Instruction To Form 8802

Instructions for Form 8802
Department of the Treasury

Internal Revenue Service
(Rev. November 2018)

Application for United States Residency Certification
Section references are to the Internal Revenue
Code unless otherwise noted.
Contents Page U.S. Residency
Line 10. Penalties of Perjury
Statements and
Certification
Contents Page
Attachments . . . . . . . . . . . . 11 Income Tax Treaty
U.S. Residency Certification . . . . . . . 1
Table 2. Current Year
General Instructions . . . . . . . . . . . . . 2 Penalties of Perjury Many foreign countries withhold tax on
Purpose of Form . . . . . . . . . . . . 2 Statements . . . . . . . . . 12 certain types of income paid from
When To File . . . . . . . . . . . . . . 2 Signature and Date . . . . . . . . . 14 sources within those countries to
User Fee . . . . . . . . . . . . . . . . . 2 Table 3. Who Has residents of other countries. The rate of
Where To File . . . . . . . . . . . . . . 3 Authority To Sign withholding is set by that country's
Who Is Eligible for Form Form 8802 . . . . . . . . . . 15 internal law. An income tax treaty
6166 . . . . . . . . . . . . . .... 3 Daytime Phone Number . . . . . . 15 between the United States and a foreign
Who Is Not Eligible for Form Line 11. Number of country often reduces the withholding
6166 . . . . . . . . . . . . . .... 3 Certifications (Forms rates (sometimes to zero) for certain
Special Rules . . . . . . . . . . .... 4 6166) Requested for types of income paid to residents of the
Certification Under the Each Country . . . . . . . . . . . 15
United States. This reduced rate is
3-Year Procedure . . .... 4 Line 12. Total Number of
Certifications (Forms referred to as the treaty-reduced rate.
Form 8802 Filed Before
Return Posted by the 6166) Requested . . . . . . . . 15 Many U.S. treaty partners require the
IRS . . . . . . . . . . . .... 4 When To Seek U.S. IRS to certify that the person claiming
Individuals With Competent Authority treaty benefits is a resident of the United
Residency Outside Assistance . . . . . . . . . . . . . 15
States for federal tax purposes. The IRS
the United States . . .... 4 provides this residency certification on
Form 1116, Foreign Tax Future Developments Form 6166, a letter of U.S. residency
Credit . . . . . . . . . . .... 5 For the latest information about certification. Form 6166 is a
United Kingdom . . . . . .... 5 developments related to Form 8802 and computer-generated letter printed on
Specific Instructions . . . . . . . . . .... 5 its instructions, such as legislation stationery bearing the U.S. Department
Check Boxes at Top of Page enacted after they were published, go to of Treasury letterhead, which includes
1 ................ . . . . 5 www.irs.gov/form8802. the facsimile signature of the Field
Additional Requests . . . . . . . 5
Director, Philadelphia Accounts
Foreign Claim Form . . . . . . . 5 What's New Management Center.
Line 2. Applicant's Address . . . . . 6
Line 3a. Mailing Address . . . . . . . 6 User fee change. For Forms 8802 Form 6166 will only certify that, for
Line 3b. Third Party postmarked on or after December 1, the certification year (the period for
Appointee's Information . . . . . 6 2018, the user fee for applicants other which certification is requested), you
Line 4a. Individual . . . . . . . . . . . 6 than individuals will increase to $185. were a resident of the United States for
Line 4b. Partnership . . . . . . . . . . 7 The $85 user fee for individuals will not purposes of U.S. taxation or, in the case
Line 4c. Trust . . . . . . . . . . . . . . 7 change. See User Fee, later. of a fiscally transparent entity, that the
Line 4d. Estate . . . . . . . . . . . . . 8 New fax procedures. You can now entity, when required, filed an
Line 4e. Corporation . . . . . . . . . 8 fax a maximum of 100 pages. Also, the information return and its partners/
Line 4f. S Corporation . . . . . . . . 9 not toll free fax number for use by filers members/owners/beneficiaries filed
Line 4g. Employee Benefit inside and outside the United States has income tax returns as residents of the
Plan/Trust . . . . . . . . . . .... 9 changed. The toll free fax number for United States.
Line 4h. Exempt use within the United States has not
Organization . . . . . . . . .... 9 Upon receiving Form 6166 from the
changed. See Fax under Electronic IRS, unless otherwise directed, you
Line 4i. Disregarded Entity . .... 9 Payment, later.
Line 4j. Nominee Applicant . .... 9
should send Form 6166 to the foreign
withholding agent or other appropriate
Line 5. Statement Required
If Applicant Did Not File a Reminder person in the foreign country to claim
U.S. Income Tax Return . .... 9 treaty benefits. Some foreign countries
First year employee benefit plans. will withhold at the treaty-reduced rate
Table 1. Statement
Required If Applicant Certification will not be issued to a trust at the time of payment, and other
Did Not File a U.S. that is part of an employee benefit plan foreign countries will initially withhold tax
Income Tax Return . . . . 10 during the employee benefit plan’s first at their statutory rate and will refund the
Line 6. Parent, Parent year of existence, unless it is amount that is more than the
Organization, or Owner . . . . . 10 administered by a qualified custodian treaty-reduced rate on receiving proof of
Line 7. Calendar Year of bank, as defined in 17 CFR U.S. residency.
Request . . . . . . . . . . . . . . 11 275.206(4)-2(d)(6)(i). See Who Is Not
Line 8. Tax Period(s) . . . . . . . . 11 Eligible for Form 6166, later. Other conditions for claiming treaty
Line 9. Purpose of benefits. In order to claim a benefit
Certification . . . . . . . . . . . . 11 under a tax treaty, there are other
requirements in addition to residence.
Nov 06, 2018 Cat. No. 10827V

These include the requirement that the in processing your application. You can 2018. If postmarked before December
person claiming a treaty-reduced rate of call (267) 941-1000 (not a toll-free 1, 2018, the user fee is $85.
withholding be the beneficial owner of number) and select the U.S. residency
the item of income and meet the option if you have questions regarding Fiscally transparent entities. A
limitation on benefits article of the treaty, your application. partnership, S corporation, grantor trust,
if applicable. or other fiscally transparent entity pays a
Early submission for a current year single $185 user fee per Form 8802
The IRS cannot certify whether you certification. The IRS cannot accept application with respect to all Forms
are the beneficial owner of an item of an early submission for a current year 6166 issued under its employer
income or that you meet the limitation Form 6166 that has a postmark date identification number (EIN),
on benefits article, if any, in the treaty. before December 1 of the prior year. notwithstanding that the IRS will verify
You may, however, be required by a Requests received with a postmark date the tax status of each of the partners,
foreign withholding agent to establish earlier than December 1 will be returned owners, or beneficiaries of the entity
directly with the agent that these to the sender. For example, a Form who have consented to the request for
requirements have been met. 6166 request for 2019: certification.
You should examine the • Received with a postmark date
before December 1, 2018, cannot be Custodial accounts. A custodian
TIP specific income tax treaty to requesting certification on behalf of an
determine if any tax credit, tax processed.
• Received with a postmark date on or account holder pays a user fee for each
exemption, reduced rate of tax, or other account holder taxpayer identification
treaty benefit or safeguards apply. after December 1, 2018, can be
processed with the appropriate number (TIN). The custodian will pay a
Income tax treaties are available at user fee of $85 or $185, depending on
IRS.gov/businesses/international- documentation.
whether that account holder is an
businesses/united-states-income-tax- individual or a non-individual applicant.
treaties-a-to-z. User Fee
Form 8802 application(s) will not be Multiple requests. Because an
Value Added Tax (VAT) processed until the non-refundable user applicant must pay the user fee of either
fee is paid. The user fee is for the $85 or $185 for each separate Form
Form 6166 can also be used as proof of
number of applications submitted, not 8802 submitted, the IRS encourages
U.S. tax residency status for purposes
the number of certifications requested. each applicant to include all Form 6166
of obtaining an exemption from a VAT
requests on a single Form 8802
imposed by a foreign country. In The user fee for all applications (separate for individual and
connection with a VAT request, the postmarked before December 1, 2018, non-individual) to avoid multiple user
United States can certify only to certain is $85. User fees for Form 8802 fee charges.
matters in relation to your U.S. federal applications postmarked on or after
income tax status, and not that you December 1, 2018, vary based on the Additional request. Additional
meet any other requirements for a VAT type of applicant. If you are sending requests for Form 6166 submitted on a
exemption in a foreign country. your Form 8802 by fax, see Fax under separate Form 8802, following the
Electronic Payment, later. Be sure to procedures established under
General Instructions include the appropriate user fee for your Additional Requests, later, will require
applicant status or the IRS will reject the the payment of the applicable user fee.
Purpose of Form application. 3-year procedure. You are required
Form 8802 is used to request Form More information. For more to pay the applicable user fee for each
6166, a letter of U.S. residency information on the change to the user Form 8802 application submitted under
certification for purposes of claiming fee for non-individual applicants, see the 3-year procedure. See Certification
benefits under an income tax treaty or Revenue Procedure 2018-50, 2018-42 Under the 3-Year Procedure, later.
VAT exemption. You cannot use Form I.R.B. 610, available at https://
6166 to substantiate that U.S. taxes
Method of Payment
www.irs.gov/irb/
were paid for purposes of claiming a 2018-42_IRB#RP-2018-50. Payment of the user fee can be by
foreign tax credit. check, money order, or electronic
Requests by individual applicants. payment.
You cannot claim a foreign tax credit The user fee for a request by an
to reduce your U.S. tax liability with individual applicant is $85 per Form Check or Money Order
respect to foreign taxes that have been 8802, regardless of the number of
countries for which certification is Form 8802 must be accompanied by a
reduced or eliminated by reason of a
requested or the number of tax year(s) check or money order in U.S. dollars,
treaty. If you receive a refund of foreign
to which the certification applies. For payable to the United States Treasury,
taxes paid with the benefit of Form
this purpose, an individual applicant in the appropriate amount. Do not
6166, you may need to file an amended
means an individual who is a citizen of submit foreign checks. Do not send
return with the IRS to adjust any foreign
the United States or a resident thereof, cash.
tax credits previously claimed for those
taxes. within the meaning of section 7701(b)(1) Multiple Forms 8802. If you are
(A) of the Internal Revenue Code. submitting multiple Forms 8802, you
When To File Requests by applicants other than can submit a single check or money
You should mail your application, individuals. The user fee for an order payment to cover the aggregate
including full payment of the user fee, at application by each non-individual amount of the user fee for all Forms
least 45 days before the date you need applicant is $185 per Form 8802, if 8802. No more than 200 Forms 8802
to submit Form 6166. We will contact postmarked on or after December 1, can be associated with one check or
you after 30 days if there will be a delay money order.
-2- Instructions for Form 8802 (Rev. 11-2018)

