Form 1040nr Foreign National Questionnaire Page 4
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4Exhibit 1: Form 1040NR foreign national questionnaire— Continued
OTHER
30.
In 2007, did you rent out your house or any other
property (whether the property is in your home
Yes / No
Yes / No
country, in another country, or in the U.S.) to any
other person?
31.
Are you participating in any home country tax-
deferred retirement or savings plans?
Yes / No
Yes / No
32.
Do you have any tax-deferred accounts held
Yes / No
Yes / No
outside the U.S.?
33.
Do you have any financial accounts located
outside the U.S.?
Yes / No
Yes / No
Name of bank with which accounts are
Account number or other account
*Max. value:
Type of account: (circle)
maintained:
designation:
(circle)
a b c d
Bank
Securities
Other
T/S/J
a b c d
Bank
Securities
Other
T/S/J
a b c d
Bank
Securities
Other
T/S/J
a b c d
Bank
Securities
Other
T/S/J
a b c d
Bank
Securities
Other
T/S/J
a b c d
Bank
Securities
Other
T/S/J
a b c d
Bank
Securities
Other
T/S/J
a b c d
Bank
Securities
Other
T/S/J
T=Taxpayer S=Spouse J=Joint
*Please indicate the maximum value of the accounts
Please circle T, S, or J to indicate the owner of
during the year (outside of the U.S.):
the account.
a. $0–$10,000
b. $10,000–$99,999
c. $100,000–$1,000,000
d. Over $1,000,000
Note: If all accounts are under $10,000 but the aggregate is over $10,000, filing form TDF 90-22.1 is required.
34.
Was any income earned in these accounts?
Yes / No
Yes / No
35.
Were there any taxes paid on these accounts?
Yes / No
Yes / No
36.
Is the account held jointly with another person?
Yes / No
Yes / No
If yes, provide the name of the joint owner, their
date of birth, and their U.S. tax number.
37.
Do you have signature authority over a foreign
financial account? If so, please answer all of the
Yes / No
Yes / No
questions above.
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