Fillable NRAinfo Nonresident Alien Information Form 2000

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NRAinfo Nonresident Alien Information Form 2000

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The NRAinfo Nonresident Alien Information Form 2000 form is 2 pages long and contains:

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University of Dayton
Nonresident Alien Information Form
The information provided on this form will be used for tax withholding and reporting purposes only. Copies of your U.S. visa from your
passport, I-94 Form, Form DS-2019 or I-20 must be attached to this form.
Name_______________________________________________________________________
Last First Middle
U.S. Social Security Number______-______-_______ or ITIN Number_______-______-_______
Local Address____________________________________________________
____________________________________________________
City State Zip
Local Telephone Number (________)_________-_________
Country of citizenship____________________
Country of foreign residence (not the United States) ______________________
Foreign Address____________________________________________________
City______________________________ Province/Region______________________
Postal Code________________________ Country_____________________________
Have you been granted permanent residency in the U.S. (Green Card)?
Yes________ No________
Current Visa Type_____________________ Visa Primary Purpose_______________________
As listed on I-20, DS-2019, or I-94
Date of Issuance_______________________________
Date of arrival to the United States with this visa type_______________________________
Estimated or actual date of departure with this visa type______________________________
University Class ------ Employee_____ Student______ Visitor________
Which Department? __________________________________________________
Prior Visa Information:
Have you had any other Visa type before? Yes________ No ________
Prior Visa Visa Primary Date of Entry Date of Departure Were treaty benefits
Type Purpose
taken?
_________ ________________ ______________ _______________ _____________
_________ ________________ ______________ _______________ _____________
_________ ________________ ______________ _______________ _____________
_________ ________________ ______________ _______________ _____________
I certify that the above information is complete and accurate.
Signature__________________________________________ Date______________________
Please return this form, with copies of your documentation, to the Assistant Treasurer and Tax
Manager’s Office, St. Mary’s Hall Rm. 300, University of Dayton, 300 College Park, Dayton, OH
45469-1640
__________________________________________________________________________________
FOR UNIVERSITY OFFICE USE ONLY
Substantial Presence Test
YEAR NUMBER OF CALCULATION
DAYS IN U.S.
Current Year _______ ____________ X 1 = ______________
1
st
Preceding Year _______ ____________ X 1/3 = ______________
2
nd
Preceding Year _______ ____________ X 1/6 = ______________
Total Days of Presence ______________
Residency Status ________________________ Change Date _________________________
Tax Rate ____________________ Tax Treaty ________________________________
Completed Information Form ___________________ With Copies____________________
Completed W-4___________________ Completed 8233_____________________________
FICA Eligibility _________________________________________________________________
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NRAinfo Nonresident Alien Information Form 2000

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Completed 23 February 2020

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