(1)Dates of U.S. presence of 30 days or more up to 3 occurrences
(mm/dd/yy-to-mm/dd/yy):
(2)Do you claim to be a U.S. resident for income tax purposes? Y/N:
(If No: go to #3) (If Yes: Do you understand that as a U.S. resident,
your worldwide income is subject to U.S. income tax? Y/N:
Have you been lawfully admitted for permanent residence? Y/N:
--If No: explain why you are a U.S. resident:
--If yes: Do you agree to notify SSA if you formally abandon or the U.S.
government takes away your U.S. residency, or you begin to be treated as a
resident of a foreign country under the provisions of a tax treaty between
the U.S. and that country? Y/N: ,Alien Registration #: )
(3)Do you claim a reduced rate of withholding under the provisions of an
income tax treaty with the U.S.? Y/N:
--If Yes: Name of country:
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | Maria |
| File Modified | 0000-00-00 |
| File Created | 2021-01-22 |