Enlarge image | Statement for Exempt Individuals and Individuals OMB No. 1545-0074 Form 8843 With a Medical Condition For use by alien individuals only. 2024 Go to www.irs.gov/Form8843 for the latest information. Attachment Department of the Treasury For the year January 1—December 31, 2024, or other tax year Sequence No. 102 Internal Revenue Service beginning , 2024, and ending , 20 . Your first name and initial Last name Your U.S. taxpayer identification number (TIN), if any Fill in your Address in country of residence Address in the United States addresses only if you are filing this form by itself and not with your U.S. tax return. Part I General Information 1a Type of U.S. visa (for example, F, J, M, Q, etc.) and date you entered the United States: b Current nonimmigrant status. If your status has changed, also enter date of change and previous status. See instructions. 2 Of what country or countries were you a citizen during the tax year? 3a What country or countries issued you a passport? b Enter your passport number(s): 4a Enter the actual number of days you were present in the United States during: 2024 2023 2022 b Enter the number of days in 2024 you claim you can exclude for purposes of the substantial presence test: Part II Teachers and Trainees 5 For teachers, enter the name, address, and telephone number of the academic institution where you taught in 2024: 6 For trainees, enter the name, address, and telephone number of the director of the academic or other specialized program you participated in during 2024: 7 Enter the type of U.S. visa (J or Q) you held during: 2018 2019 2020 2021 2022 2023 . If the type of visa you held during any of these years changed, attach a statement showing the new visa type and the date it was acquired. 8 Were you exempt as a teacher, trainee, or student for any part of 2 of the preceding 6 calendar years (2018 through 2023)? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No If you checked the “Yes” box on line 8, you cannot exclude days of presence as a teacher or trainee unless you meet the Exception explained in the instructions. Part III Students 9 Enter the name, address, and telephone number of the academic institution you attended during 2024: 10 Enter the name, address, and telephone number of the director of the academic or other specialized program you participated in during 2024: 11 Enter the type of U.S. visa (F, J, M, or Q) you held during: 2018 2019 2020 2021 2022 2023 . If the type of visa you held during any of these years changed, attach a statement showing the new visa type and the date it was acquired. 12 Were you exempt as a teacher, trainee, or student for any part of more than 5 calendar years? . . . . Yes No If you checked the “Yes” box on line 12, you must provide sufficient facts on an attached statement to establish that you do not intend to reside permanently in the United States. 13 During 2024, did you apply for, or take other affirmative steps to apply for, lawful permanent resident status in the United States or have an application pending to change your status to that of a lawful permanent resident of the United States? . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No 14 If you checked the “Yes” box on line 13, explain: For Paperwork Reduction Act Notice, see instructions. Cat. No. 17227H Form 8843 (2024) |
Enlarge image | Form 8843 (2024) Page 2 Part IV Professional Athletes 15 Enter the name of the charitable sports event(s) in the United States in which you competed during 2024 and the dates of competition: 16 Enter the name(s) and employer identification number(s) of the charitable organization(s) that benefited from the sports event(s): Note: You must attach a statement to verify that all of the net proceeds of the sports event(s) were contributed to the charitable organization(s) listed on line 16. Part V Individuals With a Medical Condition or Medical Problem 17a Describe the medical condition or medical problem that prevented you from leaving the United States. See instructions. b Enter the date you intended to leave the United States prior to the onset of the medical condition or medical problem described on line 17a: c Enter the date you actually left the United States: 18 Physician’s Statement: I certify that Name of taxpayer was unable to leave the United States on the date shown on line 17b because of the medical condition or medical problem described on line 17a and there was no indication that their condition or problem was preexisting. Name of physician or other medical official Physician’s or other medical official’s address and telephone number Physician’s or other medical official’s signature Date 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 belief, only if you they are true, correct, and complete. are filing this form by itself and not with your U.S. tax return. Your signature Date Form 8843 (2024) |
