Foreign Income Reporting 2020-2021
Student Name: _________________
Student ID: ____________________
During the 2018 calendar year, did you, your spouse or your parent(s) earn money in a foreign
country? For our purpose, the 2018 calendar year spans from January 1, 2018 to December 31, 2018
IF NO, Stop.
If yes, please select all that apply, and fill in the blanks. This form will be used to report foreign income for the
2018 calendar year: ***All income needs to be converted into US Dollars.***
☐ Student 2018 income $__________ and 2018 taxes paid $__________
☐ Spouse 2018 income $__________ and 2018 taxes paid $__________
☐ Parent 1 2018 income $__________ and 2018 taxes paid $__________
☐ Parent 2 2018 income $__________ and 2018 taxes paid $__________
In which country did you, your spouse or your parent(s) earn this income in the 2018 calendar year?
Student income earned in ______________________________________
Spouse income earned in ______________________________________
Parent 1 income earned in ______________________________________
Parent 2 income earned in ______________________________________
Were these earnings received through an employer?
If yes, please attach a letter printed on company
letterhead from the employer translated into English
that details your earnings for the 2018 calendar year,
taxes paid, and official signature of employer. ***
☐ Please list the student’s employer
__________________________________
☐ Please list the sp
ouse’s employer
__________________________________
☐ Please list the employer of parent 1
__________________________________
☐ Please list the employer of parent 2
A
ND/
OR
__________________________________
***If you were not self-employed, but you are unable to
get a letter from an employer please provide a
statement on the back of this form.***
Were these earnings received through self-employment?
☐ Describe s
tudent’s self-employment:
________________________________________
☐ De
scribe spouse’s self-employment:
________________________________________
☐ Describe pa
rent 1’s self-employment:
________________________________________
☐ Describe pa
rent 2’s self-employment:
________________________________________
Please describe the tax filing requirements in the country from which you earned income during the 2018 calendar year.
☐ Student was required to file taxes in the country listed above. Circle YES or NO
☐ Spouse was required to file taxes in the country listed above. Circle YES or NO
☐ Parent 1 was required to file taxes in the country listed above. Circle YES or NO
☐ Parent 2 was required to file taxes in the country listed above. Circle YES or NO
If yes, please attach the signed and dated tax returns from the country that would reflect the earnings for the 2018 calendar year translated
into English. If no, attach a verification of non-filing letter from the country's taxing authority. If the country does not provide a verification of non-filing
letter free of charge, provide a statement on the back of this form.
Student Name: ____________________________ Student Signature: ____________________________ Date:__________
Spouse Name: ____________________________ Spouse Signature: ____________________________ Date:__________
Parent 1 Name: ____________________________ Parent 1 Signature: ____________________________ Date:__________
Parent 2 Name: ____________________________ Parent 2 Signature: ____________________________ Date:__________
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