Fillable International - International Visitor Information Form 2014

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International - International Visitor Information Form 2014

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The International - International Visitor Information Form 2014 form is 3 pages long and contains:

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Country of origin: US
File type: PDF

U.S.A. forms for College of Wooster

BROWSE COLLEGE OF WOOSTER FORMS

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The College of Wooster Page 1 of 3
W
International Visitor Information Form
for Non-Employee Payments
(Please print)
1. General Information
Legal name (as shown on your U.S. Social Security or ITIN Card if you have one): U.S. SSN or ITIN
__ __ __ - __ __ - __ __ __ __
Please check here if you do not have a U.S. social security number or individual taxpayer identification number.
You are not required to have a U.S. tax ID number in order to be paid for services as a non-employee
Foreign Residence Mailing Address–-may not be a PO Box only (permanent address for students)
Address 1:
Address 2:
Address 3:
City: City Postal Code:
Province/Region: Region Postal Code:
Country:
U.S. Address (campus address for students)
Address 1:
Address 2:
City, State, Zip Code:
Telephone: Date of Birth:
Country of citizenship: Country that issued passport:
E-mail:
Contact Person at COW:
2. Services Outside the U.S.
I am not a U.S. citizen or resident alien of the U.S., I do not have a fixed base or permanent establishment in the
U.S., and all of my services for The College of Wooster have been and will be performed outside the U.S. in
(country): Please go to # 9.
3. Current Classification--please check any that apply:
Permanent Resident Applicant: Have you applied for Permanent Residency status and received
an “I-551” stamp in your passport or an INS letter stating approval of your application?
Yes No
Asylee: Are you currently present in the U.S. under Asylum status? If “yes”, what date did this
status begin:
Yes No
Refugee: Are you currently present in the U.S. under Refugee status? If “yes”, what date did this
status begin:
Yes No
TPS: Are you currently present in the U.S. under Temporary Protected Status? If “yes”, what date
did this status begin:
Yes No
If you answered “Yes” to any of the above, please go to # 7.
Please initial and date
The College of Wooster Page 2 of 3
4. Visitors Using a Visa other than B-1 / B-2 / WB (Business Waiver) / WT (Tourist Waiver)
F-1 Student
F-1 Student (Practical Training)
J-1 Exchange Visitor
J-1 Subtype: _____________________________
F-1 Student (Curricular Practical Training)
F-1 Student (Employment Authorization Document)
H-1B Temporary Worker in a Specialty Occupation
J-2 Spouse/Dependent of J-1 Visitor
Other Visa _____________________________
For an A, F, G, H, J, L, M, O, P, Q, R, or TN visa, please indicate the sponsoring institution listed on your immigration
documents:
5. Visitors in Business or Tourist Status (including ESTA) (Please check all that apply.)
B-1 or WB (Visa Waiver Business) B-2 or WT (Visa Waiver Tourist) Canadian with no visa
Please answer the following questions:
The honorarium payment and/or expense reimbursement will relate to an academic activity. Yes No
In the 6 months preceding the activity at The College of Wooster. I have not accepted and will not
accept honorarium payments from more than 5 U.S. organizations.
Yes No
My activity at The College of Wooster will be for 9 days or less. Yes No
6. Primary Purpose of Visit (You may need to refer to your Form I-94, I-20, IAP-66 or DS 2019, or I-797)
Primary purpose of activity (select one):
Studying in a degree program Conducting research Consulting Lecturing
Studying in a non-degree program Acquiring training Teaching Clinical activities
Entertaining (actor, artist, athlete, etc.) Other____________________________________________________
Actual date of entry to the U.S. for your current status:
Projected end date of your immigration status:
Dates of activity at The College of Wooster (mm/dd/yy): __ __ / __ __ / __ __ to __ __ / __ __ / __ __
7. Immigration Activity and Immigration Status
The College uses this information to determine tax residency with the substantial presence test. If you are not
planning to claim treaty benefits and if you are sure you are a nonresident for tax purposes, you may initial
here ________and go to #8. If you want to be eligible for treaty benefits (if available), you must complete this
section.
Please complete this table to report your time in the United States during the year of your visit to the College and the
previous 2 calendar years. If any of the visa types listed for those years are “F”, “J”, “M” or “Q”, please include
information on immigration activity back through the first year for that status. Students do not have to report short trips
home during semester breaks. Dates are for actual time in the U.S. for the visa type reported (not dates for the visa)
and should be in the format Month/Day/Year.
First Day in
U.S.
(
Mo/Day/Yr)
Last Day
in U.S.
(Mo/Day/Yr) Visa Type J-1 Subtype Primary Purpose or Activity
Did you take any
treaty benefits?
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
The College of Wooster Page 3 of 3
7. Immigration Activity and Immigration Status (continued)
First Day in
U.S.
(
Mo/Day/Yr)
Last Day
in U.S.
(Mo/Day/Yr) Visa Type J-1 Subtype Primary Purpose or Activity
Did you take any
treaty benefits?
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Please attach another page if you need additional space.
8. Tax Residence (other than U.S.)
In what country is your tax residence?
(Tax residence is the country to which you last paid taxes as a resident—it may be different from your country of citizenship.)
Tax ID number in country of tax residence:
9. Certification
I hereby certify, under penalties of perjury, that all of the information I have provided is true, correct, and
complete. I understand that if my status changes from that which I have indicated on this form, I must
complete an updated International Visitor/Vendor Information Form and provide the required documentation
for the change of status.
Signature (of the individual named in Section 1 of this form) Date
Please also initial and date the first two pages of the form.
Revised: May 2014
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International - International Visitor Information Form 2014

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Completed 17 November 2019

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