Form 14581-B - International Issues Compliance Self-Assessment For Public Employers Page 3

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Page 3
c. Is federal income tax withheld as required
Yes
No
Follow Up
Note: NRAs should compete a Form W-4, using Notice 1392, Supplemental Form W-4 Instructions for Nonresident Aliens and
Form 8233, Exemption From Withholding on Compensation for Independent (and Certain Dependent) Personal Services of a
Nonresident Alien Individual, to claim tax treaty benefits. The employer should include procedures for completing Form W-4 and use of
Form 8233 to claim a treaty exemption. See Publication 15 for the rules for completing Form W-4 and claiming a tax treaty exemption
on Form 8233.
Comments
d. Do any NRAs claim a treaty exemption using Form 8233
Yes
No
Follow Up
If yes, were federal income taxes withheld using the current treaty provisions
Yes
No
Follow Up
See Publication 901, U.S. Tax Treaties, for treaty information.
Comments
e. For NRAs who did not claim a treaty exemption, were federal income taxes withheld
Yes
No
Follow Up
using the presumption rules described in Publication 515
Note: If the NRA did not claim a treaty exemption, federal withholding taxes must be computed based on the completed Form W-4 for
the NRA and by following the steps outlined in Chapter 9 of Publication 15.
Comments
3.
Does the entity have vendors or outside contractors that are NRAs
Yes
No
Follow Up
Note: Generally, withholding is required at 30% (or lower treaty rate) from the gross amount paid to a NRA. Use Form 1042-S, Foreign
Person’s U.S. Source Income Subject to Withholding, to report payments to NRAs.
Comments
4.
Are payments to NRAs subjected to NRA Withholding and reported on Form 1042-S
Yes
No
Follow Up
If withholding was required, was Form 1042, Annual Withholding Tax Return for U.S.
Yes
No
Follow Up
Source Income of Foreign Persons, filed
Comments
Notes/Follow-up
You have completed the International Issues Compliance Self-Assessment.
14581-B
Catalog Number 69845J
Form
(6-2017)

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