally file a return to make

the treaty-based return position

disclosure under section 6114 (see

Regulations section 301.6114-1(a)(1)(ii))

or under Regulations section

301.7701(b)-7(b).

Identifying Number

Line 3

A taxpayer takes a treaty-based

return position by maintaining that a

treaty of the United States overrules or

modifies a provision of the Internal

Revenue Code and thereby causes (or

potentially causes) a reduction of tax on

the taxpayer’s tax return. For these

purposes, a treaty includes, but is not

limited to, an income tax treaty, estate

and gift tax treaty, or friendship,

commerce, and navigation treaty. See

Regulations sections 301.6114-1(a) and

(b) for more details and for examples of

treaty-based return positions taken by

taxpayers for which they must make

disclosure.