1118 Form 8802 (PDF)

Official source: IRS Forms, Instructions & Publications (https://www.irs.gov/pub/irs-pdf/f8802.pdf), retrieved 2026-10-03. U.S. Government work (17 U.S.C. § 105).

---

1 Applicant’s name and taxpayer identification number as it should appear on the certification if different from above

2 Applicant’s address during the calendar year for which certification is requested, including country and ZIP or postal code. If a P.O. box, see instructions.

3a Mail Form 6166 to the following address:

b Appointee Information (see instructions): Appointee Name ^▶ CAF No. ^▶

Phone No. ^▶ ( ) Fax No. ^▶ ( )

4 Applicant is (check appropriate box(es)): a Individual. Check all applicable boxes.

U.S. citizen U.S. lawful permanent resident (green card holder) Sole proprietor Other U.S. resident alien. Type of entry visa ^▶

Current nonimmigrant status ^▶ and date of change (see instructions) ^▶

Dual-status U.S. resident (see instructions). From ^▶ to ^▶

Partial-year Form 2555 filer (see instructions). U.S. resident from ^▶ to ^▶

c Trust. Check if: Grantor (U.S.) Simple Rev. Rul. 81-100 Trust IRA (for Individual) Grantor (foreign) Complex Section 584 IRA (for Financial Institution) d Estate e Corporation. If incorporated in the United States only, go to line 5. Otherwise, continue. Check if: Section 269B Section 943(e)(1) Section 953(d) Section 1504(d) Country or countries of incorporation ^▶

If a dual-resident corporation, specify other country of residence ^▶

If included on a consolidated return, attach page 1 of Form 1120 and Form 851. f S corporation g Employee benefit plan/trust. Plan number, if applicable ^▶

h Exempt organization. If organized in the United States, check all applicable boxes.

Section 501(c) Section 501(c)(3) Governmental entity Indian tribe Other (specify) ^▶

j Nominee applicant (must specify the type of entity/individual for whom the nominee is acting) ^▶

For Privacy Act and Paperwork Reduction Act Notice, see separate instructions. Cat. No. 10003D Form 8802 (Rev. 11-2018)

Form 8802 (Rev. 11-2018) Page 2

Applicant name:

5 Was the applicant required to file a U.S. tax form for the tax period(s) on which certification will be based? Yes. Check the appropriate box for the form filed and go to line 7.

990 990-T 1040 1041 1065 1120 1120S 3520-A 5227 5500 Other (specify) ^▶

No. Attach explanation (see instructions). Check applicable box and go to line 6.

Minor child QSub U.S. DRE Foreign DRE Section 761(a) election FASIT Foreign partnership Other ^▶

6 Was the applicant’s parent, parent organization or owner required to file a U.S. tax form? (Complete this line only if you checked “No” on line 5.)

Yes. Check the appropriate box for the form filed by the parent.

990 990-T 1040 1041 1065 1120 1120S 5500 Other (specify) ^▶

Parent’s/owner’s name and address ^▶

and U.S. taxpayer identification number ^▶

No. Attach explanation (see instructions). 7 Calendar year(s) for which certification is requested. Note. If certification is for the current calendar year or a year for which a tax return is not yet required to be filed, a penalties of perjury statement from Table 2 of the instructions must be entered on line 10 or attached to Form 8802 (see instructions).

8 Tax period(s) on which certification will be based (see instructions).

9 Purpose of certification. Must check applicable box (see instructions).

Income tax VAT (specify NAICS codes) ^▶

Other (must specify) ^▶

10 Enter penalties of perjury statements and any additional required information here (see instructions).

Sign here

Keep a copy for your records.

Applicant’s signature (or individual authorized to sign for the applicant)

Signature Date

Name and title (print or type)

Spouse’s signature. If a joint application, both must sign.

Name (print or type)

Under penalties of perjury, I declare that I have examined this application and accompanying attachments, and to the best of my knowledge and belief, they are true, correct, and complete. If I have designated a third party to receive the residency certification(s), I declare that the certification(s) will be used only for obtaining information or assistance from that person relating to matters designated on line 9.

Applicant’s daytime phone no.:

Form 8802 (Rev. 11-2018)