Request for Waiver of Certain Rights, Privileges,
Exemptions, and Immunities for French Nationals
USCIS
Form I-508F
Department of Homeland Security
OMB No. 1615-0025
U.S. Citizenship and Immigration Services
Expires 05/31/2019
►
START HERE - Please type or print in black ink.
Part 1. Information About the Person Filing This Request
Family Name (Last Name)
Given Name (First Name)
Middle Name
1.
2.
Alien Registration Number (A-Number) (if any)
► A-
Part 2. Waiver Statement
1.
Waiver Statement
I,
, a French national, believe
that I have an occupational status that entitles me to nonimmigrant status under section 101(a)(15)(A) or (G) of the Immigration
and Nationality Act (INA) as a government official or international organization representative, respectively, and I receive a
salary from the French Republic.
Accordingly, as I seek to acquire or retain lawful permanent resident status, I hereby waive all diplomatic rights, privileges,
exemptions, and immunities that would otherwise accrue to me under any U.S. law or executive order because of my occupational
status.
2.
Waiver Request
You must choose whether to retain or waive your U.S. tax exemptions under The Convention between the Government of the
United States of America and the Government of the French Republic for the Avoidance of Double Taxation and the Prevention
of Fiscal Evasion with Respect to Taxes on Income and Capital, signed at Paris on August 31, 1994, as amended (“Convention”).
Select the box for either Item A. or Item B. and type or print your initials below your selection.
A.
Retaining United States Tax Exemptions
I do not waive the benefits conferred by Articles 16 and 21 of the Convention. This means that I will not be required to
pay U.S. taxes on the salary the French Republic pays me. However, because I have not waived any benefits under the
INA, I understand that I may not use any calendar year or portion of a calendar year under my admission as a lawful
permanent resident in the United States to fulfill the residence or physical presence requirements for naturalization under
U.S. immigration and nationality laws.
Requestor's Initials
B.
Waiving United States Tax Exemptions
I do waive the exemption from taxation provided by Articles 16 and 21 of the Convention. This means that I will be
required to pay U.S. taxes on the salary the French Republic pays me. I understand that this waiver allows me to use the
time during which the waiver is in effect to fulfill residence and physical presence requirements for naturalization under
U.S. immigration and nationality laws.
Requestor's Initials
Form I-508F 05/26/17 N
Page 1 of 4