Form 8233 - Exemption From Withholding On Compensation For Independent (And Certain Dependent) Personal Services Of A Nonresident Alien Individual
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28233
Exemption From Withholding on Compensation
Form
for Independent (and Certain Dependent) Personal
OMB No. 1545-0795
(Rev. March 2009)
Services of a Nonresident Alien Individual
Department of the Treasury
See separate instructions.
Internal Revenue Service
Who Should
IF you are a nonresident alien individual who is
THEN, if you are the beneficial owner of that
receiving . . .
income, use this form to claim . . .
Use This Form?
Compensation for independent personal
A tax treaty withholding exemption
Note: For
services performed in the United States
(Independent personal services, Business
definitions of terms
profits) for part or all of that compensation
used in this section
and/or to claim the daily personal exemption
and detailed
amount.
instructions on
required
withholding forms
Compensation for dependent personal
A tax treaty withholding exemption for part or
for each type of
services performed in the United States
all of that compensation.
income, see
Note: Do not use Form 8233 to claim the daily
Definitions on
personal exemption amount.
pages 1 and 2 of
the instructions.
Noncompensatory scholarship or fellowship
A tax treaty withholding exemption for part or
income and personal services income from
all of both types of income.
the same withholding agent
IF you are a beneficial owner who is . . .
INSTEAD, use . . .
DO NOT Use
This Form. . .
Receiving compensation for dependent
Form W-4 (See page 2 of the Instructions
personal services performed in the United
for Form 8233 for how to complete Form
States and you are not claiming a tax treaty
W-4.)
withholding exemption for that compensation
Receiving noncompensatory scholarship or
Form W-8BEN or, if elected by the
fellowship income and you are not receiving
withholding agent, Form W-4 for the
any personal services income from the same
noncompensatory scholarship or
withholding agent
fellowship income
Claiming only foreign status or treaty benefits
Form W-8BEN
with respect to income that is not
compensation for personal services
This exemption is applicable for compensation for calendar year
, or other tax year beginning
and ending
.
Part I
Identification of Beneficial Owner (See instructions.)
1
Name of individual who is the beneficial owner
2
U.S. taxpayer identifying number
3
Foreign tax identifying number, if any (optional)
4
Permanent residence address (street, apt. or suite no., or rural route). Do not use a P.O. box.
City or town, state or province. Include postal code where appropriate.
Country (do not abbreviate)
5
Address in the United States (street, apt. or suite no., or rural route). Do not use a P.O. box.
City or town, state, and ZIP code
Note: Citizens of Canada or Mexico are not required to complete lines 7a and 7b.
7a
Country issuing passport
7b
Passport number
6
U.S. visa type
8
Date of entry into the United States
9a
Current nonimmigrant status
9b
Date your current nonimmigrant status expires
10
If you are a foreign student, trainee, professor/teacher, or researcher, check this box
Caution: See the line 10 instructions for the required additional statement you must attach.
8233
For Privacy Act and Paperwork Reduction Act Notice, see separate instructions.
Cat. No. 62292K
Form
(Rev. 3-2009)
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