Supporting Statement Template For Irs Form 8233

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SAMPLE
Supporting Statement for IRS Form 8233 – From IRS Publication 519
People’s Republic of China
Student
I was a resident of the People’s Republic of China on the date of my arrival in the United
States. I am not a U.S. Citizen. I have not been lawfully accorded the privilege of residing
permanently in the United States as an immigrant.
I am present in the United States solely for the purpose of my education or training.
I will receive compensation for personal services performed in the United States. This
compensation qualifies for exemption from withholding of federal income tax under the
tax treaty between the United States and the People’s Republic of China in an amount not
in excess of $5,000 for any tax year.
I arrived in the United States on _____________________ (insert the date of you last
arrival in the United States before beginning study or training). I am claiming this
exemption only for such period of time as is reasonably necessary to complete the
education or training.
Sign Here _______________________________
Date ___________________

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