Foreign National Tax Information Form
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1
2University of Florida
Foreign National Tax Information Form
Enlarged copies of the following documents are required:
1) U.S. VISA - (from your passport)
2) I-94 Form, ''Arrival and Departure Record'' (a small white card inside the passport) COPY of both sides
3) I-20, DS-2019 (IAP-66) or I-797
4) Social Security Card
5) I-9 Form, ''Employment Eligibility Verification''
6) Verification of checking Employee Name to the US Department of Treasury SDN List:
This form MUST be returned before Payroll or University Disbursement Services can issue any check.
All applicable questions below must be answered.
This section is to be completed by Department Representative.
Purpose for submitting this form:
Employee (mark the appropriate box below)
)
Independent Contractor/Honorarium (Amount $
)
New to University
Award (Amount $
)
New to Department
Fellowship (Amount $
)
Previously Employed as Student Assistant
Scholarship Student Financial Aid (Amount $
Scholarship - (Amount $
)
Change in Visa Status
Change in Personnel Office
Tuition paid to University Financial Services
Paid to Student
Annual Salary $
Position Title
Department Contact Person
Department Name
Telephone Number
Ext.
Campus PO Box
Email Address
The remainder of this form (both sides) is to be completed by Foreign National.
1. Surname
First
Middle
Mr.
Ms.
Mrs.
Dr.
/
/
2. Social Security # or ITIN #
UFID #
3. Date of Birth
Applied for SSN *
*Attach letter from Social Security Administration
Month
Day
Year
4. U.S. Local Street Address
5. Foreign Residence Address
Address Line 2
Address Line 2
Address Line 3
Address Line 3
City
City
Postal Code
State
Zip Code
Province/Region
Telephone Number
Province/Region Postal Code
(
)
Country
Email
6. Country of Citizenship
7. Country that issued Passport
8. Passport Number
9. Visa Number (not control number)
1 0. Your Current U.S. Immigration Status:
U.S. Immigrant/Permanent Resident
OPT
F-1 Student
Other
J-1 Exchange Visitor
H-1 Temporary Employee
J-2 Spouse or Child of Exchange Visitor
11. If Immigration Status is J-1, What is the Category?
Check Only One
01 Student
03 Professor
05 Research Scholar
02 Short Term Scholar
04 Alien Physician
06 Other
12. What is the Primary Purpose of your Current Stay in the U.S.? Check Only One
01 Studying in a Degree Program
05 Observing
09 Demonstrating Special Skills
02 Studying in a Non-Degree Program
06 Consulting
10 Clinical Activities
03 Teaching
07 Conducting Research
11 Temporary Employment
04 Lecturing
08 Training
12 Here with Spouse
13. What is the Actual Date you first entered the
14. What is the Start Date on your current immigration
15. What is the Projected End Date of your present
U.S. in your present immigration status?
form (i.e., DS-2019, I-20, or I-797, as applicable)?
immigration status?
/
/
/
/
/
/
Month Day
Year
Month Day
Year
Month Day
Year
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FA-UTS-FNINFO 09/07
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