PART 2: Substantial Presence Test
Determination of Residence Status for Federal Tax Withholding Purposes
For More Information, Refer to IRS Tele-Tax Service at 1-800-829-4477 (Topic 851)
CHECK ANY APPLICABLE BOX
I am a lawful permanent resident of the United States. Hold an Alien Registration Receipt
Card Form I-551 (commonly known as a "Green Card.")
If box was marked, you are a resident alien for tax purposes. Go to the "test results" section
and check the "resident alien" box.
If box is not marked, go to Test 2 and continue completing the tests.
CHECK ANY APPLICABLE BOX
I am a teacher, trainee, or non-student (i.e., professor, research scholar or specialist, short-
term scholar) on a J-1 or Q-1 VISA and have been in the USA for less than two of the
preceding six calendar years.
I am a student on an F-1, J-1, M-1 or Q-1 VISA and have been in the USA for a total of
five or fewer years.
I am a foreign government – related individual. (i.e., full time employee of an international
organization or have diplomatic or consular status.)
If box was marked, you are a nonresident alien for tax purposes. Go to the "test results" section
and check the "nonresident alien" box.
If box is not marked, go to Test 3 and continue completing the tests.
COMPLETE THE SPACES BELOW, INDICATING THE NUMBER OF DAYS PRESENT
IN THE U.S.A. DURING THE YEARS LISTED.
o. of Days
Enter Year Date Entered US Date Departed In USA
Current Year _________ __________ xxxxxxxx
_______ x 1 = ____
1st Preceding Year ________ __________ ________ _______ x 1/3 = ____
Preceding Year _______ __________ ________ _______ x 1/6 = ____
If total is greater than or equal to 183 and you are present in the U.S. at a minimum of 31 days
in the current year, then go to test results and check resident alien box. If total is less than 183
or if you have not been present in the U.S. for 31 days in the current year, you are a
nonresident alien for tax purposes. Go to the "Test Results" section and check the nonresident
MARK APPROPRIATE FEDERAL TAX WITHHOLDING STATUS. (YOU MUST
CHECK ONE OF THESE BOXES.) FOR TAX PURPOSES, I CERTIFY THAT I AM:
Resident Alien The "USA" is your Country of Resident for tax purposes.
Nonresident Alien List your home country _________________ (the country of
residence where you have established a tax home base).
I hereby certify, under penalties of perjury, that the information and tests on this form that I have answered
are to the best of my knowledge and belief, true and correct.
Print Name Clearly
Page 2 of 2 Revised 6/3/2009