Note. If you pay by check, it will be (discussed earlier) to make the are required to pay the new $185 user
converted into an electronic funds payment. Click the "Supplement fee for non-individual applicants, Forms
transfer (EFT). This means we will copy Payment" checkbox at the input screen. 8802 will be treated as postmarked
your check and use the account before December 1, 2018, if the IRS
information on it to electronically debit Where To File receives Form 8802 with a valid
your account for the amount of the The method by which you can submit electronic payment confirmation number
check. The debit from your account will Form 8802 to the IRS depends upon by fax at one of the above phone
usually occur within 24 hours, and will how you choose to pay the user fee. numbers before December 1, 2018. If
be shown on your regular account your faxed Form 8802 is received on or
statement. You will not receive your Payment by Check or Money after December 1, 2018, you will be
original check back. We will destroy Order required to pay the $185 user fee for
your original check, but we will keep a If you are paying the user fee by check non-individual applicants, if applicable.
copy of it. If the IRS cannot process the or money order, send the payment,
EFT for technical reasons, you Form 8802, and all required Who Is Eligible for Form
authorize us to process the copy of the attachments to: 6166
check.
In general, under an income tax treaty,
Internal Revenue Service an individual or entity is a resident of the
Electronic Payment (e-payment) P.O. Box 71052 United States if the individual or entity is
Philadelphia, PA 19176-6052 subject to U.S. tax by reason of
You can access the electronic payment
page at the Pay.gov website. Go to residence, citizenship, place of
Pay.gov, and enter "IRS Certs User Or, by private delivery service to: incorporation, or other similar criteria.
Fee" in the search box. At the "IRS U.S. residents are subject to tax in the
Internal Revenue Service United States on their worldwide
Certs" topic, click the "Continue to the
2970 Market Street income. An entity may be considered
Form" button. Follow the on-screen
BLN# 3-E08.123 subject to tax on its worldwide income
prompts, and enter the required
Philadelphia, PA 19104-5016 even if it is statutorily exempt from tax,
information when requested.
such as a pension fund or charity.
The user fee website requires the Electronic Payment Similarly, individuals are considered
entry of the following information. After you have received your electronic subject to tax even if their income is less
• Applicant's name. payment confirmation number, and than the amount that would require that
• Applicant's TIN or EIN. entered it on page 1 of Form 8802, you they file an income tax return.
• Submitter's name (name of person or can submit Form 8802 and all required
In general, the IRS will issue Form
entity submitting the payment). attachments by mail, private delivery
6166 only when it can verify that for the
• Contact email address. service, or fax (see below for limitations
year for which certification is requested
• Contact phone number. on the use of faxed transmissions).
one of the following applies.
• Number of Form(s) 8802 submitted.
• Payment amount.
If you are paying the user fee by • You filed an appropriate income tax
e-payment, send Form 8802 and all return (for example, Form 1120 for a
• Selection of bank account (Automatic required attachments to: domestic corporation),
Clearing House (ACH)) or debit or credit
card, which will open a window for • In the case of a certification year for
Department of the Treasury which a return is not yet due, you filed a
account information. Internal Revenue Service return for the most recent year for which
Philadelphia, PA 19255-0625 a return was due, or
Once the IRS processes your
• You are not required to file an income
electronic payment, you will receive an Or, by private delivery service to: tax return for the tax period on which
electronic payment confirmation number certification will be based and other
for the transaction. Enter the electronic Internal Revenue Service documentation is provided.
payment confirmation number on 2970 Market Street
page 1 of Form 8802 before you submit
the application. You can use either the
BLN# 3-E08.123 Who Is Not Eligible for
Philadelphia, PA 19104-5016
Agency Tracking ID or the Pay.gov ID Form 6166
as the electronic payment confirmation In general, you are not eligible for Form
Fax. You can fax up to 10 Forms 8802 6166 if, for the tax period for which your
number. Either one is acceptable. If you
(including all required attachments) for a Form 6166 is based, any of the
make an electronic payment covering
maximum of 100 pages to the fax following applies.
multiple Forms 8802, write the same
numbers below. You must use a fax
electronic payment confirmation number
cover sheet stating the number of pages
• You did not file a required U.S. return.
on each form. The IRS will not process
included in the transmission.
• You filed a return as a nonresident
Form 8802 if the application does not (including Form 1040NR, Form
include the electronic payment The following fax numbers are 1040NR-EZ, Form 1120-F, Form
confirmation number. available. 1120-FSC, or any of the U.S.
• (877) 824-9110 (within the United possession tax forms).
Supplemental User Fee Payment States only, toll free). • You are a dual resident individual
• (304) 707-9792 (inside or outside the who has made (or intends to make),
If the U.S. Residency Certification Unit United States, not toll free). pursuant to the tie-breaker provision
contacts you to make a supplemental within an applicable treaty, a
payment, you can use the electronic Non-individual user fee. For
purposes of determining whether you determination that you are not a resident
payment page at the Pay.gov website of the United States and are a resident
Instructions for Form 8802 (Rev. 11-2018) -3-

