Department of the Treasury - Internal Revenue Service
14581-B
Form
International Issues Compliance Self-Assessment
(June 2017)
For Public Employers
International Issues – Publication 515
1.
Did the entity make payments to a foreign person of any item of income that is
Yes
No
Follow Up
subject to withholding
If not, indicate “NO” and skip the International Issues section.
Note: Employees or independent contractors who are not U.S. citizens may be required to furnish their employer with a Form I-9,
Employment Eligibility Verification, Form W-4, Employee’s Withholding Allowance Certificate or a W-8 series form. P.O. Boxes from a
foreign country are acceptable.
The Form W-8 series includes:
• W-8BEN, Certificate of Foreign Status of Beneficial Owner for United States Tax Withholding;
• W-8ECI, Certificate of Foreign Person’s Claim That Income Is Effectively Connected With the Conduct of a Trade or Business in
the United States;
• W-8EXP, Certificate of Foreign Government or Other Foreign Organization for United States Tax Withholding; and
• W-8IMY, Certificate of Foreign Intermediary, Foreign Flow-Through Entity, or Certain U.S. Branches for United States Tax
Withholding.
Comments
2.
Did the entity employ resident aliens
Yes
No
Follow Up
If yes, were withholding income, Social Security and Medicare taxes followed in the
Yes
No
Follow Up
same way as for U.S. citizens
If no, skip the rest of the International Issues Compliance Self-Assessment.
Note: For information on determining who is a nonresident or resident alien, see Publication 519, U.S. Tax Guide for Aliens.
Comments
a. Did any of the nonresident aliens (NRAs) holding an F-1, J-1, M-1 or Q-1 Visa provide
Yes
No
Follow Up
documentation, including copies of the visa and Form I-9 with supporting
documents to support exemption from Social Security and Medicare taxes
Note: If this documentation was not provided, Social Security and Medicare taxes should be withheld from the wages paid to these
NRAs. However, a NRA student may be eligible for the student FICA exception under Internal Revenue Code (IRC)
Section 3121(b)(10).
Comments
b. Did any NRAs have a visa status other than F-1, J-1, M-1 or Q-1
Yes
No
Follow Up
If yes, were Social Security and Medicare taxes withheld as required
Yes
No
Follow Up
Note: NRAs holding other visas, such as an H-1 or any secondary visa are subject to Social Security and Medicare withholding.
Comments
14581-B
Catalog Number 69845J
Form
(6-2017)