Form 8843 - Statement For Exempt Individuals And Individuals With A Medical Condition Page 4
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Form 8843 (2016)
Page
Paperwork Reduction Act Notice. We
If you meet this exception, you must
If you qualify to exclude days of
attach information to verify that a foreign
presence as a student, complete Parts I
ask for the information on this form to
employer paid all the compensation you
and III of Form 8843. If you have a “Q”
carry out the Internal Revenue laws of
received in 2016 and all prior years that
visa, complete Part I and only lines 10
the United States. Section 7701(b) and
you were present in the United States as
through 14 of Part III. On line 10, enter
its regulations require that you give us
a teacher or trainee.
the name, address, and telephone
the information. We need it to determine
number of the director of the cultural
if you can exclude days of presence in
Part III—Students
exchange program in which you
the United States for purposes of the
A student is an individual who is
participated.
substantial presence test.
temporarily present in the United States
You aren’t required to provide the
Part IV—Professional
under an “F,” “J,” “M,” or “Q” visa and
information requested on a form that is
Athletes
who substantially complies with the
subject to the Paperwork Reduction Act
requirements of the visa.
unless the form displays a valid OMB
A professional athlete is an individual
If you were a student under an “F,”
control number. Books or records
who is temporarily present in the United
“J,” “M,” or “Q” visa, you are considered
relating to a form or its instructions must
States to compete in a charitable sports
to have substantially complied with the
event. For details on charitable sports
be retained as long as their contents
visa requirements if you haven’t engaged
events, see Pub. 519.
may become material in the
in activities that are prohibited by U.S.
administration of any Internal Revenue
If you qualify to exclude days of
immigration laws and could result in the
law. Generally, tax returns and return
presence as a professional athlete,
loss of your visa status.
information are confidential, as required
complete Parts I and IV of Form 8843.
by section 6103.
Even if you meet these requirements,
Part V—Individuals With a
you can’t exclude days of presence in
The average time and expenses
Medical Condition or
2016 as a student if you were exempt as
required to complete and file this form
a teacher, trainee, or student for any part
will vary depending on individual
Medical Problem
of more than 5 calendar years unless you
circumstances. For the estimated
For purposes of the substantial presence
establish that you don’t intend to reside
averages, see the instructions for your
test, don’t count the days you intended
permanently in the United States. The
income tax return.
to leave the United States but couldn’t
facts and circumstances to be
If you have suggestions for making
do so because of a medical condition or
considered in determining if you have
this form simpler, we would be happy to
medical problem that arose while you
established that you don’t intend to
hear from you. See the instructions for
were in the United States. Whether you
reside permanently in the United States
your income tax return.
intended to leave the United States on a
include, but aren’t limited to:
particular day is determined based on all
1. Whether you have maintained a
the facts and circumstances. For more
closer connection to a foreign country
details, see Pub. 519.
than to the United States (for details, see
If you qualify to exclude days of
Pub. 519), and
presence because of a medical condition
2. Whether you have taken affirmative
or medical problem, complete Part I and
steps to change your status from
lines 17a through 17c of Part V. Have
nonimmigrant to lawful permanent
your physician or other medical official
resident.
complete line 18.
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