Exemption From Withholding on Compensation for Independent
(and Certain Dependent) Personal Services of a
Nonresident Alien Individual
Purpose: This form is used to apply for tax treaty benefits by employees and independent contractors/consultants.
Applicable dates: For first year upon arrival in the U.S., enter the date of arrival as the beginning date and December 31, 20xx as the ending date. For all other years, enter the appropriate calendar year.
2. Taxpayer identification number: Enter the Social Security Number (SSN) or Individual Taxpayer Identification Number (ITIN).
Employees: All employees must have a Social Security Number. If one has been applied for but not received yet, write "TIN applied for" and the date you applied in the space provided on this form.
Independent Contractors/Consultants: If the nonresident alien has a Social Security number, then enter the number in this space. If the person does not have a Social Security Number and is not eligible to obtain one, then an Individual Taxpayer Identification Number (ITIN) may be obtained through a participating IRS office on a Form W-7.
4. Permanent foreign address: Enter an address in your home country. This area MUST be completed or the IRS will return the form as being invalid.
6. U.S. Visa Type: Enter visa type that you are currently under.
7. Enter the name of the country that issued the passport and the passport number.
8. Enter the date of entry into the United States for current visit.
9. Enter nonimmigrant status for this visit and date of expiration.
11. Compensation type:
If you are an employee paid on payroll, indicate Foreign Student, Foreign Professor/teacher or Foreign researcher, whichever is applicable.
If you are a consultant paid by Accounting, you are considered a self-employed person.
11. Compensation for services:
a. Description: Two types of entries must be made:
(1) the kind of services being provided, e.g. research, teaching, etc. This must be based on the primary purpose of the visit to the U.S. and is closely related to the visa purpose.
(2) how is the person to be paid, e.g., monthly, hourly, lump sum, etc.
b. Amount: Enter the amount the person is to be paid. If the exact amount is unknown, enter an estimated amount. Example: $25,704/year or $500 lump sum.
12. Tax treaty information:
a. Enter the applicable tax treaty provision/article. Refer to Table 2, Tax Treaty Information from IRS Pub.901 or call Accounting or Payroll Services.
b. Enter the amount that is eligible to be exempt. If you are a Chinese student who may be exempt for up to $5,000, you would enter $5,000 or your amount of compensation whichever is lower.
c. Enter the country of permanent residence.
13. Noncompensatory scholarship or fellowship income:
Complete only if you also received compensation for personal services from the same withholding
14. Pertinent immigration history should be supplied, including entry and exit dates from prior visits, along
with visa classifications and primary purposes for those visits.
15. Number of personal exemption you are claiming. In most cases, this will be 1.
16. Number of days in the period during which services are to be performed: Enter 365 days if the applicable dates are for the entire year or enter the appropriate number of days for the applicable dates (see Applicable dates above Part I).
Required Statement (for employees only)
For employees, there is an attachment to the form that must be signed.
To be valid, this form must be signed and dated by the nonresident alien. An original signature is needed.
To be completed by the Office of Accounting (for independent consultants/consultants) or by Payroll Services (for employees).