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

2009 2008 2007 .

Form 8840

Department of the Treasury

Internal Revenue Service

Closer Connection Exception Statement for Aliens

For the year January 1—December 31, 2009, or other tax year

beginning , 2009, and ending , 20 .

OMB No. 1545-0074

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

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

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) 

During 2009, 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 2009?

Enter the name of the foreign country to which you had a closer connection than to the United States during 2009 



Have you filed or will you file tax returns for 2009 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 (2009)

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, 2009, where was your tax home for the remainder of 2009? 

Where was your tax home on January 1, 2009?

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 2009 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. 2009
Form 8840 (2009) Page 2

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

26

27

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

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?

21 Yes No

22a

23

b

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

From what country or countries did you derive the majority of your 2009 income?

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

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

a c

b d

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

25 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

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

If “Yes,” in what country?

If “No,” please explain 

28 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 any of your responses to lines 14 through 30, attach a statement to this form.

Significant Contacts With Foreign Country or Countries in 2009

18 Where was your automobile(s) registered?

Part IV

14 Where was your regular or principal permanent home located during 2009 (see instructions)?

15 If you had more than one permanent home available to you at all times during 2009, list the location of each and

explain 

16 Where was your family located?

17 Where was your automobile(s) located?

Form 8840 (2009)
Purpose of Form

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.

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.

Substantial Presence Test

You are considered a U.S. resident if you

meet the substantial presence test for

2009. You meet this test if you were

physically present in the United States for

at least:

● 31 days during 2009 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 2009,

● 183 days during the period 2009, 2008,

and 2007, counting all the days of

physical presence in 2009 but only 1/3

the number of days of presence in 2008

and only 1/6 the number of days in 2007.

● You establish that during 2009, you

had a tax home in a foreign country, and

● You establish that during 2009, 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.

residence in Canada or Mexico.

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.

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, 2009, in one foreign country.

4. You had a closer connectio

foreign country than to the Unite

for the period during which you

maintained a tax home in that fo

country.

Note: You are not eligible for the closer

connection exception if any of the

following apply.

Even though you would otherwise meet

the substantial presence test, you will not

be treated as a U.S. resident for 2009 if:

5. You are subject to tax as a 

under the tax laws of either forei

country for all of 2009 or subject 

a resident in both foreign countr

period during which you maintai

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 website at

www.irs.gov.

When and Where To Fi

If you are filing a 2009 Form 104

Form 1040NR-EZ, attach Form 8

Mail your tax return by the due d

(including extensions) to the add

shown in your tax return instruct

Establishing a Closer Conn

You will be considered to have a 

connection to a foreign country t

the United States if you or the IR

establishes that you have mainta

more significant contacts with th

country than with the United Sta

Tax Home

Your tax home is your main plac

business, employment, or post o

regardless of where you maintain 

family home. If you do not have a 

or main place of business becau

nature of your work, then your ta

is the place where you regularly 

you do not fit either of these cate

you are considered an itinerant a

tax home is wherever you work.

If you do not have to file a 200

return, mail Form 8840 to the De

of the Treasury, Internal Revenu

Center, Austin, TX 73301-0215 b

due date (including extensions) f

Form 1040NR or Form 1040NR-

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.

● You were present in the United States

183 days or more in calendar year 2009.

● 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.

Your answers to the questions 

Part IV will help establish the juri

to which you have a closer conn
Specific Instructions

Line 6

Line 29

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.

room) that is available at all times,

continuously and not solely for short

stays.

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.

The average time and expens

required to complete and file thi

will vary depending on individua

circumstances. For the estimate

averages, see the instructions fo

income tax return.

If you have suggestions for ma

form simpler, we would be happ

from you. See the instructions fo

income tax return.

relating to a form or its instructio

be retained as long as their cont

become material in the administ

any Internal Revenue law. Gener

returns and return information ar

confidential, as required by sect

g

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.