of the other treaty country. For more Declaration of Representative, or Form Individuals With Residency
information and examples, see 8821, Taxpayer Information Outside the United States
Regulations section 301.7701(b)-7. Authorization, as applicable, to Form
• You are a fiscally transparent entity 8802. Form 2848 or Form 8821 must If you are in any of the following
organized in the United States (that is, a apply to all of the years for which categories for the current or prior tax
domestic partnership, domestic grantor certification is requested. For the rules year for which you request certification,
trust, or domestic LLC disregarded as relating to Forms 2848 and 8821, you must submit a statement and
an entity separate from its owner) and including the 3-year procedure, see documentation, as described below,
you do not have any U.S. partners, Line 3b. Third Party Appointee's with Form 8802.
beneficiaries, or owners. Information, later. 1. You are a resident under the
• The entity requesting certification is In year 1, a penalties of perjury internal law of both the United States
an exempt organization that is not statement is required stating that the and the treaty country for which you are
organized in the United States. applicant is a U.S. resident and will requesting certification (you are a dual
• The entity requesting certification is a continue to be so through the current tax resident).
trust that is part of an employee benefit year and the following two tax years. 2. You are a lawful permanent
plan during the employee benefit plan's See Table 2 for the penalties of perjury resident (green card holder) of the
first year of existence, and it is not statement for the 3-year procedure that United States or U.S. citizen who filed
administered by a qualified custodian you must enter on line 10 of Form 8802 Form 2555.
bank, as defined in 17 CFR or attach to the form. 3. You are a bona fide resident of a
275.206(4)-2(d)(6)(i).
Second year. In the second year for U.S. possession.
Special Rules which certification is requested under If you are a dual resident described in
this procedure, you must submit a category 1, above, your request may be
Certification Under the 3-Year completed Form 8802 requesting denied unless you submit evidence to
Procedure certification for year 2 with a copy of the establish that you are a resident of the
year 1 Form 8802 (including the United States under the tie-breaker
Estates, employee benefit plans/trusts,
penalties of perjury statement) and provision in the residence article of the
and exempt organizations (lines 4d, 4g,
Form 2848 or Form 8821 attached, as treaty with the country for which you are
and 4h) can submit a Form 8802 that
applicable. requesting certification.
covers up to a 3-year period (the current
year and the following two tax years). If Enter the current year on line 7. A
penalties of perjury statement and If you are described in category 2 or
you request certification under this 3, attach a statement and
procedure, you must submit a Form signature are not required on the Form
8802 filed in year 2. However, you must documentation to establish why you
8802 for each year, but in years 2 and 3 believe you should be entitled to
you only need to attach a copy of the enter “See attached year 1 Form 8802
filed under the 3-year procedure” on certification as a resident of the United
year 1 Form 8802 (including the States for purposes of the relevant
penalties of perjury statement), provided line 10.
treaty. Under many U.S. treaties, U.S.
there are no material changes to the Third year. In the third year for which citizens or green card holders who do
information entered on the Form 8802 in certification is requested under this not have a substantial presence,
year 1. procedure, you must submit a permanent home, or habitual abode in
Certification will not be issued to completed Form 8802 requesting the United States during the tax year are
a trust that is part of an certification for year 3 and attach a copy not entitled to treaty benefits. U.S.
!
CAUTION employee benefit plan during of the year 1 Form 8802 (including the citizens or green card holders who
the employee benefit plan’s first year of penalties of perjury statement) and reside outside the United States must
existence, unless it is administered by a Form 2848 or Form 8821 attached, as examine the specific treaty to determine
qualified custodian bank, as defined in applicable. if they are eligible for treaty benefits and
17 CFR 275.206(4)-2(d)(6)(i). Enter the current year on line 7. A U.S. residency certification. See
penalties of perjury statement and Exceptions, later.
Note. If you choose to use the 3-year signature are not required on the Form If you are described in category 2
procedure, write “Filed Under the 3-Year 8802 filed in year 3. However, you must and are claiming treaty benefits under a
Procedure” at the top of page 1 of the enter “See attached year 1 Form 8802 provision applicable to payments
Form(s) 8802 filed for each year. filed under the 3-year procedure” on received in consideration of teaching or
line 10. research activities, see Table 2 for the
You cannot use this procedure if
there is a material change of fact Form 8802 Filed Before Return penalties of perjury statement you must
(including name or permanent address) Posted by the IRS either enter on line 10 of Form 8802 or
with respect to the estate, employee attach to the form.
If your return has not been posted by the
benefit plan/trust, or exempt
IRS by the time you file Form 8802, you
organization during the period for which Exceptions
will receive a request to provide a
the certification is requested.
signed copy of your most recent return. You do not need to attach the additional
First year. In the first year for which a If you recently filed your return, it may statement or documentation requested
certification is requested under this take less time to process your if you:
procedure, you must submit a application if you include a copy of the • Are a U.S. citizen or green card
completed Form 8802, signed and income tax return with your Form 8802. holder; and
dated by the applicant, with the current Write “COPY — do not process” on the • Are requesting certification only for
year entered on line 7. Attach Form tax return. Bangladesh, Bulgaria, Cyprus, Hungary,
2848, Power of Attorney and Iceland, India, Kazakhstan, Malta, New

Zealand, Russia, South Africa, Sri An applicant can only use this Note. For more information about
Lanka, or Ukraine; and additional request procedure if there are foreign countries with which the IRS has
• The country for which you are no changes to the applicant's tax an agreement to process a foreign claim
requesting certification and your country information provided on the original form, call the U.S. residency certification
of residence are not the same. Form 8802. An applicant can use this unit at (267) 941-1000 (not a toll-free
procedure to obtain a Form 6166 for any number).
Form 1116, Foreign Tax Credit country or countries, whether or not the
If you have filed or intend to file a Form country was identified on a previously Applicant's Name and U.S.
1116 claiming either a foreign tax credit filed Form 8802. An additional request
amount in excess of $5,000 U.S. or a
Taxpayer Identification
for Form 6166 using this procedure
foreign tax credit for any amount of must be made within 12 months of the Number
foreign earned income for the tax period most recently issued Form 6166 relating As part of certifying U.S. residency, the
for which certification is requested, you to the same tax period. IRS must be able to match the name(s)
must submit evidence that you were (or and taxpayer identification number(s)
will be if the request relates to a current Additional documentation. If you are (TIN(s)) on this application to those
year) a resident of the United States and requesting certification for a previously previously verified on either the U.S.
that the foreign taxes paid were not identified country and if additional return filed for the tax period for which
imposed because you were a resident documentation was necessary for the certification is to be based or on other
of the foreign country. original application, it does not need to documentation you provide.
be resubmitted with the request for an
In addition, individuals who have additional Form 6166. In the signature Enter the applicant's name and TIN
already filed their federal income tax line of the additional request form, write exactly as they appear on the U.S.
return must submit a copy of it, including “See attached copy of the original Form return filed for the tax period(s) for
any information return(s) relating to 8802.” Attach a copy of the original which certification will be based. If the
income, such as Form W-2 or Form Form 8802. applicant was not required to file a U.S.
1099, along with the Form 1116. Your If you are requesting Form 6166 for a return, enter the applicant's name and
request for U.S. residency certification country not identified on a previously TIN as they appear on documentation
may be denied if you do not submit the filed Form 8802 that requires previously provided to the IRS (for
additional materials. documentation not previously example, Form 8832, Entity
submitted, you must include that Classification Election) or on
United Kingdom documentation with the additional documentation provided by the IRS (for
If you are applying for relief at source request. Sign and date the additional example, a determination letter).
from United Kingdom (U.K.) income tax request form. Attach a copy of the Joint return. If a joint income tax return
or filing a claim for repayment of U.K. original Form 8802. was filed for a tax period for which
income tax, you may need to complete certification will be based, enter the
a U.K. certification form (US-Individual Additional request made by third
party appointees. Third party spouse's name and TIN exactly as they
2002 or US-Company) in addition to appear on the return filed.
Form 8802. For copies of these forms, appointees cannot use this special
contact HM Revenue and Customs. procedure to request additional Form(s) Change in taxpayer's name. If the
• On the Internet at 6166 for countries that were not taxpayer's name has changed since the
www.hmrc.gov.uk, enter "US Double originally authorized by the taxpayer in most recent Form 8802 was filed with
Taxation" in the search box, and scroll their previously signed and dated Form the IRS, the Form 8802 and tax
down to the link for the Form 8802. If you anticipate using the disclosure authorization for each
US-Individual 2002 or Form additional request procedure to individual or entity must be submitted
US-Company. authorize a third party appointee to under the taxpayer's new name. In
• Telephone at: 44-135-535-9022 if request additional Forms 6166 for a addition, the taxpayer must submit
calling from outside the U.K., or country not identified in your current documentation of the name change with
0300-200-3300 if calling from the U.K. Form 8802, you must include in line 10 a Form 8802 (for example, trust
written statement authorizing the third agreement, corporate charter).
Send the completed U.K. form to the party appointee to request Form 6166 Certification will not be issued if the
IRS with your completed Form 8802. covering the same tax period for any name change has not been updated in
country. the IRS database. Businesses and
Specific Instructions Foreign Claim Form trusts or estates can notify the IRS of a
name change by checking the
Check the box if you have included with
appropriate box on Forms 1120, 1120S,
Check Boxes at Top of Form 8802 a foreign claim form sent to
1065, or 1041, when filed. Individuals
Page 1 you by a foreign country. The
can indicate a name change on Form
submission or omission of a foreign
1040 when filed. If you change your
Additional Requests claim form will not affect your residency
name and address, you can notify the
Check this box if you are submitting certification. If the IRS does not have an
IRS of the changes on Form 8822.
Form 8802 to request additional Form(s) agreement with the foreign country to
Individuals should also notify the Social
6166 for a tax period for which the IRS date stamp or otherwise process the
Security Administration (SSA) of a name
has previously issued a Form 6166 to form, we will not process it and we will
change by filing Form SS-5, Application
you. Additional requests on a separate mail such foreign claim form back to
for a Social Security Card, with the SSA.
Form 8802 will require the payment of you.
See IRS.gov for more information.
the applicable non-refundable user fee.
For additional information on how to
See User Fee, earlier.
notify the IRS of your new name, you

