Treaty-Based Return Position Disclosure 
Form  8833                           Under Section 6114 or 7701(b)                                                    OMB No. 1545-1354
(Rev. December 2021)                                  ▶ Attach to your tax return.
Department of the Treasury      ▶ Go to www.irs.gov/Form8833 for the latest information.
Internal Revenue Service 
Attach a separate Form 8833 for each treaty-based return position taken. Failure to disclose a treaty-based return position may result 
in a penalty of $1,000 ($10,000 in the case of a C corporation) (see section 6712). 
Name                                                                   U.S. taxpayer identifying number  Reference ID number, if any (see instructions)

Address in country of residence                                        Address in the United States 

Check one or both of the following boxes as applicable. 
• The taxpayer is disclosing a treaty-based return position as required by section 6114 .           . . . . . . . .   . . . .  ▶
• The taxpayer is a dual-resident taxpayer and is disclosing a treaty-based return position as required by 
Regulations section 301.7701(b)-7  . . .    .       . .   . . . .      .   . . .  . . . .           . . . . . . . .   . . . .  ▶
Note: If the taxpayer is a dual-resident taxpayer and a long-term resident, by electing to be treated as a resident of a foreign country 
for purposes of claiming benefits under an applicable income tax treaty, the taxpayer will be deemed to have expatriated pursuant to 
section 877A. For more information, see the instructions.
Check this box if the taxpayer is a U.S. citizen or resident or is incorporated in the United States  .   . . . . .   . . . .  ▶
1     Enter the specific treaty position relied on:                    3   Name,  identifying  number  (if  available  to  the  taxpayer),  and 
a     Treaty country                                                       address  in  the  United  States  of  the  payor  of  the  income  (if 
b     Article(s)                                                           fixed or determinable annual or periodical). See instructions. 
2     List  the  Internal  Revenue  Code  provision(s)  overruled  or  
      modified by the treaty-based return position 

4     List the provision(s) of the limitation on benefits article (if any) in the treaty that the taxpayer relies on to prevent application
      of that article ▶
5     Is the taxpayer disclosing a treaty-based return position for which reporting is specifically required pursuant 
      to Regulations section 301.6114-1(b)? .       . .   . . . .      .   . . .  . . . .           . . . . . . . .       Yes   No
      If “Yes,” enter the specific subsection(s) of Regulations section 301.6114-1(b) requiring reporting .   . . .   ▶
      Also include the information requested in line 6. 
6     Explain the treaty-based return position taken. Include a brief summary of the facts on which it is based. Also, list the nature 
      and amount (or a reasonable estimate) of gross receipts, each separate gross payment, each separate gross income item, or 
      other item (as applicable) for which the treaty benefit is claimed 

For Paperwork Reduction Act Notice, see the instructions.                      Cat. No. 14895L                    Form 8833 (Rev. 12-2021) 

