5151 State University Drive
Los Angeles, California 90032
Tel: 323.343.3560
Fax: 323.343.3650
Non Resident Alien Notification Form
All fields must be completed x x
Payee Information
Last Name: ________________________________________
First Name: _________________________ Middle Name: ___________________________
Email Address: _________________________________________________
Please provide an email that you access on a daily or frequent basis. Please print clearly.
Check One:
Faculty/Staff/GA Consultant Student Assistant
Why we are collecting this information:
Cal State LA can not issue payments to you until information regarding your immigration status is provided. This
information will be used to determine your correct withholding allowances for taxation purposes. The Internal
Revenue Service (IRS), the U.S. government tax authority, has issued strict regulations regarding the taxation and
reporting of payments made to non-United States citizens. As a result, Cal State LA may be required to withhold
U.S. income tax and file reports with the IRS in connection with any payments made to you.
What to expect:
Within a few days, you will receive an email message at the email address you provided, notifying you to log on to
the Foreign National Information System (FNIS). The email will contain the username and your password required
to log on to the system. For your convenience, Cal State LA allows you to provide information and complete
the necessary forms via the internet from any web-accessed computer. YOU MUST LOG ON TO THE
Failure to comply:
I understand that if I do not provide the requested information, Cal State LA is unable to honor the withholding
exemption and other terms of my tax treaty. The maximum amount of U.S. tax will be withheld from any payments
made to me.
Signature: _________________________________________ Date:_________________________
If you have questions: Contact Financial Reporting Accountant, Alberto Contreras at (323) 343-3568 or email at
For office use only:
Tax Administrator: ___________________ Date Received_____________________
Date Email Notification/Password sent: __________________________
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