can also contact customer service. For communicate with any person • Enrolled Retirement Plan Agents (the
businesses, the number is employed by the entity. authority to practice before the IRS is
1-800-829-4933. For individuals, the limited)
If you have multiple appointees,
number is 1-800-829-1040. If you are
attach a list of the additional appointees
• Certain individuals who have a
deaf, hard of hearing, or have a speech special relationship or status with the
not identified on line 3b whom the IRS
disability and have access to TTY/TDD taxpayer.
can communicate with regarding your
equipment, you can call For more information, see Pub. 947.
Form 8802. If only one individual is
1-800-829-4059.
shown on line 3b, the IRS is authorized 3-year procedure. Under the 3-year
to communicate only with that person.
Line 2. Applicant's procedure, the third party appointee
completes a Form 8802 in the first year
Address You are not required to enter the
that must be signed and dated by the
telephone or fax number of your third
Do not enter a P.O. box number party appointee. However, providing a applicant. In the following two tax years
or C/O address. Certification telephone or fax number will expedite the third party appointee must complete
!
CAUTION may be denied if the applicant the processing of your Form 8802 if the a new Form 8802 that is not required to
enters a P.O. box or C/O address. IRS has any questions. By providing a be signed and dated by the applicant.
telephone or fax number, you are Form 2848 or Form 8821 must be
Enter your address for the calendar attached to Form 8802 in year 1 and
year for which you are requesting authorizing the IRS to communicate with
your third party appointee(s). must indicate all years in the 3-year
certification. If you are an individual who period for which certification is
lived outside the United States during The Centralized Authorization File requested.
the year for which certification is (CAF) contains information on third
requested, the special rules under For more information, see
parties authorized to represent
Individuals With Residency Outside the Certification Under the 3-Year
taxpayers before the IRS and/or receive
United States, earlier, may apply to you. Procedure, earlier.
and inspect confidential tax information.
If your appointee has a CAF number,
Line 3a. Mailing Address enter it on line 3b.
Line 4a. Individual
Form 6166 and any related In general, you do not need to fill out Green card holder. If you are a
correspondence can be mailed to you or line 3b if you have attached Form 2848 resident alien with lawful permanent
to a third party appointee. If you provide or Form 8821. In line 3b, write “See resident status who recently arrived in
an address on line 3a, it will be used for attached authorization.” Attach a Form the United States and you have not yet
all mail correspondence relating to your 2848 or Form 8821 for each third party filed a U.S. income tax return, you
Form 6166 request. If you do not that you authorize to receive your tax should provide a copy of your current
indicate a mailing address on line 3a, information. If you have multiple third Form I-551, Alien Registration Receipt
the IRS will mail Form 6166 to the party appointees, see the instructions Card (green card). Instead of a copy of
address on line 2. If the mailing address for Form 2848 or Form 8821. your green card, you can attach a
entered on line 3a is for a third party statement from U.S. Citizenship and
appointee, you must provide written Form 8821, Taxpayer Information Immigration Services (USCIS) that gives
authorization on line 3b for the IRS to Authorization, and Form 2848, Pow- your alien registration number, the date
release the certification to the third er of Attorney and Declaration of and port of entry, date of birth, and
party. Representative. Form 8821 is used to classification. For more information on
authorize disclosure of tax information determining your U.S. resident status for
Line 3b. Third Party to a third party designee of the taxpayer. tax purposes, see Nonresident Alien or
Form 8821 cannot be used to authorize Resident Alien, in Pub. 519.
Appointee's Information a third party to sign Form 8802 on your
Enter the name of your third party behalf, and it does not authorize a third Other U.S. resident alien. An
appointee(s) on line 3b of Form 8802. party to represent you before the IRS. individual who is not a lawful permanent
Providing this information constitutes According to section 6103(c) and the resident of the United States but who
written authorization for the IRS to regulations thereunder, authorization on meets the “substantial presence test”
communicate with the third party Form 8821 will not be accepted if it under section 7701(b) is a resident alien
appointee(s) identified on line 3b when covers matters other than federal tax for purposes of U.S. taxation. If you are
you submit the signed and dated Form matters. a resident alien under the substantial
8802. presence test and you have not yet filed
Form 2848 authorizes a third party to
The third party appointee identified represent you before the IRS. Only a U.S. income tax return for the year for
on line 3b should be someone the IRS individuals who are recognized to which certification is requested, you
can communicate with in order to practice before the IRS can be must attach a copy of your current Form
resolve questions related to the authorized to represent you. The only I-94, Arrival-Departure Record. Enter
processing of your Form 8802. This individuals who can be recognized the date (YYYYMMDD) your status
individual should be knowledgeable representatives are the following: changed on the line provided. For
information on determining your period
about Form 8802 and able to respond to • Attorneys of residency, see Substantial Presence
any IRS questions regarding your Form • Certified Public Accountants Test in Pub. 519.
8802. If you enter an entity such as a • Enrolled Agents
corporation or trust on line 3b, identify a • Enrolled Actuaries (the authority to Students, teachers, and trainees.
specific individual at the entity who can practice before the IRS is limited) If you filed Form 1040 and you are in the
answer questions about your Form • Student attorney or CPA (must United States under an “F-1,” “J-1,”
8802. If you do not identify a specific receive permission to practice before
individual, the IRS is authorized to the IRS)

“M-1,” or “Q-1” visa, include the United States create multiple periods of 3. Unless the requester is a partner
following with Form 8802. U.S. resident and non-resident status. in the partnership during the tax year for
1. A statement explaining why Form For information and examples of a which certification is requested,
1040 was filed. dual-status alien, and to determine your authorization from the partnership must
period of residency, see Pub. 519. explicitly allow the third-party requester
2. A statement and documentation to receive the partnership's tax
showing that you reported your If you checked the dual-status box,
enter the dates (YYYYMMDD) that information. The authorization must not
worldwide income. address matters other than federal tax
correspond to the period that you were
Note. Nonresident aliens present in the a resident of the United States during matters.
United States on these visas may be the year(s) for which certification is An LLC that is classified as a
exempt individuals for 2 or more years, requested. partnership follows the above
and are not resident aliens under the Partial-year Form 2555 filer. Check procedures. Members of the LLC are
substantial presence test while they are this box if you filed a Form 2555 that treated as partners.
exempt individuals. See section 7701(b) covered only part of a year for which
(5). Nominee partnership. Do not check
certification is requested. For each year the partnership box on line 4b. Instead,
First-year election. If you are an that this applies, enter the eight-digit check line 4j and attach the information
individual who made or intends to make dates (YYYYMMDD) that correspond to required by the instructions.
the first-year election under section the beginning and ending of the period
7701(b)(4) applicable to the year for you were a resident of the United Line 4c. Trust
which certification is requested, enter States.
Domestic and foreign grantor trusts and
the date (YYYYMMDD) your status as a Sole proprietor. Include on line 6 the simple trusts can be certified for U.S.
U.S. resident for tax purposes will begin. type of tax return, name, TIN, and any residency, to the extent the owner of the
For more information regarding the other information that would be required grantor trust or beneficiaries of simple
first-year election and determining your if certification were being requested for trusts are U.S. residents. Domestic
period of residency, see First-Year the individual owner that filed the complex trusts can be certified without
Choice in Pub. 519. Schedule C (Form 1040). regard to the residence of the settler or
• If you have made a first-year beneficiaries.
residence election under section Line 4b. Partnership A trust is domestic if a court within
7701(b)(4) applicable to the year for Partnerships are not considered U.S.
which you are requesting certification, the United States is able to exercise
residents within the meaning of the primary supervision over the
attach to Form 8802 the election residence article of U.S. income tax
statement you filed with your income tax administration of the trust and one or
treaties. A domestic partnership is not more U.S. persons has authority to
return for the taxable year of election. considered a U.S. resident, even if all
• If, for the calendar year for which control all substantial decisions of the
partners are U.S. residents. Treaty trust.
certification is requested, you have not benefits are only available to a partner
yet filed a first-year residence election who is a U.S. resident whose Grantor trust. Include the following
statement, attach to Form 8802 a distributive share of partnership income with Form 8802.
statement that you intend to file such includes the item of income paid to the 1. The name and TIN of each owner
statement and that you are eligible to partnership. and any information that would be
make the election. required if certification were being
Dual-status alien. An individual is a Note. The Form 6166 issued to requested for each owner.
dual-status alien for U.S. tax purposes if partnerships will include an attached list
of partners that are U.S. residents. The 2. Authorization (for example, Form
the individual is a part-year resident 8821) from each owner. Each
alien and a part-year nonresident alien IRS does not certify the percentage of
ownership interest of the listed partners. authorization must explicitly allow the
during the calendar year(s) for which third-party requester to receive the
certification is requested. Dual-status It is the responsibility of the partnership
to provide such information to the owner's tax information and must not
generally occurs in the year an address matters other than federal tax
individual acquires status as a U.S. withholding agent.
matters.
resident or terminates such status. For Include the following with Form 8802: 3. Unless the requester is a trustee
example, you are a dual-status alien if
1. The name and TIN of each of the trust, authorization from the trust
you are a U.S. citizen or green card
partner for which certification is must explicitly allow the third-party
holder and you lost citizenship or green
requested and any additional requester to receive the trust's tax
card holder status during the same
information that would be required if information. The authorization must not
calendar year. You may also be a
certification were being requested for address matters other than federal tax
dual-status alien if you are a
each of those partners. matters.
non-resident alien but due to meeting
the substantial presence test become a 2. Authorization (for example, Form 4. If the grantor trust is a foreign
resident alien during the same calendar 8821) from each partner, including all trust, also include a copy of Form
year. partners listed within tiered 3520-A with the foreign grantor trust
partnerships. Each authorization must owner statement completed.
The dual-status alien classification
explicitly allow the third-party requester
does not occur merely due to a Domestic complex trust. Unless the
to receive the partner's tax information
temporary absence from the United requester is a trustee of the trust during
and must not address matters other
States, nor will multiple periods of the tax year for which certification is
than federal tax matters.
temporary absence and re-entry into the requested, authorization from the trust

