Instructions For Form 8802 (Rev. November 2015) (Page 4 of 16) in pdf

certification for year 3 and attach a copy

citizens or green card holders who

, click the link for

of the year 1 Form 8802 (including the

reside outside the United States must

"Publications." In the "Contains" box on

penalty of perjury statement) and Form

examine the specific treaty to determine

the left, enter "US Double Taxation

2848 or Form 8821 attached, as

if they are eligible for treaty benefits and

2002."

applicable.

U.S. residency certification. See

Telephone at: 44-115-974-0897 if

Exceptions, below.

calling from outside the U.K., or

Enter the current year on line 7. A

0115-974-0897 if calling from the U.K.

penalty of perjury statement and

If you are described in category 2

signature are not required on the Form

Send the completed U.K. form to the

and are claiming treaty benefits under a

8802 filed in year 3. However, you must

IRS with your completed Form 8802.

provision applicable to payments

enter “See attached year 1 Form 8802

received in consideration of teaching or

filed under the 3-year procedure” on

Specific Instructions

research activities, see Table 2 for the

line 10.

penalties of perjury statement you must

either enter on line 10 of Form 8802 or

Check Boxes at Top of

Form 8802 Filed Before Return

attach to the form.

Posted by the IRS

Page 1

If your return has not been posted by the

Exceptions

Additional Requests

IRS by the time you file Form 8802, you

You do not need to attach the additional

Check this box if Form 8802 is being

will receive a request to provide a

statement or documentation requested

submitted to request additional Form(s)

signed copy of your most recent return.

if you:

6166 for a tax period for which the IRS

If you recently filed your return, it may

Are a U.S. citizen or green card

has previously issued a Form 6166 to

take less time to process your

holder; and

you. Additional requests on a separate

application if you include a copy of the

Form 8802 will require a non-refundable

income tax return with your Form 8802.

Are requesting certification only for

user fee of $85. See User Fee, earlier.

Write “COPY — do not process” on the

Bangladesh, Bulgaria, Cyprus, Hungary,

tax return.

Iceland, India, Kazakhstan, Malta, New

An applicant can only use this

Zealand, Russia, South Africa, Sri

additional request procedure if there are

Individuals With Residency

Lanka, Ukraine; and

no changes to the applicant's tax

Outside the United States

The country for which you are

information provided on the original

If you are in any of the following

requesting certification and your country

Form 8802. An applicant may use this

categories for the current or prior tax

of residence are not the same.

procedure to obtain a Form 6166 for any

year for which certification is requested,

country or countries, whether or not the

Form 1116, Foreign Tax Credit

you must submit a statement and

country was identified on a previously

If you have filed or intend to file a Form

documentation, as described below,

filed Form 8802. An additional request

1116, Foreign Tax Credit, claiming

with Form 8802.

for Form 6166 using this procedure

either a foreign tax credit amount in

must be made within 12 months of the

1. You are a resident under the

excess of $5,000 U.S. or a foreign tax

most recently issued Form 6166 relating

internal law of both the United States

credit for any amount of foreign earned

to the same tax period.

and the treaty country for which you are

income for the tax period for which

requesting certification (you are a dual

Additional documentation. If you are

certification is requested, you must

resident).

requesting certification for a previously

submit evidence that you were (or will

2. You are a green card holder or

identified country and if additional

be if the request relates to a current

U.S. citizen who filed Form 2555,

documentation was necessary for the

year) a resident of the United States and

Foreign Earned Income.

original application, it does not need to

that the foreign taxes paid were not

be resubmitted with the request for an

3. You are a bona fide resident of a

imposed because you were a resident

additional Form 6166. In the signature

U.S. possession.

of the foreign country.

line of the additional request form, write

If you are a dual resident described in

In addition, individuals who have

“See attached copy of the original Form

category 1, above, your request may be

already filed their federal income tax

8802.” Attach a copy of the original

denied unless you submit evidence to

return must submit a copy of it, including

Form 8802.

establish that you are a resident of the

any information return(s) relating to

If you are requesting Form 6166 for a

United States under the tie-breaker

income, such as Form W-2 or Form

country not identified on a previously

provision in the residence article of the

1099, along with the Form 1116. Your

filed Form 8802 that requires

treaty with the country for which you are

request for U.S. residency certification

documentation not previously

requesting certification.

may be denied if you do not submit the

submitted, you must include that

additional materials.

documentation with the additional

If you are described in category 2 or

United Kingdom

request. Sign and date the additional

3, attach a statement and

request form. Attach a copy of the

documentation to establish why you

If you are applying for relief at source

original Form 8802.

believe you should be entitled to

from United Kingdom (U.K.) income tax

certification as a resident of the United

or filing a claim for repayment of U.K.

Additional request made by third

States for purposes of the relevant

income tax, you may need to complete

party appointees. Third party

treaty. Under many U.S. treaties, U.S.

a U.K. certification form (US/Individual

appointees cannot use this special

citizens or green card holders who do

2002 or US/Company 2002) in addition

procedure to request additional Form(s)

not have a substantial presence,

to Form 8802. For copies of these

6166 for countries that were not

permanent home, or habitual abode in

forms, contact HM Revenue and

originally authorized by the taxpayer in

the United States during the tax year are

Customs.

their previously signed and dated Form

not entitled to treaty benefits. U.S.

On the Internet at

8802. If you anticipate using the

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Instructions For Form 8802 (Rev. November 2015) Page 4

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