Department of the Treasury

Internal Revenue Service

Ogden, UT 84201

Form 8843 Statement for Exempt Individuals and Individuals with a Medical Condition
If you are filing a Form 1040 NR or Form 1040 NR-EZ, attach Form 8843 to it. Mail your tax return, by
the due date (including extensions), to the address shown in your tax return instructions.
If you do not have to file a tax return, mail Form 8843, by the due date (including extensions) for filing
Form 1040NR or Form 1040 NR-EZ, to:
Department of the Treasury
Internal Revenue Service
Austin, TX 73301