must explicitly allow the third-party A bank or financial institution acting Rul. 2014-24, available at https://
requester to receive the trust's tax as the trustee for IRAs can request www.irs.gov/irb/
information. The authorization must not certification for multiple IRAs grouped 2014-37_IRB#RR-2014-24. Also, see
address matters other than federal tax by year and by country for which Notice 2012-6, available at https://
matters. certification is requested. The bank or www.irs.gov/irb/
financial institution must include the 2012-03_IRB#NOT-2012-6.
Simple trust. A simple trust is not a
following with Form 8802.
resident, because all of its income is
required to be distributed currently to its 1. A list of IRA account names and Line 4d. Estate
beneficiaries. A simple trust must, account numbers for which certification If you are filing a Form 8802 on behalf of
therefore, be certified at the beneficiary is requested. the estate of a decedent, you must
level. Include the following with Form 2. A statement that each IRA include proof that you are the executor
8802. account name and number listed is an or administrator of the decedent's
IRA within the meaning of section estate. Form 8802 can be submitted on
1. The name and TIN of each
408(a) or 408A. behalf of an estate for the year of the
beneficiary and any information that is
taxpayer's death or any prior year. Proof
required to certify each beneficiary. 3. A statement that the bank or can include a court certificate naming
2. Authorization (for example, Form financial institution is a trustee of the you executor or administrator of the
8821) from each beneficiary. Each IRA. estate. U.S. residency certification will
authorization must explicitly allow the be based on the tax information and
third-party requester to receive the Common trust fund as defined in
section 584. Include the following with residency of the decedent.
beneficiary's tax information and must
not address matters other than federal Form 8802. 3-year procedure. If you check
tax matters. 1. The name and TIN of each box 4d, you may be able to use the
participant and any information that 3-year procedure. See Certification
3. Unless the requester is a trustee Under the 3-Year Procedure, earlier.
of the trust, authorization from the trust would be required if certification were
must explicitly allow the third-party being requested for each participant.
requester to receive the trust's tax 2. Authorization (for example, Form
Line 4e. Corporation
information. The authorization must not 8821) from each participant. Each Generally, a corporation is a resident
address matters other than federal tax authorization must explicitly allow the entitled to U.S. residency certification
matters. third-party requester to receive the only if it is incorporated in the United
participant's tax information and must States. An unincorporated domestic
Group trust arrangement, described not address any matters other than entity, such as an LLC, can be a
in Rev. Rul. 81-100. A group trust federal tax matters. If a pass-through resident if it is an association taxable as
arrangement that has received a entity is a participant, you must list the a corporation.
determination letter recognizing its partners/shareholders/owners/ Certain foreign corporations can be
exempt status under section 501(a) participants/members/beneficiaries in treated as domestic corporations if they
must attach a copy of that letter to Form the pass-through entity and obtain qualify as U.S. corporations under
8802. authorization from each such sections 269B, 953(d), and 1504(d).
A group trust arrangement that is participant. Only Canadian and Mexican
seeking benefits from Switzerland with 3. Unless the requester is a trustee corporations are eligible to be treated as
respect to dividends paid by a Swiss of the trust, authorization from the trust domestic corporations under section
corporation must also attach to Form must explicitly allow the third-party 1504(d). Foreign corporations can
8802 the name of each participant and a requester to receive the trust's tax obtain residency certification if they can
statement that each participant listed is information. The authorization must not establish that they are covered by these
a trust forming part of a plan described address matters other than federal tax Code sections.
in section 401(a), 403(b), or 457(b). matters.
Corporations requesting U.S.
IRA. Domestic individual retirement A common trust fund that is seeking residency certification on behalf of their
arrangements (individual retirement benefits from Switzerland with respect subsidiaries must attach a list of the
accounts within the meaning of section to dividends paid by a Swiss corporation subsidiaries and the Form 851,
408(a) and Roth IRAs within the must also attach to Form 8802 the name Affiliations Schedule, filed with the
meaning of section 408A) (collectively of each participant and a statement that corporation's consolidated return.
referred to as IRAs) can be certified as each participant listed is a trust forming
residents (without regard to the Dual-resident corporation. If you are
part of a plan that is described in section
residence of the IRA holder). Either the requesting certification for treaty
401(a), 403(b), or 457(b), or is a trust
IRA holder or the trustee of the IRA can benefits in the other country of
forming part of a plan described in
request certification on behalf of the residence named on line 4e,
section 401(a), 403(b), or 457(b) that is
IRA. certification depends on the terms of the
within a group trust arrangement
residence article of the relevant treaty. If
An IRA holder requesting certification described in Rev. Rul. 81-100, 1981-13
the treaty provides that benefits are
on behalf of an IRA must provide the I.R.B. 33, as clarified and modified by
available only if the competent
IRA account name (that is, the IRA Rev. Rul. 2004-67, available at https://
authorities reach a mutual agreement to
holder's name) and number, the IRA www.irs.gov/irb/
that effect, request competent authority
holder's TIN, and a copy of Form 8606 2004-28_IRB#RR-2004-67, and
assistance in accordance with Rev.
or Form 5498. Complete the remainder modified by Rev. Rul. 2011-1, available
Proc. 2015-40, available at https://
of Form 8802 as if the IRA was at https://www.irs.gov/irb/
www.irs.gov/irb/
requesting the certification. 2011-02_IRB#RR-2011-1, and Rev.

