Fillable UNIVERSITY OF HAWAII STATEMENT OF CITIZENSHIP AND FEDERAL (Research Corporation of University of Hawaii)

Fill Online, Printable, Fillable, Blank UNIVERSITY OF HAWAII STATEMENT OF CITIZENSHIP AND FEDERAL (Research Corporation of University of Hawaii) Form

Use Fill to complete blank online RESEARCH CORPORATION OF UNIVERSITY OF HAWAII pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

UNIVERSITY OF HAWAII STATEMENT OF CITIZENSHIP AND FEDERAL (Research Corporation of University of Hawaii)

On average this form takes 28 minutes to complete

The UNIVERSITY OF HAWAII STATEMENT OF CITIZENSHIP AND FEDERAL (Research Corporation of University of Hawaii) form is 2 pages long and contains:

  • 1 signature
  • 14 check-boxes
  • 100 other fields

Country of origin: US
File type: PDF

Use our library of forms to quickly fill and sign your Research Corporation of University of Hawaii forms online.

BROWSE RESEARCH CORPORATION OF UNIVERSITY OF HAWAII FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
DISB WH-1
(REV 04/29/20 ADA)
UNIVERSITY OF HAWAII
STATEMENT OF CITIZENSHIP AND FEDERAL TAX STATUS
PURPOSE: This form is for individuals. To comply with applicable tax provisions of the Internal Revenue Service (IRS)
regulations, the information requested on this form is required to determine the appropriate federal tax
withholding and is required for each calendar year. (Business entities should use IRS Form W-9)
DIRECTIONS:
UNITED STATES (US) CITIZENS:
1. Complete Sections A and E only.
1. Complete Sections A and E only.
PERMANENT RESIDENT ALIENS:
2. Attach a photocopy (front and back) of your Alien Registration Card.
1.
Complete Sections A, B, C, and E.
5.
For J-1 visaholders, submit copy of DS-2019.
ALL OTHERS:
2.
Complete Section D if applicable.
6.
For B visaholders, submit DISB-45.
3.
Submit copy of your electronic I-94
7.
For F-1 visaholders, submit copy of I-20.
Passport ID Page and Visa page.
8.
Submit IRS Form 8233 if performing services
4.
Submit IRS Form W8-BEN for foreign status.
as independent contractor (Treaty only).
Section A. PERSONAL INFORMATION
1. General Information
Last Name
US Social Security Number or ITIN Number
Country of Citizenship
Country of Residence for Tax Purpose
E-Mail Address
[FOR NON-UH PERSONNEL]
Are you a PostDoc?
[ ] YES
[
] NO
Are you employed anywhere? [ ] YES
[
] NO If you answered "YES", please provide your employer's information:
Employer's Name Number & Street City / Province State Postal Code
2. US Mailing Address
Number and Street
City
State
Zip Code
3. Foreign Mailing Address
Number and Street
City/Province Country
Postal Code
Section B. US IMMIGRATION ACTIVITY
1. Current Visa Status
Date of US Entry
Expiration Date of Current Visa
Intended Length of Stay (Days)
Anticipated Departure Date
Current Visa Type (check appropriate box):
What is the primary purpose of the visit? (check appropriate box)
[ ] F-1 Student
[ ] Studying/Training/Research in a Degree Program
[ ] J-1 Student [ ] Studying/Training/Research in a Non-Degree Program
[ ] J-1 Visitor (Non-Student) [ ] Training/Research as a Post-Doctoral Fellow
[ ] Providing Service as an Independent Contractor
[ ] B-1/WB Visitor for Business
(e.g., consulting, conducting a workshop, etc.)
[ ] B-2/WT Visitor for Pleasure (Tourist)
[ ] Other:
[ ] Other INS Classification (list status):
2. Is this the first time you have entered the United States? [ ] YES [ ] NO
3. Past Visa History
Provide the number of days you were or will be physically present
in the United States. Note: Calendar year refers to the period January 1 - December 31.
Enter Visa Type/INS
Calendar
classification held while
Number of days Have you taken any
Year
present in the US during
present in the Are you leaving the treaty benefits during
the listed calendar year
Enter period(s) when you were or
will be physically present in the US
during the listed calendar year.
(list dates as mm/dd/yy, e.g., 01/01/12 – 12/31/12
United States?
US this year?
the listed year?
[ ] YES [ ] NO [ ] YES [ ] NO
[ ] YES [ ] NO
[ ] YES [ ] NO
[ ] YES [ ] NO
[ ] YES [ ] NO
[ ] YES [ ] NO
[ ] YES [ ] NO
Reset Form
2020
2019
2018
2017
2016
2015
2014
Section C. Tax Status Determination
STEP 1: Complete the Substantial Presence Test (SPT) by completing the table below.
For F, J, M or Q Visaholders, please note the following:
• For F, J, or M Student Visaholders:
Do NOT count any days during your first 5 years in the United States in which you
