2
Form 8840 (2008)
Page
Part IV
Significant Contacts With Foreign Country or Countries in 2008
14
Where was your regular or principal permanent home located during 2008 (see instructions)?
15
If you had more than one permanent home available to you at all times during 2008, list the location of each and
explain
16
Where was your family located?
17
Where was your automobile(s) located?
18
Where was your automobile(s) registered?
19
Where were your personal belongings, furniture, etc., located?
20
Where was the bank(s) with which you conducted your routine personal banking activities located?
a
c
b
d
21
Did you conduct business activities in a location other than your tax home?
Yes
No
If “Yes,” where?
22a
Where was your driver’s license issued?
b
If you hold a second driver’s license, where was it issued?
23
Where were you registered to vote?
24
When completing official documents, forms, etc., what country do you list as your residence?
25
Have you ever completed:
a
Form W-8 or Form W-8BEN (relating to foreign status)?
Yes
No
b
Form W-9, Request for Taxpayer Identification Number and Certification?
Yes
No
c
Form 1078, Certificate of Alien Claiming Residence in the United States?
Yes
No
d
Any other U.S. official forms? If “Yes,” indicate the form(s)
Yes
No
26
In what country or countries did you keep your personal, financial, and legal documents?
27
From what country or countries did you derive the majority of your 2008 income?
28
Did you have any income from U.S. sources?
Yes
No
If “Yes,” what type?
29
In what country or countries were your investments located (see instructions)?
30
Did you qualify for any type of government-sponsored “national” health plan?
Yes
No
If “Yes,” in what country?
If “No,” please explain
If you have any other information to substantiate your closer connection to a country other than the United States or you wish
to explain in more detail any of your responses to lines 14 through 30, attach a statement to this form.
Sign here
Under penalties of perjury, I declare that I have examined this form and the accompanying attachments, and to the best of my knowledge and
only if you
belief, they are true, correct, and complete.
are filing
this form by
itself and
not with
your U.S.
tax return
Your signature
Date
8840
Form
(2008)