Transcription of 2017 Form 8843
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2017 Form 8843
form 8843 Department of the Treasury internal revenue ServiceStatement for Exempt Individuals and Individuals With a medical ConditionFor use by alien individuals only. Go to for the latest the year January 1 December 31, 2017, or other tax yearbeginning, 2017, and ending, No. 1545-00742017 Attachment Sequence No. 102 Your first name and initial Last nameYour taxpayer identification number, if anyFill in your addresses only if you are filing this form by itself and not with your tax returnAddress in country of residenceAddress in the United StatesPart IGeneral Information1aType of visa (for example, F, J, M, Q, etc.) and date you entered the United States bCurrent nonimmigrant status. If your status has changed, also enter date of change and previous status. See what country or countries were you a citizen during the tax year?3aWhat country or countries issued you a passport?bEnter your passport number(s) 4aEnter the actual number of days you were present in the United States during:201720162015bEnter the number of days in 2017 you claim you can exclude for purposes of the substantial presence test Part IITeachers and Trainees5 For teachers, enter the name, address, and telephone number of the academic institution where you taught in 2017 6 For trainees, enter the name, address, and telephone number of the director of the academic or other specialized programyou participated in during 2017 7 Enter the type of visa (J or Q) you held during: 201
Form 8843 Department of the Treasury Internal Revenue Service Statement for Exempt Individuals and Individuals With a Medical Condition For use by alien individuals only.
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