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This questionnaire is used to complete the streamlined filing compliance procedures for non-resident, non-filer taxpayers.
Streamlined Filing Compliance Procedures for
Non-Resident, Non-Filer Taxpayers Questionnaire
TAX YEARS YEAR: YEAR: YEAR:
Please respond to the following questions by checking YES or NO or providing the
ELIGIBILTY YES NO
1. Have you resided in the U.S. for any period of time since January 1,
2. Have you filed a U.S. tax return for tax year 2009 or later
3. Do you owe more than $1,500 in U.S. tax on any of the tax returns you
are submitting through this program
4. If you are submitting an amended return (Form 1040X) solely for the
purpose of requesting a retroactive deferral of income on Form 8891, are
there any adjustments reported on the amended return to income,
deductions, credits or tax
If you answered yes to questions 1, 2 (except for taxpayers submitting
amended returns solely for the purpose of requesting a retroactive deferral
of income on Form 8891), 3, or 4, any returns submitted through this
program will not be eligible for the streamlined processing procedures and
will be treated as high risk returns subject to an examination. If your
answer is yes to any of these questions, you may want to consider a
submission through the Offshore Voluntary Disclosure Program.
5. Since January 1, 2006, have you had a financial interest in or signature
or other authority over any financial accounts located outside your country
a. If yes, are the accounts held in your name
b. If yes, list the countries where the accounts were/are held.
6. Since January 1, 2006, did you have a financial interest in any entities
located outside your country of residence
a. If yes, do these entities control U.S. investments
b. If yes, list the countries where the entities were/are located.
7. Do you have a retirement account located in your country of residence
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