Form 8840

Department of the Treasury 

Internal Revenue Service 

Closer Connection Exception Statement for Aliens

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

▶ Information about Form 8840 and its instructions is at www.irs.gov/form8840.

For the year January 1—December 31, 2012, or other tax year

beginning , 20 .

OMB No. 1545-0074

Attachment 

, 2012, and ending Sequence No. 101

2012

Your first name and initial Last name Your U.S. taxpayer identification number, if any

Fill in your 

addresses only if 

you are filing this 

form by itself and 

not with your U.S. 

tax return

Address in country of residence Address in the United States

Part I General Information

1 Type of U.S. visa (for example, F, J, M, etc.) and date you entered the United States ▶

2 Of what country or countries were you a citizen during the tax year?

3 What country or countries issued you a passport?

4 Enter your passport number(s) ▶

5 Enter the number of days you were present in the United States during:

2012 2011 2010 .

6 During 2012, 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)? . . . . . . . . . . . . . . . . . . . . . . . . Yes No

Part II Closer Connection to One Foreign Country

7 Where was your tax home during 2012?

8 Enter the name of the foreign country to which you had a closer connection than to the United States during 2012 

▶

Next, complete Part IV on the back.

Part III Closer Connection to Two Foreign Countries

9 Where was your tax home on January 1, 2012?

10 After changing your tax home from its location on January 1, 2012, where was your tax home for the remainder of 2012? 

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? . . . . . . . . . . Yes No

If “No,” attach an explanation.

12 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 2012 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

13 Have you filed or will you file tax returns for 2012 in the countries listed on lines 9 and 10? . . . . . . Yes No

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

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

Next, complete Part IV on the back.

For Paperwork Reduction Act Notice, see page 4. Cat. No. 15829P Form 8840 (2012)
Form 8840 (2012) Page 2

Part IV Significant Contacts With Foreign Country or Countries in 2012

14 Where was your regular or principal permanent home located during 2012 (see instructions)?

15 If you had more than one permanent home available to you at all times during 2012, list the location of each and 

explain ▶

16 Where was your family located?

17 Where was your automobile(s) located?

18 Where was your automobile(s) registered?

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

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

a

b

c

d

21 Did you conduct business activities in a location other than your tax home? . . . . . . . . . . . Yes No

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 Where were you registered to vote?

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

25 Have you ever completed:

a Form W-8BEN or any other W-8 form (relating to foreign status)? . . . . . . . . . . . . . . Yes No

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

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

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

26 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 2012 income?

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

If “Yes,” what type?

29 In what country or countries were your investments located (see instructions)?

30 Did you qualify for any type of “national” health plan sponsored by a foreign government? . . . . . . 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 (2012)
Form 8840 (2012) Page 3

Section references are to the U.S. 

Internal Revenue Code, unless otherwise 

specified.

Future Developments

For the latest information about 

developments related to Form 8840 and 

its instructions, such as legislation 

enacted after they were published, go to 

www.irs.gov/form8840.

General Instructions

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 2012.

• 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 at IRS.gov.

Substantial Presence Test

You are considered a U.S. resident if you 

meet the substantial presence test for 

2012. You meet this test if you were 

physically present in the United States 

for at least:

• 31 days during 2012 and

• 183 days during the period 2012, 2011, 

and 2010, counting all the days of 

physical presence in 2012 but only 1/3 

the number of days of presence in 2011 

and only 1/6 the number of days in 2010.

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 

2012 if:

• You were present in the United States 

for fewer than 183 days during 2012,

• You establish that during 2012, you 

had a tax home in a foreign country, and

• You establish that during 2012, 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, 2012, in one foreign country.

2. You changed your tax home during 

2012 to a second foreign country.

3. You continued to maintain your tax 

home in the second foreign country for 

the rest of 2012.

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 2012 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 2012 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 2012 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.

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.
Form 8840 (2012) Page 4

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 1

If you had a visa on the last day of the 

tax year, enter your visa type and the 

date you entered the United States. If 

you do not have a visa, enter your U.S. 

immigration status on the last day of the 

tax year and the date you entered the 

United States. For example, if you 

entered under the visa waiver program, 

enter “VWP”, the name of the Visa 

Waiver Program country and the date 

you entered the United States.

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.

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.