4
I.R.S. SPECIFICATIONS
TO BE REMOVED BEFORE PRINTING
DO NOT PRINT — DO NOT PRINT — DO NOT PRINT — DO NOT PRINT
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text files for this
cycle update?
Date
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Revised proofs
requested
Date
Signature
O.K. to print
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)
OMB No. 1545-0074
Statement for Individuals Who Begin or End
Bona Fide Residence in a U.S. Possession
8898
Form
Department of the Treasury
Internal Revenue Service
Name. If married, file a separate form for each spouse required to file Form 8898.
Your social security number:
Current Address:
American Samoa
Guam
Commonwealth of the Northern Mariana Islands (CNMI)
Address in Possession (if different from current address):
General Information
1
Are you a U.S. citizen or resident alien (see instructions)?
2
4a
If you checked box a on line 1 above, enter the date (month/day/year) you moved to the possession to establish bona fide residence
5
Presence in the United States or Possession
7
9
Did you have a tax home outside the possession at any time during the tax year (see instructions)?
Where was your principal permanent home located during the tax year (see instructions)?
If you had more than one permanent home available to you at all times during the tax year, list the location of each:
Part I
Part II
Enter your average worldwide gross income for the three-year period prior to the tax year you became (or ceased
to be) a bona fide resident of the possession (see instructions)
3
10
Did you have a closer connection to the United States or a foreign country than to the possession at any time during
the tax year (see instructions)?
Enter the number of days you were present in the United States during the tax year (see instructions)
Form 8898 (Rev. 1-2007)
I am notifying the IRS that I (check box a or b below and enter the tax year in the space provided):
b
c
Of which U.S. possession did you become (or cease to be) a bona fide resident:
Commonwealth of Puerto Rico
U.S. Virgin Islands
Yes
No
Did you have a significant connection to the United States during the tax year (see instructions)?
Yes
No
Closer Connection to the United States, Foreign Country, or Possession
Part III
Yes
No
If “Yes,” where?
Yes
No
If “Yes,” where?
For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 37706B
(Rev. January 2007)
©
See separate instructions.
became
ceased to be
%
a bona fide resident of a U.S. possession in tax year
©
a
If you checked box b on line 1 above, enter the date (month/day/year) you moved from the possession to end bona
fide residence
b
/ / .
/ / .
Where was your immediate family located during the tax year (see instructions)?
12
Where was your automobile(s) located during the tax year?
13
Where was your automobile(s) registered during the tax year?
14
Where were your personal belongings, furniture, etc., located during the tax year?
15
16
17
©
Do not file with your tax return.
8
Did you have any earned income from U.S. sources during the tax year (see instructions)?
Yes
No
If “Yes,” was the amount of the income more than $3,000?
Yes
No
If you answered “Yes” to line 9 or 10, are you using the year-of-the-move exception?
Yes
No
11
(See Exception for the Year of the Move on page 1 of the instructions.)
6
Enter the number of days you were present in the possession during:
The tax year listed on line 1
a
The first tax year immediately preceding the tax year listed on line 1
b
The second tax year immediately preceding the tax year listed on line 1
c
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.