2015-35_IRB#RP-2015-40, before Certification will not be issued to that may be required to be included with
seeking certification. ! a trust that is part of an your Form 8802.
CAUTION employee benefit plan during
Line 4f. S Corporation the employee benefit plan’s first year of Line 4j. Nominee Applicant
S corporations are not considered U.S. existence, unless it is administered by a If you act as a nominee for another
residents within the meaning of the qualified custodian bank, as defined in person or entity, you must provide all
residence article of U.S. income tax 17 CFR 275.206(4)-2(d)(6)(i). certification information required for
treaties. Treaty benefits are only each individual or entity for which you
available to a shareholder who is a U.S. 3-year procedure. If you check are acting as a nominee. For example, if
resident for purposes of the applicable box 4g, you may be able to use the you are acting as a nominee for a
treaty. 3-year procedure. See Certification resident alien, you must attach the
Under the 3-Year Procedure, earlier. information required of applicants that
Include the following with Form 8802. are resident aliens. Similarly, if one of
1. The name and TIN of each Line 4h. Exempt the entities for which you are acting as a
shareholder for which certification is Organization nominee is a partnership, then you must
requested and any additional Generally, an organization that is submit the certification information for
information that would be required if exempt from U.S. income tax must each of the partners requesting
certification were being requested for attach to Form 8802 a copy of either the certification. In addition, you must
each of those shareholders. organization's determination letter from include the following with Form 8802.
2. Authorization (for example, Form the IRS or the determination letter for 1. Authorization (for example, Form
8821) from each shareholder. Each the parent organization. 8821) from each individual or entity.
authorization must explicitly allow the The IRS will not issue a Form 6166 to Each authorization must explicitly allow
third-party requester to receive the an exempt organization that is not the nominee applicant to receive the
shareholder's tax information and must required to file a U.S. income tax return individual's or entity's tax information
not address any matters other than and that has not received a and must not address any matters other
federal tax matters. determination letter, unless such than federal tax matters.
3. Unless the requester is a organization has other means of proving 2. A statement under penalties of
shareholder in the S corporation during U.S. residency for tax treaty purposes. perjury signed by an individual with legal
the tax year for which certification is For such an entity, include with Form authority to bind the nominee applicant,
requested, authorization from an officer 8802 the entity's bylaws, corporate explicitly stating the nominee applicant
with legal authority to bind the charter, trust agreement, partnership is acting as an agent on behalf of the
corporation must explicitly allow the agreement, etc. above-named individual(s) or entity(ies)
third-party requester to receive the Governmental entity. Federal, state, for whom the Form 6166 is being
corporation's tax information. The or local government agencies requested.
authorization must not address matters requesting U.S. residency certification
other than federal tax matters. Note. If you are a nominee partnership,
that have not obtained a determination please do not provide information
letter, private letter ruling, revenue
Line 4g. Employee Benefit ruling, etc., can submit in writing, on
concerning your partners. The
residence of your partners will not be
Plan/Trust official government letterhead, a letter verified.
Trusts that are part of an employee under penalties of perjury from a legally
authorized government official stating
benefit plan that is required to file Form
that the organization is a government
Line 5. Statement
5500 must include a copy of the signed
Form 5500 with Form 8802. agency. Required If Applicant Did
3-year procedure. If you check Not File a U.S. Income Tax
An employee plan that is not subject
to the Employee Retirement Income box 4h, you may be able to use the Return
Security Act (ERISA) or is not otherwise 3-year procedure. See Certification If the applicant was not required to file a
required to file Form 5500 must include Under the 3-Year Procedure, earlier. U.S. income tax return for the tax
with Form 8802 a copy of the employee period(s) for which certification will be
benefit plan determination letter. Line 4i. Disregarded Entity based, check the applicable box next to
Disregarded entities (DRE) are not “No.” If the applicant does not fit in any
An employee plan that is not required considered U.S. residents within the of the categories listed, check “Other”
to file Form 5500 and does not have a meaning of the residence article of U.S. and on the dotted line that follows enter
determination letter must provide income tax treaties. Treaty benefits will the code section that exempts the
evidence that it is entitled to only be available to a DRE owner who is applicant from the requirement to file a
certification. It must also provide a a U.S. resident. The DRE type must be U.S. income tax return. See Table 1 for
statement under penalties of perjury specified on line 4i. the statement required if the applicant
explaining why it is not required to file did not file a U.S. income tax return.
Form 5500 and why it does not have a Note. See line 5 for more information
determination letter. regarding the DRE's owner information

Table 1. Statement Required If Applicant Did Not File a U.S. Income Tax Return
IF the applicant was not

required to file a U.S. income
tax return and the applicant
is... THEN ...
an individual attach proof of income (for example, an income statement, Form W-2, Form 1099, etc.) and a
written statement that explains why the individual is not required to file an income tax return for
the tax period(s) for which certification is based. If the individual is a U.S. citizen, the written
statement must be made under penalties of perjury.
a child under age 19, or under attach a signed copy of the Form 8814, Parents' Election To Report Child's Interest and
age 24 if a full-time student, Dividends.
whose parent(s) elected to
report the child's income on their
return
a qualified subchapter S attach proof of the election made on Form 8869, and all other requirements listed in the
subsidiary (QSub) (include the instructions for line 4f that apply to the parent S corporation.
parent S corporation information
on line 6 of Form 8802)
a trust or estate attach an explanation of why the trust or estate is not required to file Form 1041.
a common trust fund attach a copy of the determination letter or proof that a participant is not required to file.
a group trust arrangement attach a copy of the determination letter or private letter ruling.
a partnership described in attach a copy of the section 761(a) election submitted with Form 1065 or a statement from a
section 761(a) general partner that is signed and dated under penalties of perjury. See Table 2, Current Year
Penalties of Perjury Statements.
a government entity submit in writing, on official government letterhead, an explanation of why the government entity
is exempt from a filing requirement. A government official with the authority to bind the
organization or agency must sign and date the letter under penalties of perjury.
a foreign partnership include all information indicated in the instructions for line 4b for each partner requesting
certification.
a domestic disregarded entity include the entity's single owner information on line 6 of Form 8802. Include with Form 8802: the
(domestic DRE) owner's name and entity type (e.g., corporation, partnership), TIN, and all other certification
information required for the owner's type of entity. If the DRE has not filed a Form 8832 with the
IRS, also include a statement from the owner, signed under penalties of perjury (see Table 2).
a foreign disregarded entity for tax years beginning on or after January 1, 2004, if the disregarded entity is organized outside
(foreign DRE) the United States and the owner is a U.S. person, attach a copy of the Form 8858 filed with the
U.S. owner's income tax return for the calendar year(s) for which certification is requested. If the
owner has not identified the foreign DRE on the Form 8858, the IRS cannot certify the foreign
DRE. Include the foreign DRE's owner information on line 6. Include with Form 8802 the owner's
name and entity type, TIN, and all other certification information required for the owner's type of
entity. If certification is being requested for tax years prior to January 1, 2004, the IRS does not
require the U.S. owner to attach a copy of the Form 8858, but the U.S. owner must attach proof
that a U.S. resident owns the foreign DRE. For example, if a U.S. corporation owns the foreign
DRE, the applicant must attach a copy of Schedule N (Form 1120) filed with the owner's income
tax return for the calendar year for which certification is requested. If the owner has not identified
the DRE on an attachment to its Schedule N, the IRS cannot certify the foreign DRE.
Line 6. Parent, Parent and TIN of the parent who reported the • On line 6, check the box
child's income. corresponding to the entity type of the
Organization, or Owner owner, and enter the owner's name,
If you answered “Yes” to line 5, do not If you answered “No” to line 6, attach address, and TIN.
complete line 6. proof of the parent's, parent • On line 10, enter a statement signed
organization's, or owner's income and under penalties of perjury if the single
If you answered “No” to line 5, you an explanation of why the parent is not owner has not filed a Form 8832 with
must complete line 6. required to file a tax return for the tax the IRS (see Table 2).
period(s) for which certification is
If you answered “Yes” to line 6, check
based.
the appropriate box and enter the
parent's, parent organization's, or Disregarded entity. The single owner
owner's information. If the applicant is a of a DRE must include the following
minor child, enter the name, address, information on Form 8802.

