Alien Information Request Form

Georgetown University Alien Information Request Form The Internal Revenue Service requires that all withholding agents withhold taxes at the appropriate percentage of gross compensation. If you are not a United States citizen it is necessary to determine your residency status for tax purposes. The following questions will help determine whether you are a Resident Alien or a Non-Resident Alien* This status is for tax purposes only and is not to be associated with visa classification or immigrant status. This information is strictly confidential and for tax withholding purposes only. Provide all information requested* All applicable questions must be answered* A copy of your I-94 card Arrival Departure record VISA Passport and I-20 or IAP66 form must be submitted with this form* This form must be returned to the Tax Department for processing* Last or Family Name First Middle Social Security or ITIN Number Country of Citizenship Passport Number VISA Number Country that Issued Passport Passport Expiration Date Local US Address Street Foreign Residence Address City State Zip Code Country Foreign Zip Code Immigration Status U*S* immigrant / F-1 Student J-1 Exchange Visitor Permanent Resident Other F-2 Spouse J-2 Spouse or Child 02 Teacher 03 Professor 05 Short Term Scholar 06 Alien Physician 07 Trainee What is the date of your original Entry Into the United States / / Month Day Year Country of Tax Residence if different from Foreign Residence Address Country H-1B Temporary Employee 04 Research Scholar What is your entry date for your Current Immigration Status For Consultants / Self Employed Individuals Do you have an office Fixed Base in the United States Yes No How many days will you be performing services in United States Days Please list any VISA Immigration activity in the last Three Calendar Years Date of Entry Date of Exit VISA Immigration Status Primary Activity Did you take a Treaty Benefit Yes No Substantial Presence Test Generally students will be considered nonimmigrant nonresidents for Five years. An individual will not be exempt if he/she was exempt as a J category nonimmigrant Teacher or Trainee for two years during the last 6 calendar years. Do not count any days you were present in the U*S* as an F or J category nonimmigrant. Number of Days of actual physical presence in the U*S* in the Current Calendar Year / 3 Total Number of Days Present in the U*S* If the total days are less than 183 days you are a Non-Resident Alien for Tax Purposes. If the total is equal to or greater than 183 days you are a I certify that all the information on this form is true to the best of my knowledge. I understand that if my status changes from that which I have indicated on this form I must submit a new form to the Tax Department. The following questions will help determine whether you are a Resident Alien or a Non-Resident Alien* This status is for tax purposes only and is not to be associated with visa classification or immigrant status. This information is strictly confidential and for tax withholding purposes only. Provide all information requested* All applicable questions must be answered* A copy of your I-94 card Arrival Departure record VISA Passport and I-20 or IAP66 form must be submitted with this form* This form must be returned to the Tax Department for processing* Last or Family Name First Middle Social Security or ITIN Number Country of Citizenship Passport Number VISA Number Country that Issued Passport Passport Expiration Date Local US Address Street Foreign Residence Address City State Zip Code Country Foreign Zip Code Immigration Status U*S* immigrant / F-1 Student J-1 Exchange Visitor Permanent Resident Other F-2 Spouse J-2 Spouse or Child 02 Teacher 03 Professor 05 Short Term Scholar 06 Alien Physician 07 Trainee What is the date of your original Entry Into the United States / / Month Day Year Country of Tax Residence if different from Foreign Residence Address Country H-1B Temporary Employee 04 Research Scholar What is your entry date for your Current Immigration Status For Consultants / Self Employed Individuals Do you have an office Fixed Base in the United States Yes No How many days will you be performing services in United States Days Please list any VISA Immigration activity in the last Three Calendar Years Date of Entry Date of Exit VISA Immigration Status Primary Activity Did you take a Treaty Benefit Yes No Substantial Presence Test Generally students will be considered nonimmigrant nonresidents for Five years.