Fillable Form 8854 - Initial And Annual Expatriation Statement

Form 8854 (2015)

Page

Section B

Property Owned on Date of Expatriation

Do not complete Section B if:

• Your average net income tax liability for the 5 tax years immediately before expatriation (see line 1 in Section A) was not

more than $160,000, your net worth (see line 2 in Section A) was under $2 million, and you checked “Yes” on line 6 in

Section A;

• In Section A, you checked “Yes” on lines 3, 4, and 6; or

• In Section A, you checked “Yes” on lines 5 and 6.

7 a Do you have any eligible deferred compensation items? Checking the “Yes” box is an irrevocable waiver

of any right to claim any reduction in withholding for such eligible deferred compensation item under any

treaty with the United States

Yes

b Do you have any ineligible deferred compensation items? If “Yes,” you must include in income the

present value of your account on the day before your expatriation date

Yes

c Do you have any specified tax deferred accounts? If “Yes,” you must include in income the entire

account balance on the day before your expatriation date .

Yes

d Do you have an interest in a nongrantor trust? Checking the “Yes” box is a waiver of any right to claim

any reduction in withholding on any distribution from such trust under any treaty with the United States

unless you make the election below .

Yes

Check this box to elect under section 877A(f)(4)(B) to be treated as having received the value of your entire interest in the

trust (as determined for purposes of section 877A) as of the day before your expatriation date. Attach a copy of your

valuation letter ruling issued by the IRS (see instructions).

Recognition of gain or loss on the deemed sale of mark-to-market property. Caution. Do not include in column (a) any property

described on line 7a, 7b, 7c, or 7d.

Complete column (g) only if you are deferring tax on gain from any property listed in column (a).

(e)

(a)

(b)

(c)

(d)

(f)

(g)

Gain after

Gain or (loss).

Description of property

Fair market value

Cost or other

Form or Schedule

Amount of tax

allocation of the

on day before date

basis*

Subtract (c)

on which gain

deferred (attach

exclusion amount

of expatriation

from (b)

or loss is reported

computations)

(see instructions)

9 Total. Add the amounts in column (d) and column (e) .

10 Total tax deferred. Add the amounts in column (g). Enter here

and on line 15

*You must identify as “(h)(2)” any property for which you are making the special basis election under section 877A(h)(2). This election is irrevocable.

See the instructions for Part IV, Section B, line 8, column (c).

8854

Form

(2015)

Form 8854 - Initial And Annual Expatriation Statement - 2015 Page 3

Related Articles

Related forms

Related Categories