Line 7. Calendar Year of Line 8. Tax Period(s) Line 9. Purpose of
Request If you are requesting certification for a Certification
The certification period is generally 1 tax period for which a tax return is not You must indicate the purpose of the
year. You can request certification for yet due, enter the four-digit year and certification.
both the current year and any number of two-digit month (YYYYMM) that
correspond to the latest return required The IRS will return your
prior years.
to have been filed (including ! application to you for
If you entered the most recent prior CAUTION completion if you do not include
extensions). If you are a fiscal year
year on this line, see Form 8802 Filed taxpayer, enter the year and month that a purpose on the application.
Before Return Posted by the IRS, correspond to the end of that fiscal tax
earlier. year. For a prior year certification, the Income tax treaty. If you are
four-digit year and two-digit month requesting certification to obtain
Enter the four-digit (YYYY) calendar benefits under an income tax treaty but
year(s) for which you are requesting should correspond to the end of the
prior year tax period for which you have requested certification for a
certification. However, see the non-treaty country, the IRS will return
Exception below. certification is requested.
your application to you for correction.
Exception. If you were a dual-status Note. These examples assume no VAT. You can find the North American
alien during any year for which you are extension is filed, unless stated Industry Classification System (NAICS)
requesting certification, enter instead otherwise. codes in the instructions for your tax
the eight-digit dates (YYYYMMDD) that Example 1. A Form 1040 filer who is return (for example, Form 1120 or
correspond to the beginning and ending completing Form 8802 for certification Schedule C (Form 1040)). If you do not
of the period you were a resident of the year 2018 on January 1, 2018, would provide an NAICS code on Form 8802
United States. You must show the enter 201612 on line 8. This is because and one was not provided on the return
specific period of residence for each on January 1, 2018, the 2016 Form you filed, one will not be entered
year for which you are requesting 1040 is the latest return required to have automatically. Form 6166 will only
certification. For information on been filed by an individual requesting certify that you filed a return with a
determining your period of residency, certification for 2018. particular NAICS code if it matches the
see Pub. 519. NAICS code on your application. If you
Example 2. On May 1, 2018, the
Fiscal year taxpayers. Fiscal year same Form 1040 filer would enter provide a code that does not match,
filers also enter a four-digit (YYYY) 201712 on line 8 as the tax period for Form 6166 will state that you represent
calendar year on line 7. You must certification year 2018 (the 2017 Form that your NAICS code is as stated on
request a separate calendar year 1040 was required to have been filed Form 8802.
certification for any part of a fiscal tax before May 1, 2018).
year that falls outside the calendar year. Note. VAT certification requires a
If the Form 1040 filer had filed an penalties of perjury statement, and a
Current year certification. If the extension for 2017, the filer would enter statement that the NAICS codes have
applicant requests certification for 201612 on line 8. This is because on not changed since the last return was
purposes of claiming benefits under an May 1, 2018, the 2016 Form 1040 is the filed. For more information, see the
income tax treaty or VAT exemption for latest return required to be filed. instructions for line 10 next.
any period during the current calendar Example 3. On January 1, 2018, a
year or a year for which a tax return is Form 1040 filer completing Form 8802 Line 10. Penalties of
not yet required to be filed with the IRS,
the applicant must include penalties of
for certification year 2015 would enter Perjury Statements and
201512. Attachments
perjury statement(s) stating that such
applicant is a U.S. resident and will Example 4. A Form 1120 filer has a Enter penalties of perjury statements
continue to be so throughout the current fiscal year ending on September 30. from Table 2 in the space provided
tax year. See Table 2 for the current The Form 1120 filer completing Form under line 10 or as an attachment to
year penalties of perjury statement you 8802 for certification year 2018 on Form 8802. Penalties of perjury
must enter on line 10 of Form 8802 or February 15, 2018, would enter 201709 statements submitted independently of
attach to the form. on line 8. This is because on February Form 8802 must have a valid signature
15, 2018, the 2016 Form 1120 with and date. See Table 3.
Note. For VAT certification, the fiscal year ending September 30, 2017,
penalties of perjury statement must is the latest return required to have been VAT. For VAT certifications, the
include a statement that the business filed. penalties of perjury statement must also
activity has not changed since the last include a statement that the business
If you were not required to file a U.S. activity (NAICS code) has not changed
return was filed. For more information,
tax return for the tax period for which since your last filed return.
see the instructions for line 10 below.
certification is requested, enter the tax
3-year procedure. If you are using the period that would have been applicable, 3-year procedure. If you are using the
3-year procedure (discussed earlier), if you were required to file a U.S. tax 3-year procedure (discussed earlier),
enter all years in the 3-year period, as return. After the tax period, add "(not you are required to enter a penalties of
applicable, on the Form 8802 filed for required to file)." perjury statement in the first year stating
the first year. For years two and three, that the applicant is a U.S. resident and
enter only the current calendar year for will continue to be so through the
which you are requesting certification. current tax year and the following two
tax years. See Table 2 for the 3-year
procedure penalties of perjury

statement you must enter on line 10 of Attachments. If someone other than Additional information. If you must
Form 8802 or attach to Form 8802. the person signing Form 8802 prepares submit additional information with Form
an attachment that is submitted 8802, use the space provided under
Note. For a Form 8802 submitted after independently of Form 8802, an line 10 or attach the information to the
the first year of the 3-year procedure, individual who has authority to sign form.
enter “See attached year 1 Form 8802 Form 8802 must sign and date the
filed under the 3-year procedure” in attachment under penalties of perjury.
place of the penalties of perjury See Table 3.
statement on line 10.
Table 2. Current Year Penalties of Perjury Statements
THEN the Form

8802 penalties of
IF the applicant perjury statement STATING: “This certification is given under penalties of perjury and to the best of
is... must include... my knowledge and belief, the statements are true, correct, and complete.”
a statement from [Insert name of individual and TIN] is a U.S. resident and will continue to be throughout the
an individual
the individual current tax year.
an individual a statement from Countries other than Japan: [Insert name of individual and TIN] was a U.S. resident
claiming treaty the individual within the meaning of Article [#] of the U.S.-[country] treaty (including, in some cases,
benefits for physical presence in the United States) immediately before entering [country]. The
teaching or assignment began on [date] and ends on [date]. Article [#] of the U.S.-[country] treaty
research provides a [2 or 3] year exemption from income tax.
activities Japan: [Insert name of individual and TIN] is (and will continue to be) a U.S. resident
within the meaning of Article 4(1) of the U.S.-Japan treaty. The assignment began on
[date] and ends on [date]. Article 20 of the U.S.-Japan treaty provides a 2-year
exemption from income tax.
a partnership a statement from [Insert name of partner and TIN] is a U.S. resident and will continue to be throughout the
each individual current tax year, and
partner for which
certification is
requested
a statement from a [Insert name of partnership and EIN] has filed its required return and the entity
general partner classification has not changed since the return was filed.
a statement from [Insert name of shareholder and TIN] is a U.S. resident and will continue to be throughout
each individual the current tax year, and
an S corporation shareholder for
which certification
is requested
a statement from [Insert name of S corporation and EIN] has filed its required return and the entity
an officer of the classification has not changed since the return was filed.
corporation with the
authority to legally
bind the corporation
a statement from [Insert name and TIN] is a U.S. resident and will continue to be throughout the current tax
a common trust each individual year, and
fund, grantor participant/owner/
trust, or simple beneficiary for
trust which certification
is requested
a statement from [Insert name of trust and EIN] has filed its required return and the entity classification has
the trustee with not changed since the return was filed.
authority to legally Note: When the participant, beneficiary, or owner is other than an individual, use the
bind the trust statement that corresponds to the type of entity.
any trust other a statement from [Insert name of trust and EIN] is a U.S. resident and will continue to be throughout the
than a common the trustee with current tax year.
trust fund, authority to legally
grantor trust, or bind the trust
simple trust

THEN the Form
8802 penalties of
a statement from [Insert name of corporation and EIN] is a U.S. resident and will continue to be throughout
a corporation an officer of the the current tax year.
corporation with the
bind the corporation
a statement from [Insert name of organization and EIN] is a U.S. resident and will continue to be throughout
an exempt an officer of the the current tax year.
organization organization with
bind the
organization
an exempt a statement from [Insert name of organization and EIN] is a U.S. resident and will continue to be
organization an officer of the throughout the current tax year and the following two tax years.
submitting a organization with
Form 8802 under authority to legally
the 3-year bind the
procedure (in organization
year 1)
a statement from [Insert name of estate and EIN] is a U.S. resident and will continue to be throughout the
an estate of a the personal current tax year.
decedent representative
an estate of a a statement from [Insert name of estate and EIN] is a U.S. resident and will continue to be throughout the
decedent the personal current tax year and the following two tax years.
submitting a representative
Form 8802 under
the 3-year
procedure (in
year 1)
a statement from [Insert name of plan/trust and EIN] is a U.S. resident and will continue to be throughout the
an employee an officer of the current tax year.
benefit plan/trust plan/trust with
bind the plan/trust
an employee a statement from [Insert name of plan/trust and EIN] is a U.S. resident and will continue to be throughout
benefit plan/trust an officer of the the current tax year and the following two tax years.
submitting a plan/trust with
Form 8802 under authority to legally
the 3-year bind the plan/trust
procedure (in
year 1)
a partnership a statement from [Insert name of partner and TIN] is a U.S. resident and will continue to be throughout the
under a section each partner for current tax year, and
761(a) election which certification
is requested
a statement from a a. [Insert name of partnership and EIN] has made an election pursuant to section 761(a).
general partner As a result, it is not required to file Form 1065 on an annual basis and all of its partners
report their respective shares of income, gain, loss, deductions, and credits on their tax
returns as required.
b. The [insert name of partnership] 's entity classification has not changed since the filing of
the partners' returns.

