Is a Form 8833 neccesary? Status code

[aoatley]

Is a Resident Alien teacher filing a 1040 with a 1042-S that has less than $100,000 gross income on it, with

Exemption Code 04: exempt under tax treaty (with Bulgaria)

Exemption Code 15: Payee not subject to chapter 4 withholding

Chapter 3 Status code 41: U.S. government entity or tax exempt entity (other than section 501(c) entities and

Chapter 4 status code 02: Government – contracting state/political subdivision/local authority

obligated to file a Form 8833?

[MaryK4]

Yes you want to include the Form 8833 with your federal tax return.  While the qualified intermediary did receive the information for the withholding purposes, it is always best to provide the details with your tax return.  This affirms your position on the income instead of relying on the 1042-S which the IRS does not necessarily review.  

Taxpayers use this form to make the treaty-based return position disclosure required by Internal Revenue Code section 6114. Dual-resident taxpayers use this form to make the treaty-based return position disclosure required by Regulations section 301.7701(b)-7.  About Form 8833