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Form 8833 (Rev. 12-2021)                                                                                                     Page 3 
Section references are to the Internal      • That a treaty reduces or modifies the    specifically reportable, and thus careful 
Revenue Code unless otherwise noted.        branch profits tax (section 884(a)) or the review of the regulations is advised. In 
                                            tax on excess interest (section 884(f)(1)  addition, some waivers do not apply to 
Future Developments                         (B));                                      positions that are specifically required to 
For the latest information about            • That a treaty exempts from tax or        be reported under these form 
developments related to Form 8833 and       reduces the rate of tax on dividends or    instructions. See Reporting specifically 
its instructions, such as legislation       interest paid by a foreign corporation     required by Form 8833 instructions, later.
enacted after they were published, go to    that are U.S.-sourced under section        Positions for which reporting is waived 
IRS.gov/Form8833.                           861(a)(2)(B) or section 884(f)(1)(A);      include, but are not limited to, the 
                                            • That a treaty exempts from tax or        following. See Regulations section 
General Instructions                        reduces the rate of tax on fixed or        301.6114-1(c) for other waivers from 
                                            determinable annual or periodical (FDAP)   reporting.
Purpose of Form                             income that a foreign person receives      • That a treaty reduces or modifies the 
Form 8833 must be used by taxpayers         from a U.S. person, but only if:           taxation of income derived by an 
to make the treaty-based return position     (1) The amount is not properly            individual from dependent personal 
disclosure required by section 6114 and     reported on Form 1042-S and the foreign    services, pensions, annuities, social 
the regulations thereunder (Regulations     person is: (a) a controlled foreign        security, and other public pensions, as 
section 301.6114-1). The  form must also    corporation (as defined in section 957) in well as income derived by artists, 
be used by dual-resident  taxpayers         which the U.S. person is a U.S.            athletes, students, trainees, or teachers;
(defined later) to make the treaty-based    shareholder (as defined in section         • That a Social Security Totalization 
return position disclosure required by      951(b)); (b) a foreign corporation that is Agreement or Diplomatic or Consular 
Regulations section 301.7701(b)-7. A        controlled by a U.S. person within the     Agreement reduces or modifies the 
separate form is required annually for      meaning of section 6038; (c) a foreign     income of a taxpayer;
each treaty-based return  position taken    corporation that is a 25-percent           •  That a treaty exempts a taxpayer from 
by the taxpayer, although a taxpayer        shareholder of the U.S. person under       the excise tax imposed by section 4371, 
may treat payments or income items of       section 6038A; or (d) a foreign related    but only if certain conditions are met (for 
the same type received from the same        party, as defined under section            example, the taxpayer has entered into 
payor as a single item for reporting        6038A(c)(2)(B);                            an insurance excise tax closing 
purposes.
                                            (2) The foreign person is related to the   agreement with the IRS);
Who Must File                               payor under section 267(b) or section      •  That a treaty exempts from tax or 
Generally, a taxpayer who takes a           707(b) and receives income exceeding       reduces the rate of tax on FDAP income, 
treaty-based return position must           $500,000, in the aggregate, from the       if the beneficial owner is an individual or 
disclose that position, unless reporting is payor and the treaty contains a limitation governmental entity;
specifically waived. See Exceptions         on benefits article; or
                                                                                       •  If a partnership, trust, or estate has 
from reporting below.                       (3) The treaty imposes additional          disclosed a treaty position that the 
A taxpayer takes a treaty-based return      conditions for the entitlement of treaty   partner or beneficiary would otherwise 
position by maintaining that a treaty of    benefits (for example, the treaty requires be required to disclose;
the United States overrules or modifies a   the foreign corporation claiming a 
provision of the Internal Revenue Code      preferential rate on dividends to meet     •  Unless modified by the instructions 
and thereby causes (or potentially          ownership percentage and ownership         below, that a treaty exempts from tax or 
causes) a reduction of tax on the           period requirements);                      reduces the rate of tax on FDAP income 
                                                                                       that is properly reported on Form 1042-S 
taxpayer’s tax return. For these            • That income effectively connected with   and the amount is received by a:
purposes, a treaty includes, but is not     a U.S. trade or business of a taxpayer is 
limited to, an income tax treaty; estate    not attributable to a permanent            a. Related party (within the meaning of 
and gift tax treaty; or friendship,         establishment or a fixed base in the       section 6038A(c)(2)) from a reporting 
commerce, and navigation treaty.            United States;                             corporation within the meaning of 
                                                                                       section 6038A(a) (a domestic corporation 
Reporting specifically required.            • That a treaty modifies the amount of     that is 25% foreign owned and required 
Regulations section 301.6114-1(b)           business profits of a taxpayer             to file Form 5472);
specifically requires reporting on a Form   attributable to a permanent 
8833 for the following treaty-based         establishment or a fixed base in the       b. Beneficial owner that is a direct 
return positions. Note that this is not an  United States;                             account holder of a U.S. financial 
                                                                                       institution or qualified intermediary, or a 
exhaustive list of all positions that are   • That a treaty alters the source of any   direct partner, beneficiary, or owner of a 
reportable on a Form 8833 and that          item of income or deduction (unless the    withholding foreign partnership or trust, 
some specifically reportable positions      taxpayer is an individual);                from that U.S. financial institution, 
are waived in certain circumstances 
under Regulations section 301.6114-1(c).    • That a treaty grants a credit for a      qualified intermediary, or withholding 
                                            foreign tax which is not allowed by the    foreign partnership or withholding 
• That a nondiscrimination provision of     Code;                                      foreign trust (whether the Form 1042-S 
the treaty prevents the application of an                                              reporting is on a specific payee or 
otherwise applicable Code provision,        • That the residency of an individual is 
other than with respect to making an        determined under a treaty and apart        pooled basis); or
election under section 897(i);              from the Code. See Dual-resident           c. Taxpayer that is not an individual or 
                                            taxpayer below.                            a State, if the amounts are not received 
• That a treaty reduces or modifies the                                                through an account with an intermediary 
taxation of gain or loss from the           Exceptions from reporting. Regulations 
disposition of a U.S. real property         section 301.6114-1(c) waives reporting     or with respect to an interest in a 
interest;                                   on a Form 8833 for certain treaty-based    partnership or a simple or grantor trust, 
                                            return positions. In some instances, the   and if the amounts do not total more 
                                            waiver narrowly applies to exempt from     than $500,000 for the tax year.  
                                            reporting a treaty position that is 

