Note:

A dual status taxpayer who gives up U.S. residency during the tax year files a Form 1040-NR. A dual status taxpayer must attach a separate schedule to the Form 1040-NR to show the income tax computation for the part of the taxable year during which the individual was a citizen or resident of the United States. A Form 1040, clearly marked “Statement” across the top, may be used as such a separate schedule.

If an individual is a resident of both the United States and the country for which certification is requested, the certification may be denied, unless the individual can establish that the individual is solely a resident of the United States under the tiebreaker provision of the applicable treaty. For example, Article 4(3) of the 2016 United States Model Income Tax Convention, the tiebreaker provision, states that where an individual is a resident of both Contracting States, then the individual’s residency status will be determined as follows:

If

Then

1. Has a permanent home in the specific state

The individual will be deemed to be a resident of the State in which a permanent home has been established.

2. A permanent home is available to the individual in both States

The individual will be deemed to be a resident of the State with which personal and economic relations are closer (center of vital interests).

3. The State in which the individual has a center of vital interests cannot be determined, or if a permanent home has not been established in either state

The individual will be deemed to be a resident of the State in which a habitual abode has been established.

4. A habitual abode has been established in both States or in neither of them

The individual will be deemed to be a resident of the national state.

5. The individual is a national of both States or neither of them

The competent authorities of the Contracting States endeavor to settle the question by mutual agreement.