Form 8833
Form 8833
(Rev. December 2013)
Department of the Treasury
Internal Revenue Service
Treaty-Based Return Position Disclosure
Under Section 6114 or 7701(b)
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Attach to your tax return.
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Information about Form 8833 and its instructions is at www.irs.gov/form8833.
OMB No. 1545-1354
Attach a separate Form 8833 for each treaty-based return position taken. Failure to disclose a treaty-based return position may
result in a penalty of $1,000 ($10,000 in the case of a C corporation) (see section 6712).
Name
U.S. taxpayer identifying number Reference ID number, if any (see instructions)
Address in country of residence
Address in the United States
Check one or both of the following boxes as applicable:
• The taxpayer is disclosing a treaty-based return position as required by section 6114 .............
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• The taxpayer is a dual-resident taxpayer and is disclosing a treaty-based return position as required by
Regulations section 301.7701(b)-7 ..............................
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Note.If the taxpayer is a dual-resident taxpayer and a long-term resident, by electing to be treated as a resident of a foreign country
for purposes of claiming benefits under an applicable income tax treaty, the taxpayer will be deemed to have expatriated pursuant to
section 877A. For more information, see the instructions.
Check this box if the taxpayer is a U.S. citizen or resident or is incorporated in the United States ..........
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1 Enter the specific treaty position relied on:
a
Treaty country
b Article(s)
2
List the Internal Revenue Code provision(s) overruled or
modified by the treaty-based return position
3 Name, identifying number (if available to the taxpayer), and
address in the United States of the payor of the income (if
fixed or determinable annual or periodical). See instructions.
4
List the provision(s) of the limitation on benefits article (if any) in the treaty that the taxpayer relies on to prevent application
of that article
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5
Is the taxpayer disclosing a treaty-based return position for which reporting is specifically required pursuant
to Regulations section 301.6114-1(b)?.......................
YesNo
If “Yes,” enter the specific subsection(s) of Regulations section 301.6114-1(b) requiring reporting....
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Also include the information requested in line 6.
6
Explain the treaty-based return position taken. Include a brief summary of the facts on which it is based. Also, list the nature
and amount (or a reasonable estimate) of gross receipts, each separate gross payment, each separate gross income item, or
other item (as applicable) for which the treaty benefit is claimed
For Paperwork Reduction Act Notice, see the instructions.
Cat. No. 14895L
Form 8833 (Rev. 12-2013)
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Form 8833 (Rev. 12-2013)
Page 3
Section references are to the Internal
Revenue Code unless otherwise noted.
Future Developments
For the latest information about
developments related to Form 8833 and
its instructions, such as legislation
enacted after they were published, go to
www.irs.gov/form8833.
General Instructions
Purpose of Form
Form 8833 must be used by taxpayers
to make the treaty-based return position
disclosure required by section 6114. The
form must also be used by dual-resident
taxpayers (defined later) to make the
treaty-based return position disclosure
required by Regulations section
301.7701(b)-7. A separate form is
required for each treaty-based return
position taken by the taxpayer.
Who Must File
Generally, a taxpayer who takes a
treaty-based return position must
disclose that position. See Exceptions
from reporting below.
A taxpayer takes a treaty-based return
positionby maintaining that a treaty of
the United States overrules or modifies
a provision of the Internal Revenue
Code and thereby causes (or potentially
causes) a reduction of tax on the
taxpayer’s tax return. For these
purposes, a treaty includes, but is not
limited to, an income tax treaty; estate
and gift tax treaty; or friendship,
commerce, and navigation treaty. See
Regulations sections 301.6114-1(a) and
(b) for more details and for examples of
treaty-based return positions taken by
taxpayers for which they must make
disclosure.
Exceptions from reporting. See
Regulations section 301.6114-1(c) for
examples of treaty-based return
positions taken by taxpayers for which
they are notrequired to make
disclosure.
In general, disclosure of a treaty-
based return position is not required for
amounts that are:
1. Reported on Form 1042-S, and
2. Received by a:
a. Related party from a reporting
corporation within the meaning of
section 6038A (relating to information
returns on Form 5472 filed by U.S.
corporations that are 25-percent owned
by a foreign person),
b. Beneficial owner that is a direct
account holder of a U.S. financial
institution or qualified intermediary, or a
direct partner, beneficiary or owner of a
withholding foreign partnership or trust,
from that U.S. financial institution,
qualified intermediary, or withholding
foreign partnership or trust, or
c. Taxpayer that is not an individual or
a State, if the amounts are not received
through an account with an intermediary
or with respect to an interest in a
partnership or a simple or grantor trust,
and if the amounts do not total more
than $500,000 for the tax year.
However, Regulations sections
301.6114-1(c)(6)(ii), (7)(iv), and (8)(ii)
provide that the exceptions described
above do not apply to any amounts for
which a treaty-based return disclosure is
specifically required under these
instructions.
The following are amounts for which a
treaty-based return disclosure on Form
8833 is specifically required.
• Amounts described in paragraph 2a or
2c earlier that are received by a
corporation that is a resident under the
domestic law of both the United States
and a foreign treaty jurisdiction.
• Amounts described in paragraph 2a or
2c earlier that are received by a
corporation that is a resident of both the
jurisdiction whose treaty is invoked and
another foreign jurisdiction that has an
income tax treaty with that treaty
jurisdiction. See Revenue Ruling
2004-76, 2004-31 I.R.B. 111, available at
www.irs.gov/pub/irs-irbs/irb04-31.pdf.
• Amounts described in paragraph 2a or
2c earlier that are received by a foreign
collective investment vehicle that is a
contractual arrangement and not a
person under foreign law. See Example
7 of Regulations section 1.894-1(d)(5).