Form 8833 (Rev. 12-2021)                                                                                                      Page 4 
Reporting specifically required by           for U.S. competent authority assistance.     year your status as an LTR ends. For 
Form 8833 instructions. The following        See Rev. Proc. 2015-40, 2015-35 I.R.B.       additional information, see the 
are amounts for which a treaty-based         236, or its successor.                       Instructions for Form 8854, Initial and 
return disclosure on Form 8833 is            If you choose to be treated as a             Annual Expatriation Statement, and 
specifically required under these            resident of a foreign country under an       Pub. 519, U.S. Tax Guide for Aliens.
instructions.                                income tax treaty, you are still treated as  Line 3 
• Amounts described in paragraph a or        a U.S. resident for purposes other than 
c, above, that are received by a             figuring your U.S. income tax liability      Income that is fixed or determinable  
corporation that is a resident under the     (see Regulations section                     annual or periodical includes interest  
domestic law of both the United States       301.7701(b)-7(a)(3)).                        (other than original issue discount),  
and a foreign treaty jurisdiction (a dual-                                                dividends, rents, premiums, annuities,  
resident corporation).                       When and Where To File                       salaries, wages, and other  
                                                                                          compensation. For more information  
• Amounts described in paragraph a or        Attach Form 8833 to your tax return          (including other items of income that are  
c, above, that are received by a             (Form 1040-NR, Form 1120-F, etc.). If        fixed or determinable annual or 
corporation that is a resident of both the   you would not otherwise be required to       periodical), nonresident aliens and dual-
jurisdiction whose treaty is invoked and     file a tax return, you must file one at the  resident taxpayers filing as  nonresident 
another foreign jurisdiction that has an     IRS Service Center where you would           aliens should see section 871(a) and 
income tax treaty with that treaty           normally file a return to make  the treaty-  Regulations section 1.871-7(b) and (c). 
jurisdiction. See Revenue Ruling             based return position disclosure under       Foreign corporations  should see section 
2004-76, 2004-31 I.R.B. 111, available at    section 6114 (see Regulations section        881(a) and Regulations section 
www.irs.gov/pub/irs-irbs/irb04-31.pdf.       301.6114-1(a)(1)(ii)) or under Regulations   1.881-2(b) and (c). 
• Amounts described in paragraph a or        section 301.7701(b)-7.
                                                                                          Line 4
c, above, that are received by a foreign 
collective investment vehicle that is a      Specific Instructions                        Name the specific test in the Limitations 
contractual arrangement and not a                                                         on Benefits (LOB) article that is met. See 
person under foreign law. See Example 7      U.S. Taxpayer Identifying Number             Table 4, Limitation on Benefits, at 
of Regulations section 1.894-1(d)(5).        The identifying number of an individual is   IRS.gov/Individuals/International-
• Amounts described in paragraph a or        his or her social security number or         Taxpayers/Tax-Treaty-Tables, for a 
c, above, that are received by a foreign     individual taxpayer identification number.   summary of the various tests contained 
“interest holder” in a “domestic reverse     The identifying number of all others is      in the LOB article of each treaty.  If you 
hybrid entity,” as those terms are used in   their employer identification number.        have made a request with the U.S. 
                                                                                          competent authority for a discretionary 
Regulations section 1.894-1(d)(2).           For more information about identifying       determination and that request is still 
Dual-resident taxpayer. An alien             numbers, see the instructions for the tax    pending, you may not claim benefits, 
individual is a dual-resident taxpayer if    return with which this form is filed.        unless the treaty or technical explanation 
                                                                                          specifically provides otherwise. 
that individual is considered to be a        Reference ID Number 
resident of both the United States and  
another country under each country’s         If the taxpayer is a foreign corporation,    Line 5 
tax laws. If the income tax treaty           enter any reference ID number assigned       If the taxpayer answers “Yes” to the 
between the United States and the other      to the foreign corporation by a U.S.         question on line 5, the taxpayer must 
country contains a provision for             person with respect to which information     enter the subsection of Regulations 