Enlarge image | Form 8843 (2024) Page 3 Section references are to the Internal Days of presence in the United States. In this case, enter “Information provided Revenue Code unless otherwise specified. Generally, you are treated as being present on Form 1040-NR” on line 1a of Form in the United States on any day that you 8843. Complete line 4b and the rest of Future Developments are physically present in the country at any Form 8843. For the latest information about time during the day. However, you don’t If Form 8843 is filed separately, you must developments related to Form 8843 and its count the following days of presence in the complete all entries on the form. instructions, such as legislation enacted United States for purposes of the Line 1a. Enter your nonimmigrant visa type after they were published, go to substantial presence test. (for example, F-1, F-2, J-1, J-2, H1-B, etc.) www.irs.gov/Form8843. 1. Days you regularly commuted to work and the corresponding date of the most in the United States from a residence in recent entry to the United States. See your General Instructions Canada or Mexico. USCIS Form I-94, Arrival-Departure Who Must File 2. Days you were in the United States for Record. If you are an alien individual (other than a less than 24 hours when you were traveling Line 1b. Enter your current nonimmigrant foreign government-related individual), you between two places outside the United status, as of the last day of the tax year, must file Form 8843 to explain the basis of States. such as that shown on your current USCIS your claim that you can exclude days of 3. Days you were temporarily in the Form I-94. Usually, this is the same as your presence in the United States for purposes United States as a regular crew member of entry on line1a, unless you changed your of the substantial presence test because a foreign vessel engaged in transportation status while in the United States since your you: between the United States and a foreign last entry. If your status has changed while • Were an exempt individual, or country or a territory of the United States in the United States (for example, you unless you otherwise engaged in trade or entered with a B-1 or B-2 visitor visa and • Were unable to leave the United States business on such a day. without leaving, you changed to an F-1 or because of a medical condition or medical 4. Days you were unable to leave the M-1 student visa status), enter the date of problem. United States because of a medical change and previous status. See USCIS When and Where To File condition or medical problem that arose Form I-797, Notice of Action, for If you are filing a 2024 Form 1040-NR, while you were in the United States. information on the date that your change of attach Form 8843 to it. Mail your tax return 5. Days you are in the United States status was approved. by the due date (including extensions) to under a NATO visa as a member of a force Part II—Teachers and Trainees the address shown in your tax return or civilian component to NATO. However, A teacher or trainee is an individual who is instructions. this exception does not apply to an temporarily present in the United States If you don’t have to file a 2024 tax return, immediate family member who is present in under a “J” or “Q” visa (other than as a mail Form 8843 to the Department of the the United States under a NATO visa. A student) and who substantially complies Treasury, Internal Revenue Service Center, dependent family member must count with the requirements of the visa. Austin, TX 73301-0215 by the due date every day of presence for purposes of the (including extensions) for filing Form substantial presence test. If you were a teacher or trainee under a “J” or “Q” visa, you are considered to have 1040-NR. 6. Days you were an exempt individual. substantially complied with the visa Penalty for Not Filing Form 8843 Exempt Individuals requirements if you haven’t engaged in activities that are prohibited by U.S. If you don’t file Form 8843 on time, you For purposes of the substantial presence immigration laws that could result in the may not exclude the days you were test, an exempt individual includes anyone loss of your “J” or “Q” visa status. present in the United States as a in the following categories. Even if you meet these requirements, professional athlete or because of a • A teacher or trainee (defined on this you can’t exclude days of presence in 2024 medical condition or medical problem that page). as a teacher or trainee if you were exempt arose while you were in the United States. • A student (defined on the next page). as a teacher, trainee, or student for any Failure to exclude days of presence in the United States could result in your being • A professional athlete temporarily present part of 2 of the 6 prior calendar years. But considered a U.S. resident under the in the United States to compete in a see the Exception , later. substantial presence test. charitable sports event. If you qualify to exclude days of You won’t be penalized if you can show The term “exempt individual” also presence as a teacher or trainee, complete by clear and convincing evidence that you includes an individual temporarily present Parts I and II of Form 8843. If you have a took reasonable actions to become aware in the United States as a foreign “Q” visa, complete Part I and only lines 6 of the filing requirements and significant government-related individual under an “A” through 8 of Part II. On line 6, enter the steps to comply with those requirements. or “G” visa, other than individuals holding name, address, and telephone number of “A-3” or “G-5” class visas. An individual the director of the cultural exchange Substantial Presence Test present under an “A-3” or “G-5” class visa program in which you participated. You are considered a U.S. resident if you is not considered a foreign government- Exception. If you were exempt as a meet the substantial presence test for related individual and must count all their teacher, trainee, or student for any part of 2 2024. You meet this test if you were days of presence in the United States for of the 6 prior calendar years, you can physically present in the United States for purposes of the substantial presence test. exclude days of presence in 2024 as a at least: For more details, see Pub. 519. If you are teacher or trainee only if all four of the • 31 days during 2024; and present under any other “A” or “G” class following apply. visa, you