Citizenship Status Form - University Of Maryland Page 2
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3SSN: ____________________________________________
Page 2
COMPLETION REQUIRED
BY ALL EXCEPT PERMANENT RESIDENTS.
Visa Detail History
Calendar Year (CY) = January 1 to December 31.
LIST ALL PERIODS OF STAY IN THE U.S. SINCE 01/01/1986 (attach additional paper if needed)
HAVE YOU
NUMBER OF
PERIODS PHYSICALLY
VISA
TAKEN ANY
If J visa holder,
DAYS PRESENT
PRESENT IN THE U.S.
TYPE
TAX TREATY
enter Exchange
IN THE U.S.
(example: 01/01/01-
or
BENEFITS IN
Visitor Category
DURING THE
12/31/01)
other
THIS LISTED
from #4 of the
YEAR
status
YEAR?
DS-2019:
↓
↓
F OR J VISAS
CAN JUST ENTER A
□
□
CURRENT CY
YES
NO
2013
□
□
PREVIOUS CY
YES
NO
2012
□
□
2 YEARS AGO
YES
NO
2011
□
□
3 YEARS AGO
YES
NO
2010
□
□
4 YEARS AGO
YES
NO
2009
□
□
5 YEARS AGO
YES
NO
2008
□
□
6 YEARS AGO
YES
NO
2007
□
□
7 YEARS AGO
YES
NO
2006
*** For F and J visa holders ONLY: Presence for any part of a year counts as a full year.
DETERMINATION OF RESIDENCY STATUS FOR TAX WITHHOLDING:
A. F-1 OR J-1 STUDENT: Have you been present in the U.S. as a student or trainee during any part of 5
EXEMPT
□
□
FROM THE
or fewer years?
YES
NO=resident alien for tax purposes.
SUBSTANTIAL
B. J-2 SPOUSE/DEPENDENT OF STUDENTS: Have you been present in the U.S. as a spouse or
PRESENCE TEST
(SPT)
□
□
dependent of an F-1 student during any part of 5 or fewer years?
YES
NO
F or J
C. J-1 PROFESSOR OR TEACHER or RESEARCHER (NON-STUDENT VISITORS): Within the period
CLASSIFICATIONS
of the previous six (6) calendars years: were you either entirely absent from the U.S. or were you
ONLY
present in the U.S. as a professor, teacher, or researcher for only 1 calendar year prior to the current
(The 5 year student
□
□
year?
YES
NO= resident alien for tax purposes.
exemption from the SPT
is available over a
D. J-2 SPOUSE/DEPENDENT OF J-1 NON-STUDENT VISITORS: within the period of the previous six
student’s lifetime, and is
(6) calendars years: were you either entirely absent from the U.S. or were you present in the U.S. for
a one-time exemption
□
□
only 1 calendar year prior to the current year?
YES
NO
only!)
If you answered “YES” to any of the questions above & as a spouse or dependent you have
included your individual years of presence if different from the primary visa holder, you are a
“NONRESIDENT ALIEN (NRA) for tax purposes”. You do NOT need to complete the SPT below.
SUBSTANTIAL
CALCULATE THE NUMBER OF DAYS PHYSICALLY PRESENT IN THE U.S. DURING THE YEARS
PRESENCE TEST (SPT)
LISTED. (VISA TYPES “A” & “G” REMAIN NRAs FOR TAX PURPOSES)
If “TOTAL” is less than
List calendar year
Number of days physically Computation
183, you are NRA for tax
Present in the U.S.
for the Test
purposes.
If “TOTAL” is more than
Current year
______2013_____
____________________ ÷
1 = ____________
or equal to 183, and you
have been in the US 31
Last year
______2012_____
____________________ ÷
3 = ____________
days in this CY, you a
Resident Alien for Tax
2 years ago
______2011______
____________________
÷
6 = ____________
Purposes.
TOTAL
……………….
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