THEN the Form
8802 penalties of
a foreign an additional [Insert name of partnership and EIN] is not required to file Form 1065 under Regulations
partnership statement from a section 1.6031(a)-1(b) and the entity classification has not changed since the filing of the
under general partner partners' returns.
Regulations
section
1.6031(a)-1(b)
a disregarded a statement from This certifies that [insert name and TIN of the owner of the DRE corporation, partnership, or
entity (DRE) the owner of the individual] trading as [insert name of limited liability company] is a single-owner limited
DRE liability company that is treated as a disregarded entity for U.S. income tax purposes, that
[insert name of corporation, partnership, or individual] is the single owner of [insert name of
limited liability company], and, as such, [insert name of corporation, partnership, or
individual] is required to take into account all the income, gain, losses, deductions, and
credits of [insert name of limited liability company] on its/his/her U.S. federal income tax or
information return.
a nominee a statement from [Insert name and TIN of individual(s)/entity(ies) on whose behalf the nominee is acting] is a
each individual or U.S. resident and will continue to be throughout the current tax year.
entity for whom the
nominee is acting
Signature and Date attach documentation (for example, instructions signs Form 8802, enter a
An individual who has the authority to Form 2848) of the authorization. See statement in line 10 and attach any
sign Form 8802 must sign and date the Table 3 to determine who has authority appropriate documentation to indicate
application or the IRS will not consider to sign Form 8802. such individual's authority to sign Form
Form 8802 to be complete and valid. A 8802. If you are granting authority to a
To avoid processing delays and third party, you must sign and date the
third-party representative with possible rejection of Form 8802, if an
authorization to sign Form 8802 must documentation.
individual who is not identified in the

Table 3. Who Has Authority To Sign Form 8802
IF the applicant is... THEN the individual with authority to sign Form 8802 is...
an individual the individual.

a married couple both spouses.
a minor child who cannot sign either parent by signing the child's name and adding “By (your signature), parent for minor child.”
a child under age 19, or under the parent who filed Form 8814 with his/her income tax return.
age 24 if a full-time student,
whose parent(s) reported the
child's income on Form 8814
a partnership any partner or partners duly authorized to act for the partnership (general partner or partnership
representative). Each partner must certify that he or she has such authority.
an S corporation any corporate officer, for example, president, vice president, treasurer, chief accounting officer,
etc., duly authorized by the corporation to bind the corporation in accordance with applicable state
law.
a trust, common trust fund, the fiduciary (trustee, executor, administrator, receiver, or guardian).
grantor trust, or simple trust
an estate of a decedent the personal representative (executor or administrator).
a corporation any corporate officer, for example, president, vice president, treasurer, chief accounting officer,
etc., duly authorized by the corporation to bind the corporation in accordance with applicable state
law.
an employee benefit plan or any organization officer, for example, president, vice president, treasurer, chief accounting officer,
trust etc., duly authorized by the plan or trust to bind the plan or trust in accordance with applicable
state law.
an exempt organization any organization officer, for example, president, vice president, treasurer, chief accounting officer,
etc., duly authorized by the organization to bind the organization in accordance with applicable
state law.
a partnership under a section any partner or partners duly authorized to act for the partnership. Each partner must certify that he
761(a) election or she has such authority.
a governmental organization an officer of the governmental organization with authority in the course of his or her official duties
to bind the organization.
Daytime Phone Number the number of certifications requested When To Seek U.S.
for all years to get the total number of
Providing your daytime phone number
certifications requested for that country.
Competent Authority
speeds the processing of Form 8802, if
we have questions about items on your Example. You are requesting
Assistance
application, such as the NAICS code, certifications for Germany. You need 3 If your request for Form 6166 is denied,
type of applicant, etc. By answering our certifications for 2015, 2 certifications or if you are denied treaty benefits by a
questions over the phone, we may be for 2016, and 4 certifications for 2017. U.S. treaty partner, and you believe you
able to continue processing your Form Enter 9 as the total number of are entitled to treaty benefits under a
8802 without mailing you a letter. If you certifications requested for Germany. specific treaty article, you can request
are filing a joint application, you can U.S. competent authority assistance
enter either your or your spouse's Note. If you are requesting following the procedures established in
daytime phone number. certifications for multiple years, attach a Rev. Proc. 2015-40, available at https://
statement to Form 8802 identifying the www.irs.gov/irb/
2015-35_IRB#RP-2015-40.
Line 11. Number of country, year, and number of
certifications per year. The total must
Certifications (Forms agree with the number entered to the
A request for U.S. competent
authority assistance regarding a
6166) Requested for Each right of the related country code on residency issue will be accepted for
Country line 11. consideration only if it is established that
Enter the number of certifications the issue requires consultation with the
(Forms 6166) requested for each Line 12. Total Number of foreign competent authority to ensure
country listed in columns A, B, C, and D. Certifications (Forms consistent treatment by the United
For any country not listed, enter the 6166) Requested States and the applicable treaty partner.
country in the blank spaces at the The U.S. competent authority does not
Add the total number of certifications
bottom of column D. If you are make unilateral determinations with
requested in columns A, B, C, and D of
requesting certifications for more than respect to residency. Residency
line 11, and enter the total on line 12.
one calendar year for a country, enter determinations are made by mutual

agreement between the two competent benefits under a tax treaty between the subject to the Paperwork Reduction Act
authorities. United States and the foreign country unless the form displays a valid OMB
(countries) indicated on Form 8802. We control number. Books or records
The U.S. competent authority
need this information to determine if the relating to a form or its instructions must
! cannot consider requests
CAUTION involving countries with which
applicant can be certified as a U.S. be retained as long as their contents
resident for tax purposes for the period may become material in the
the United States does not have an
specified. Failure to provide the administration of any Internal Revenue
income tax treaty.
requested information may prevent law.
certification. Providing false or
Your request for U.S. competent fraudulent information may subject you The time needed to complete and file
authority assistance should be mailed to penalties. If you designate an this form will vary depending on
to: appointee to receive Form 6166, but do individual circumstances. The estimated
not provide all of the information average time is:
Commissioner, Large Business requested, we may be unable to honor
and International Division the designation. Recordkeeping . . . . . . . 33 min.
Internal Revenue Service Learning about the law
1111 Constitution Avenue, NW Generally, tax returns and tax return
or the form . . . . . . . . . . 1hr., 13 min.
SE:LB:TTPO:TA:TAIT:NC570-03 information are confidential, as required Preparing the form . . . . . 1 hr., 3 min.
Washington, DC 20224 by section 6103. However, section 6103 Copying, assembling,
(Attention: TAIT) authorizes or requires us to disclose this and sending the form
information in certain circumstances. to the IRS . . . . . . . . . . . 48 min.
Note. Do not send Form 8802 to the We may disclose the information to the
address above. This address should tax authorities of other countries
only be used to request U.S. competent pursuant to a tax treaty. We may
disclose this information to the If you have comments concerning the
authority assistance. Mail Forms 8802 accuracy of these time estimates or
to the appropriate address in Department of Justice for civil and
criminal litigation. We may also disclose suggestions for making this form
Philadelphia, PA, under Where To File, simpler, we would be happy to hear
earlier. this information to cities, states, the
District of Columbia, and U.S. from you. You can send us comments
commonwealths and possessions for from IRS.gov/FormComments. You can
Privacy Act and Paperwork Reduc- write to the Internal Revenue Service,
tion Act Notice. We ask for the use in administering their tax laws, to
federal and state agencies to enforce Tax Forms and Publications Division,
information on this form under sections 1111 Constitution Ave. NW, IR-6526,
6103 and 6109 of the Internal Revenue federal nontax criminal laws, or to
federal law enforcement and Washington, DC 20024. Do not send
Code. You are required to provide the the form to this address. Instead, see
information requested on this form only intelligence agencies to combat
terrorism. Where To File, earlier.
if you wish to have your U.S. residency
for tax purposes certified in order to You are not required to provide the
claim VAT exemption or to claim certain information requested on a form that is

Instruction To Form 8802

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Instruction To Form 8802

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Instructions for Form 8802

Department of the Treasury

(Rev. November 2018)

Nov 06, 2018 Cat. No. 10827V

-2- Instructions for Form 8802 (Rev. 11-2018)

Instructions for Form 8802 (Rev. 11-2018) -3-

-4- Instructions for Form 8802 (Rev. 11-2018)

Instructions for Form 8802 (Rev. 11-2018) -5-

-6- Instructions for Form 8802 (Rev. 11-2018)

Instructions for Form 8802 (Rev. 11-2018) -7-

-8- Instructions for Form 8802 (Rev. 11-2018)

Instructions for Form 8802 (Rev. 11-2018) -9-

IF the applicant was not

-10- Instructions for Form 8802 (Rev. 11-2018)

Instructions for Form 8802 (Rev. 11-2018) -11-

Table 2. Current Year Penalties of Perjury Statements

THEN the Form

-12- Instructions for Form 8802 (Rev. 11-2018)

Instructions for Form 8802 (Rev. 11-2018) -13-

-14- Instructions for Form 8802 (Rev. 11-2018)

an individual the individual.

Instructions for Form 8802 (Rev. 11-2018) -15-

-16- Instructions for Form 8802 (Rev. 11-2018)

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