4
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INSTRUCTIONS TO PRINTERS
Form 8898, PAGE 1 of 2
MARGINS: TOP 13 mm (
1
⁄ 2 "), CENTER SIDES. PRINTS: HEAD TO FOOT
PAPER: WHITE WRITING, SUB. 20. INK: BLACK
FLAT SIZE: 216 mm (8
1
⁄ 2 ") x 559 mm (22") FOLD TO: 216 mm (8
1
⁄ 2 ") x 279 mm (11")
PERFORATE: (ON FOLD)
Form 8898
(Rev. January 2007)
Statement for Individuals Who Begin or End
Bona Fide Residence in a U.S. Possession
OMB No. 1545-0074
Cat. No. 37706B
Department of the Treasury
Internal Revenue Service
For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions.
See separate instructions. Do not file with your tax return.
Name. If married, file a separate form for each spouse required to file Form 8898. Your social security number:
Current Address: Address in Possession (if different from current address):
Part I General Information
1 I am notifying the IRS that I (check box a or b below and enter the tax year in the space provided):
a became
b
ceased to be
a bona fide resident of a U.S. possession in tax year
c Of which U.S. possession did you become (or cease to be) a bona fide resident:
American Samoa Guam Commonwealth of the Northern Mariana Islands (CNMI)
Commonwealth of Puerto Rico U.S. Virgin Islands
2 Are you a U.S. citizen or resident alien (see instructions)? Yes No
3 Enter your average worldwide gross income for the three-year period prior to the tax year you became (or ceased
to be) a bona fide resident of the possession (see instructions)
Part II
Presence in the United States or Possession
4a
If you checked box a on line 1 above, enter the date (month/day/year) you moved to the possession to establish bona fide residence
/ / .
b If you checked box b on line 1 above, enter the date (month/day/year) you moved from the possession to end bona
fide residence
/ / .
5 Enter the number of days you were present in the United States during the tax year (see instructions)
6
Enter the number of days you were present in the possession during:
a The tax year listed on line 1
Note. Complete lines 6b and 6c if you were in the possession for less than 183 days during the tax year entered on line 1 and you are
following the new alternative to the 183-day rule of the presence test. See item (2) under Presence Test on page 2 of the instructions.
b The first tax year immediately preceding the tax year listed on line 1
c The second tax year immediately preceding the tax year listed on line 1
7 Did you have a significant connection to the United States during the tax year (see instructions)? Yes No
8 Did you have any earned income from U.S. sources during the tax year (see instructions)? Yes No
If “Yes,” was the amount of the income more than $3,000? Yes No
Part III
Closer Connection to the United States, Foreign Country, or Possession
9 Did you have a tax home outside the possession at any time during the tax year (see instructions)? Yes No
If “Yes,” where?
10 Did you have a closer connection to the United States or a foreign country than to the possession at any time during
the tax year (see instructions)?
Yes No
If “Yes,” where?
11 If you answered “Yes” to line 9 or 10, are you using the year-of-the-move exception? Yes No
(See Exception for the Year of the Move on page 1 of the instructions.)
12 Where was your principal permanent home located during the tax year (see instructions)?
13 If you had more than one permanent home available to you at all times during the tax year, list the location of each:
14 Where was your immediate family located during the tax year (see instructions)?
15 Where was your automobile(s) located during the tax year?
16 Where was your automobile(s) registered during the tax year?
17 Where were your personal belongings, furniture, etc., located during the tax year?
Form 8898 (Rev. 1-2007)
