OMB No. 1545-0074

Statement for Individuals Who Begin or End 8898 Bona Fide Residence in a U.S. Possession Form

Department of the Treasury

Internal Revenue Service

Name. If married, file a separate form for each spouse required to file Form 8898. Your social security number:

Current Address:

American Samoa Guam Commonwealth of the Northern Mariana Islands (CNMI)

Address in Possession (if different from current address):

General Information

1

2 Are you a U.S. citizen or resident alien (see instructions)? 

4a If you checked box a on line 1 above, enter the date (month/day/year) you moved to the possession to establish bona fide residence

5

Presence in the United States or Possession

7

9 Did you have a tax home outside the possession at any time during the tax year (see instructions)?

Where was your principal permanent home located during the tax year (see instructions)?

If you had more than one permanent home available to you at all times during the tax year, list the location of each:

Part I

Part II

Enter your average worldwide gross income for the three-year period prior to the tax year you became (or ceased

to be) a bona fide resident of the possession (see instructions) 

3

10 Did you have a closer connection to the United States or a foreign country than to the possession at any time during

the tax year (see instructions)? 

Enter the number of days you were present in the United States during the tax year (see instructions)

Form 8898 (Rev. 1-2007)

I am notifying the IRS that I (check box a or b below and enter the tax year in the space provided):

b

c Of which U.S. possession did you become (or cease to be) a bona fide resident:

Commonwealth of Puerto Rico U.S. Virgin Islands

Yes No

Did you have a significant connection to the United States during the tax year (see instructions)? Yes No

Part III Closer Connection to the United States, Foreign Country, or Possession

Yes No

If “Yes,” where?

Yes No

If “Yes,” where?

For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions. Cat. No. 37706B

(Rev. January 2007)

© See separate instructions.

became

ceased to be % a a bona fide resident of a U.S. possession in tax year ©

If you checked box b on line 1 above, enter the date (month/day/year) you moved from the possession to end bona 

fide residence 

b

/ / .

/ / .

Where was your immediate family located during the tax year (see instructions)?

12

Where was your automobile(s) located during the tax year?

13

Where was your automobile(s) registered during the tax year?

14

Where were your personal belongings, furniture, etc., located during the tax year?

15

16

17

© Do not file with your tax return.

8 Did you have any earned income from U.S. sources during the tax year (see instructions)? Yes No

If “Yes,” was the amount of the income more than $3,000? Yes No

11 If you answered “Yes” to line 9 or 10, are you using the year-of-the-move exception? Yes No

(See Exception for the Year of the Move on page 1 of the instructions.)

6 Enter the number of days you were present in the possession during:

a The tax year listed on line 1 

b The first tax year immediately preceding the tax year listed on line 1 

c The second tax year immediately preceding the tax year listed on line 1 

Note. Complete lines 6b and 6c if you were in the possession for less than 183 days during the tax year entered on line 1 and you are

following the new alternative to the 183-day rule of the presence test. See item (2) under Presence Test on page 2 of the instructions.
Part III Closer Connection to the United States, Foreign Country, or Possession (Continued)

Did you claim a homestead exemption for the tax year (see instructions)? 

If “Yes,” where?

22

Form 8898 (Rev. 1-2007) Page 2

Form 8898 (Rev. 1-2007)

23 When completing official documents, forms, etc., what address did you list as your residence?

28 Where (for example, in the United States, possession, other country) were your investments located (see instructions)?

Did you have any income from possession sources for the tax year (see instructions)? 

During the tax year, did you have an office in the possession from which you conducted a trade or business?

If “Yes,” what type(s)?

If “Yes,” provide the address of that office and a short description of your trade or business:

During the tax year, did you receive compensation for personal services? 

During the tax year, did you manufacture an article in the possession for sale to customers? 

If “Yes,” where did you perform these services?

27

29

30

31

24 Where (for example, in the United States, possession, other country) did you keep your personal, financial, and legal documents?

25 Where (for example, from the United States, possession, other country) did you derive the majority of your income for the tax year?

Did you have any income from U.S. sources for the tax year (see instructions)? 

If “Yes,” what type(s)?

26

Part IV Source of Income

Did you sell or exchange appreciated property during the tax year after becoming a resident of the possession?

If “Yes,” provide a short description of the property and the amount of the gain (see instructions).

If you conducted a trade or business in the possession during the tax year, did that business consist of:

b

32

33

a

c

Note. If you have any other information to substantiate your closer connection to the United States or the possession, or you wish to explain in 

more detail any of your responses, attach a statement to this form.

Sign

Here

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

Receiving rents or royalties for the use of intangible property? 

Receiving dividends or interest in connection with a banking, financing, or similar business? 

The sale or exchange (outside the possession) of personal property consisting of stock in trade or inventory?

Note. If you used more than one address, specify the type of documents, forms, etc., and the addresses used.

a

c

e

d

b

Address

Address

Address

Address

Address

Keep a copy for

your records.

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

a

b

c

d

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

If “Yes,” where?

20a Where was your driver’s license issued?

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

Yes No

Were you registered to vote during the tax year? 

If “Yes,” where?

21 Yes No

18

19

Yes No

Yes No

Yes No

Yes No

Yes No

Yes No

Yes No

Yes No

Yes No

Yes No