resolution of conflicting claims of          reporting is required (for example, on       section 301.6114-1(b) with respect to 
residence by the United States and its       Form 5471 or Form 5472).                     which the taxpayer is disclosing a treaty-
treaty partner, and the individual                                                        based return position. The taxpayer must 
determines that under those provisions       Address in Country of Residence              also provide the information requested 
he or she is a resident of the foreign       Enter the information in the following       on line 6.
country for treaty purposes, the             order: city, province or state, and  
individual may claim treaty benefits as a    country. Follow the country’s practice for   Line 6
resident of that foreign country, provided   entering the postal code. Please do not      All taxpayers taking a treaty-based 
that he or she complies with the             abbreviate the country name.                 return position must provide the 
instructions below.                                                                       requested information on line 6, 
                                             Termination of U.S. Residency 
If you are an individual who is a                                                         regardless of whether reporting is 
dual-resident taxpayer and you choose        If you are a dual-resident taxpayer and a    explicitly required under Regulations 
to claim treaty benefits as a resident of    long-term resident (LTR) and you are         section 301.6114-1(b), unless it is 
the foreign country, you are treated as a    filing this form to be treated as a resident waived under Regulations section 
nonresident alien in figuring your U.S.      of a foreign country for purposes of         301.6114-1(c). If applicable, the taxpayer 
income tax liability for the part of the tax claiming benefits under an applicable        must explain why it meets the Limitation 
year you are considered a dual-resident      U.S. income tax treaty, you will be          on Benefits test identified on line 4, the 
taxpayer. If you are eligible to be treated  deemed to have terminated your U.S.          basis for the taxpayer meeting any 
as a resident of the foreign country         residency status for federal income tax      special requirements for claiming 
pursuant to the applicable income tax        purposes. Because you are terminating        benefits, such as those required to be 
treaty and you choose to claim benefits      your U.S. residency status, you may be       included on line 15 of Form W-8BEN-E, 
as a resident of such foreign country,       subject to tax under section 877A and        and the amount (or a reasonable 
you must file Form 1040-NR, U.S.             you must file Form 8854, Initial and         estimate thereof) of the income affected 
Nonresident Alien Income Tax Return,         Annual Expatriation Statement. You are       by the treaty claim.  See Regulations 
with Form 8833 attached. A dual-             an LTR if you were a lawful permanent        section 301.6114-1(d)(3) regarding rules 
resident taxpayer may also be eligible       resident of the United States in at least 8  for reporting estimates of certain types 
                                             of the last 15 tax years ending with the     of income, such as sales or services 
                                                                                          income.

Form 8833 (Rev. 12-2021)                                                                                                      Page 5 
Paperwork Reduction Act Notice. We           be retained as long as their contents      for all other taxpayers who file this form 
ask for the information on this form to      may become material in the                 is shown below.
carry out the Internal Revenue laws of       administration of any Internal Revenue     Recordkeeping   . . . .  3 hr., 7 min.
the United States. You are required to       law. Generally, tax returns and return  
give us the information. We need it to       information are confidential, as required  Learning about the 
ensure that you are complying with these     by section 6103.                           law or the form . . . . 1 hr., 35 min. 
laws and to allow us to figure and collect   The time needed to complete and file       Preparing and sending 
the right amount of tax.                     this form will vary depending on           the form to the IRS . . 1 hr., 43 min. 
You are not required to provide the          individual circumstances. The estimated    If you have comments concerning the  
information requested on a form that is      burden for individual and business         accuracy of these time estimates or  
subject to the Paperwork Reduction Act       taxpayers filing this form is approved     suggestions for making this form  
unless the form displays a valid OMB         under OMB control numbers 1545-0074        simpler, we would be happy to hear  
control number. Books or records             and 1545-0123. The estimated burden        from you. See the instructions for the tax 
relating to a form or its instructions must                                             return with which this form is filed.