Form Fnif - Foreign National Information Form Page 2
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2Last Name/Surname _______________________________________________ First/Given Name ________________________________
Section C – Visa Type Activity in the Last Six Calendar Years (Substantial Presence Test)
(19) List the original date (the very first date) of your entry to the United States:
________/________/________
month
day
year
(20) List the start and end date of your current purpose or program activity as indicated by your visa type
(i.e., I-20, DS-2019, I-797, etc.)
________/________/________
:
________/________/________
Check if I-94 is marked
Start Date:
End Date
as “
Duration of Stay”
month
day
year
month
day
year
(21) Visa Type History – enter your visits to the US for the last six calendar years. For F, J, M or Q status visits, list your visa type
history since January 1, 1985. Attach an additional schedule if need be. **Note – also include status change dates if you
remained in the U.S. while changing status.
Date of Entry
Date of Exit
Visa
Country of
Did you take any
to U.S. **
from U.S. **
Visa Type
Number
Primary Purpose or Activity
Tax Residence
Treaty Benefits?
Yes
No
/
/
/
/
Yes
No
/
/
/
/
Yes
No
/
/
/
/
Yes
No
/
/
/
/
Yes
No
/
/
/
/
/
/
/
/
Yes
No
Yes
No
/
/
/
/
Yes
No
/
/
/
/
/
/
/
/
Yes
No
Section D – Tax Treaty Exemption Information / IRS Forms 8233 and W-9
You must have a Social Security Number and sign an approved treaty exemption form to qualify for tax treaty benefits.
Payments to nonresident aliens for services performed in the U.S. may be subject to federal and state withholding taxes. If you believe you
may qualify for a tax treaty exemption, additional forms (IRS Form 8233 or IRS Form W-9) must be signed and dated by you and the
Withholding Acceptance Agent in Payroll Services. This can take place only after you complete the “Foreign National Information Form”.
Alert Payroll Services if you believe you qualify. Payroll Services determine eligibility.
IRS Form 8233 is used by nonresident aliens to claim exemption from withholding of taxes on compensation. The exemption must be based
on a tax treaty to which the United States is a party. Payroll Services will determine if the payee is eligible for the exemption per IRS
regulations and University administrative procedures. Payroll Services will complete Parts I & II of the form and any applicable attachment
and apply for the exemption after you have signed the form .The form is valid for one calendar year. Make sure you coordinate with Payroll
Services to sign a new form for each year you qualify for the exemption.
IRS Form W-9 is used by nonresident aliens who are classified as resident aliens for tax purposes and qualify for treaty exemption. Refer to
Payroll Services for more information. Payroll Services prepares this form if you qualify.
HOW TO COMPLETE THE FOREIGN NATIONAL INFORMATION FORM
1.
13.
Give full name as listed on your Social Security Card or as listed in your
List your current passport number.
14.
passport if you have not yet received a Social Security Card.
List the country that issued your passport (not the country where obtained).
2.
List the number on your Social Security Card as issued to you by the Social
and country of citizenship.
15.
Security Administration.
List the 10-digit number on your I-94 card (white card in your passport).
3.
16.
Enter your Employee/Student Identification Number.
Indicate your marital status.
4.
17.
Enter the date of your birth
If applicable, indicate your spouse’s work status and number of dependent
5.
List your current home address in the United States.
children in the US.
6.
18.
List your non-US home address.
If applicable to you, check correct box and list days at locations specifically
7.
Give your US home telephone number.
identified with you.
8.
19.
Write your email address. If none, write “none”.
Give the date you first entered the United States.
20.
9.
Select the category of visa you currently hold.
List the program dates of your current immigration status.
10.
21.
Write the full name of the company/institute that is sponsoring your U.S. stay.
Account for your US visits and list the visa and purpose for your stay (The
11.
Select a purpose or give a reason for your stay in the U.S.
visa number is listed in your passport – The red number stamped on your
12.
If you are s student, list the type.
US visa).
Section E - Certification
I certify that all of the above information is true and correct. I understand that if my “Passport and Visa Information” or “Residence Status
for Tax Purposes” changes, I must submit a new Foreign National Information Form reflecting the changes to: Rowan University Payroll
Services, 201 Mullica Hill Rd, Glassboro, NJ, 08028 or email milliganc@rowan.edu.
Signature________________________________________________________ Date ___________________________________
Form FNIF (07/10/08)
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