are not required to file Form 8843. • 183 days during the period 2024, 2023, 1. You were exempt as a teacher, trainee, or student for any part of 3 (or and 2022, counting all the days of physical Specific Instructions fewer) of the 6 prior calendar years. presence in 2024 but only 1/3 the number of days of presence in 2023 and only 1/6 Part I—General Information 2. A foreign employer paid all your the number of days in 2022. If you are attaching Form 8843 to Form compensation during 2024. Note: To claim the closer connection to a 1040-NR, you aren’t required to complete 3. You were present in the United States foreign country(ies) exception to the lines 1a through 4a of Form 8843 if you as a teacher or trainee in any of the 6 prior substantial presence test described in provide the requested information on the years. Regulations section 301.7701(b)-2, you corresponding lines of Form 1040-NR. See 4. A foreign employer paid all of your must file Form 8840. Schedule OI (Form 1040-NR). compensation during each of those prior 6 years you were present in the United States as a teacher or trainee. |
Enlarge image | Form 8843 (2024) Page 4 For more details, see Pub. 519. Part IV—Professional Athletes Paperwork Reduction Act Notice. We If you meet this exception, you must A professional athlete is an individual who ask for the information on this form to carry attach information to verify that a foreign is temporarily present in the United States out the Internal Revenue laws of the United employer paid all the compensation you to compete in a charitable sports event. States. Section 7701(b) and its regulations received in 2024 and all prior years that For details on charitable sports events, see require that you give us the information. you were present in the United States as a Pub. 519. We need it to determine if you can exclude days of presence in the United States for teacher or trainee. If you qualify to exclude days of purposes of the substantial presence test. presence as a professional athlete, Part III—Students complete Parts I and IV of Form 8843. You aren’t required to provide the A student is an individual who is information requested on a form that is temporarily present in the United States Part V—Individuals With a Medical subject to the Paperwork Reduction Act under an “F,” “J,” “M,” or “Q” visa and who Condition or Medical Problem unless the form displays a valid OMB substantially complies with the For purposes of the substantial presence control number. Books or records relating requirements of the visa. test, don’t count the days you intended to to a form or its instructions must be If you were a student under an “F,” “J,” leave the United States but couldn’t do so retained as long as their contents may “M,” or “Q” visa, you are considered to because of a medical condition or medical become material in the administration of have substantially complied with the visa problem that arose while you were in the any Internal Revenue law. Generally, tax requirements if you haven’t engaged in United States. Whether you intended to returns and return information are activities that are prohibited by U.S. leave the United States on a particular day confidential, as required by section 6103. immigration laws and could result in the is determined based on all the facts and The average time and expenses required loss of your visa status. circumstances. For more details, see Pub. to complete and file this form will vary Even if you meet these requirements, 519. depending on individual circumstances. you can’t exclude days of presence in 2024 If you qualify to exclude days of For the estimated averages, see the as a student if you were exempt as a presence because of a medical condition instructions for your income tax return. teacher, trainee, or student for any part of or medical problem, complete Part I and If you have suggestions for making this more than 5 calendar years unless you lines 17a through 17c of Part V. Have your form simpler, we would be happy to hear establish that you don’t intend to reside physician or other medical official complete from you. See the instructions for your permanently in the United States. The facts line 18. income tax return. and circumstances to be considered in Note: You cannot exclude any days of determining if you have established that presence in the United States under any of you don’t intend to reside permanently in the following circumstances. the United States include, but aren’t limited • You entered or returned to the United to: States for medical treatment. It does not 1. Whether you have maintained a closer matter whether you intended to leave the connection to a foreign country than to the United States immediately after the United States (for details, see Pub. 519); medical treatment but couldn’t do so and because of unforeseen complications from 2. Whether you have taken affirmative the medical treatment. steps to change your status from nonimmigrant to lawful permanent resident. • The medical condition existed before If you qualify to exclude days of your arrival in the United States and you presence as a student, complete Parts I were aware of the condition. It does not and III of Form 8843. If you have a “Q” matter whether you needed treatment for visa, complete Part I and only lines 10 the condition when you entered the United through 14 of Part III. On line 10, enter the States. name, address, and telephone number of • You were initially prevented from leaving, the director of the cultural exchange were then able to leave, but remained in program in which you participated. the United States beyond a reasonable period for making arrangements to leave. |