How does a tax evader flee the country?

I have a relative who owes the IRS almost a million dollars, and has been for years. He is a doctor who makes a decent amount of house calls, so does a lot of his biz in cash. He’s also owed the IRS before, but because he’s a doctor, they let him off easy. He also hoards cash.

However, as his debts accumulate, I wonder if this guy could flee the country. If he could, where could he go that would not extradite him? Where could he go that would technically be supposed to do so but in practice wouldn’t?
How might he have access to non-cash financial assets in another country (like if he put money in accounts physically there in the past)?

Most countries won’t extradite for political or revenue offences. Some of the US’s newer extradition treaties do cover revenue offences, but this is a recent development. So there’s probably no shortage of places he can go, and be at no risk of extradition for revenue offences. What may limit his choice is his ability to acquire permanent residency rights in the country to which he flees, so as to be at no risk of deportation.

As to how he might have access to assets while in exile, that’s not a problem. He may already have moved much of his wealth offshore, and if and when he does decide to leave the US he will presumably move the rest of it. There are no barriers to US residents sending their assets abroad. The only thing that might cause a problem is highly illiquid assets, like land; if he leaves it too late, when it all comes crashing down it may be that the revenue authorities will move to seize land in less time than it takes him to sell the land and export the sale proceeds.

how might he get permanent residency in a country?

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Tax evasion is illegal.

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