• Amounts described in paragraph 2a or
2c earlier that are received by a foreign
“interest holder” in a “domestic reverse
hybrid entity,” as those terms are used
in Regulations section 1.894-1(d)(2).
Dual-resident taxpayer. An alien
individual is a dual-resident taxpayerif
that individual is considered to be a
resident of both the United States and
another country under each country’s
tax laws. If the income tax treaty
between the United States and the other
country contains a provision for
resolution of conflicting claims of
residence by the United States and its
treaty partner, and the individual
determines that under those provisions
he or she is a residentof the foreign
country for treatypurposes, the
individual may claim treatybenefits as a
resident of that foreign country, provided
that he or she complies with the
instructions below.
If you are an individual who is a
dual-resident taxpayer and you choose to
claim treaty benefits as a resident of the
foreign country, you are treated as a
nonresident alien in figuring your U.S.
income tax liability for the part of the tax
year you are considered a dual-resident
taxpayer. If you are eligible to be treated as
a resident of the foreign country pursuant
to the applicable income tax treaty and you
choose to claim benefits as a resident of
such foreign country, attach Form 8833 to
Form 1040NR, U.S. Nonresident Alien
Income Tax Return, or Form 1040NR-EZ,
U.S. Income Tax Return for Certain
Nonresident Aliens With No Dependents.
In order to be treated as a resident of the
foreign country, you must timely file
(including extensions) Form 1040NR or
Form 1040NR-EZ with the Form 8833
attached. If you choose to be treated as a
resident of a foreign country under an
income tax treaty, you are still treated as a
U.S. resident for purposes other than
figuring your U.S. income tax liability (see
Regulations section 301.7701(b)-7(a)(3)).
When and Where To File
Attach Form 8833 to your tax return (i.e.,
Form 1040NR, Form 1040NR-EZ, Form
1120-F, etc.). If you would not otherwise
be required to file a tax return, you must
file one at the IRS Service Center where
you would normally file a return to make
the treaty-based return position
disclosure under section 6114 (see
Regulations section 301.6114-1(a)(1)(ii))
or under Regulations section
301.7701(b)-7.
Specific Instructions
U.S. Taxpayer Identifying Number
The identifying number of an individual is
his or her social security number or
individual taxpayer identification number.
The identifying number of all others is
their employer identification number.
For more information about identifying
numbers, see the instructions for the tax
return with which this form is filed.
Reference ID Number
If the taxpayer is a foreign corporation,
enter any reference ID number assigned
to the foreign corporation by a U.S.
person with respect to which information
reporting is required (for example, on
Form 5471 or Form 5472).
Address in Country of Residence
Enter the information in the following
order: city, province or state, and
country. Follow the country’s practice for
entering the postal code. Please do not
abbreviate the country name.
Form 8833 (Rev. 12-2013)
Page 4
Termination of U.S. Residency
If you are a dual-resident taxpayer and a
long-term resident (LTR) and you are
filing this form to be treated as a resident
of a foreign country for purposes of
claiming benefits under an applicable
U.S. income tax treaty, you will be
deemed to have terminated your U.S.
residency status for federal income tax
purposes. Because you are terminating
your U.S. residency status, you may be
subject to tax under section 877A and
you must file Form 8854, Initial and
Annual Expatriation Statement. You are
an LTR if you were a lawful permanent
resident of the United States in at least 8
of the last 15 tax years ending with the
year your status as an LTR ends. For
additional information, see the
Instructions for Form 8854, and
Publication 519, U.S. Tax Guide for
Aliens.
Line 3
Income that is fixed or determinable
annual or periodical includes interest
(other than original issue discount),
dividends, rents, premiums, annuities,
salaries, wages, and other
compensation. For more information
(including other items of income that are
fixed or determinable annual or
periodical), nonresident aliens and dual-
resident taxpayers filing as nonresident
aliens should see section 871(a) and
Regulations section 1.871-7(b) and (c).
Foreign corporations should see section
881(a) and Regulations section
1.881-2(b) and (c).
Line 5
If the taxpayer answers “Yes” to the
question on line 5, the taxpayer must
enter the subsection of Regulations
section 301.6114-1(b) with respect to
which the taxpayer is disclosing a treaty-
based return position. The taxpayer must
also provide the information requested
on line 6.
Line 6
All taxpayers taking a treaty-based
return position must provide the
requested information on line 6,
regardless of whether reporting is
explicitly required under Regulations
section 301.6114-1(b).
Paperwork Reduction Act Notice. We
ask for the information on this form to
carry out the Internal Revenue laws of
the United States. You are required to
give us the information. We need it to
ensure that you are complying with these
laws and to allow us to figure and collect
the right amount of tax.
You are not required to provide the
information requested on a form that is
subject to the Paperwork Reduction Act
unless the form displays a valid OMB
control number. Books or records
relating to a form or its instructions must
be retained as long as their contents
may become material in the
administration of any Internal Revenue
law. Generally, tax returns and return
information are confidential, as required
by section 6103.
The time needed to complete and file
this form will vary depending on
individual circumstances. The estimated
burden for individual taxpayers filing this
form is approved under OMB control
number 1545-0074 and is included in
the estimates shown in the instructions
for their individual income tax return. The
estimated burden for all other taxpayers
who file this form is shown below.
Recordkeeping ....3 hr., 7 min.
Learning about the
law or the form ....1 hr., 35 min.
Preparing and sending
the form to the IRS ..1 hr., 43 min.
If you have comments concerning the
accuracy of these time estimates or
suggestions for making this form
simpler, we would be happy to hear
from you. See the instructions for the tax
return with which this form is filed.