held an F, J, or M student visa.
• For J or Q Non-Student Visaholders:
Do NOT count any days during your first 2 years in the previous 6 years in the
United States in which you held a J or Q Non-Student visa.
CALENDAR CAL
CULATE TOTAL NUMBER OF DAYS TO
YEAR RATIO COUNT FOR EACH YEAR
ENTER TOTAL NUMBER OF DAYS YOU
WERE OR WILL BE PRESENT IN THE
UNITED STATES FOR EACH YEAR
(A)
(B)
(A X B)
1
1/3
1/6
TOTAL # OF DAYS
STEP 2: Please answer the following questions:
A. Does the TOTAL NUMBER OF DAYS TO COUNT for the current calendar year equal to 31 days or more?
[ ] YES [ ] NO
B. Does the TOTAL # OF DAYS for all three years equal to 183 days or more?
[ ] YES [ ] NO
STEP 3: Determine your tax status:
• If you marked “YES” to both questions A and B, then you passed the Substantial Presence Test and will be treated as a
RESIDENT ALIEN (RA) FOR TAX PURPOSES for this calendar year. Go to and sign Section E below.
• If you marked “No” to one or both questions, then you did not pass the Substantial Presence Test and will be treated as a
NONRESIDENT ALIEN FOR TAX PURPOSES for this calendar year. Go to Section D below.
Section D. EXEMPTION FROM WITHHOLDING FOR THE NONRESIDENT ALIEN
1. All Pay
ments made to Nonresident Aliens are subject to US federal tax withholding at a statutory rate of 30%.
Ho
wever,
yo
u
may claim an exemption from withholding or reduced rate via a US Tax Treaty if you meet the following requirements:
a
. You m
ust be a resident of a
country that has a tax treaty with the US. (Consult IRS Publication 901, US Tax Treaties,
at
http:
/www.irs.gov/pub/irs-pdf/p901.pdf. The tax treaty must have a treaty article applicable to the type of payment you'll be
receivi
ng:
•
Sc
holarship or Fellowship Article for Scholarship, Fellowship, Traineeship, and Stipend Payments.
OR
•
In
ependent Personal Services Article for Fee for Services, Honoraria, and Reportable Travel payments.
b.
You
m
ust meet all requirements regarding residency, time, and dollar limitations described in the tax treaty.
c.
You
m
ust have a Social Security Number (SSN) or Individual Taxpayer Identification Number (ITIN) to claim a treaty exemption.
2. Do you
want to claim a treaty exemption from US federal tax withholding?
(Check one box only.)
[ ] YES
I am a resident of a country that has a tax treaty with the US and has an applicable tax treaty article. Therefore, I
claim exemption from US tax withholding via a US Tax Treaty with , my country of residence
.
I have attached one of the following IRS forms: (Consult IRS website for Forms and Instructions
at http://www.irs.gov/formspubs/index.html)
• IRS Form 8233 for Fee for Services, Honoraria, and Reportable Travel payments.
OR
• IRS Form W8-BEN for Scholarship, Fellowship, Traineeship, Stipend, and Royalty payments.
[ ] NO
I choose not to claim a treaty exemption from US tax withholding, even though I am a resident of a country that has a tax
treaty with the US and an applicable treaty article. I understand taxes will be withheld at 14% (Scholarships, Fellowship,
Traineeship, or Stipend) or 30% (All other payments.).
[ ] NO
I cannot claim a treaty exemption from US tax withholding because I do not meet the requirements stated in Part 1 above.
I understand taxes will be withheld at 14% (Scholarships, Fellowship, Traineeship, or Stipend) or 30% (All other payments).
Section E. CERTIFICATION OF INFORMATION PROVIDED ON THIS FORM
Under penalties of perjury, I certify the information entered above is correct; and if a reduced rate of exemption from tax applies, I further certify that I have
complied with all tax treaty requirements to qualify for the reduced rate. (For Resident Aliens, IRS has not notified me of backup withholding.)
Signature:
Date:
Disbursing Office Use Only
Tax [ ] US Citizen
[ ] Permanent Resident Alien
Vendor Code
Status:
[ ] Resident Alien for Tax Purposes (SPT exp 12/ ) [ ] Nonresident Alien
Nonresident Withholding:
Expiration Date
1099/1042 & WH Ind:
[ ] Statutory Rate of 30% Form 8233
[ ] Reduced Rate of 14% or %
Form W8-BEN
Initials
Date
[ ] Exempt
Form W-9
2020
2019
2018
click to sign
signature
click to edit
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

UNIVERSITY OF HAWAII STATEMENT OF CITIZENSHIP AND FEDERAL (Research Corporation of University of Hawaii)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 29 July 2020

Message

View Audit Log
Print With Audit Log
Duplicate Document