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Nonresident Alien Intake and Interview Form

    Instructions:
    • Please choose Your Best Plan and submit payment

    • Complete the New Client Intake Form for US Taxpayers

    • Complete the Non-Residential Form for Foreign Taxpayers

    • Submit the form to the Tax Expert

    • A Tax Expert will contact you via phone or email with additional information

    Last or Family Name:   

    First:   

    Middle Initial:   

    ITIN or Social Security #:   

    Visa #:   

    Passport #:   

    Date of Birth:   

    Telephone #:   

    e-mail Address:   

    Were you a U.S. citizen or resident alien the entire year?YesNo

    Were you ever a U.S. citizen?YesNo

    U.S. Local Street Address:

    City:   

    State:   

    Zip Code:   

    Foreign Residence Address:   

    Address Line 2:   

    Foreign Country:   

    Province/Country:   

    Postal Code:   

    Country of Citizenship:   

    Country that issued Passport:   

    Are you married? YesNo

    If “YES”, is your spouse in the U.S.? YesNo

    If "YES", is it recognized by the State where you will be filing? YesNo

    Are you a:

    U.S. National
    YesNo

    Resident of Canada
    YesNo

    Resident of Mexico
    YesNo

    Resident of South Korea
    YesNo

    Resident of India
    YesNo

    Dependent Information:

    First Name:

    Last or Family Name

    Date of Birth
    (mm/dd/yyyy)

    ITIN or SSN

    Relationship to you (son, daughter, none, etc.)

    Number of months lived with you in the U.S.

    U.S. citizen, U.S. residentalien, U.S. national, or a resident of Canada, Mexico, or South Korea

    Did person file joint return?

    Did child provide more than 50% of their own support?

    Did you provide more than 50% of their support?

    Did the person have Gross Income of $4,000 or more?

    What is the date you FIRST entered the United States?     

    Entry Immigration Status - Check one:

    U.S. Immigrant/Permanent Resident

    F-1 Student

    F-2 Spouse or child of Student

    H-1 Temporary Employee

    *J-1 Exchange Visitor

    J-2 Spouse or child of Exchange Visitor

    Current Immigration Status - Check one:

    U.S. Immigrant/Permanent Resident

    F-1 Student

    F-2 Spouse or child of Student

    H-1 Temporary Employee

    *J-1 Exchange Visitor

    J-2 Spouse or child of Exchange Visitor

    Have you ever changed your visa type or U.S. immigration status?   YesNo
    If “Yes”, indicate the date and nature of the change.  

    Enter the type of U.S. visa you held during these years:

    * If Immigration status is J-1, what is the subtype? Check one:

    01 Student

    05 Professor

    12 Research Scholar

    02 Short Term Scholar

    What is the actual primary activity of the visit? Check one:

    01 Studying in a Degree Program

    04 Lecturing

    07 Conducting Research

    10 Clinical Activities

    02 Studying in a Non-Degree Program

    05 Observing

    08 Training

    11 Temporary Employment

    03 Teaching

    06 Consulting

    09 Demonstrating Special Skills

    12 Here with Spouse

    Check the years you were present in the United States as a teacher, trainee, or student for any part of the year.

    2014

    2015

    2016

    2017

    2018

    2019

    2020

    2021

    Were you present in the U.S. on a teacher, trainee or student visa for any part of more than any 5 calendar years?      YesNo

    How many days (including vacations, nonworkdays and partial days) were you present in the U.S. during:

    List the dates you entered and left the United States during 2020:

    Did you file a U.S. income tax return for any year before 2020?     YesNo
    If “Yes”, give latest year MM/DD/YYYY
    Form number filed

    During 2020, did you apply to be a green card holder (lawful permanent resident) of the United States?     YesNo

    Do you have an application pending to change your status to lawful permanent resident?      YesNo

    1. Are you claiming the benefits of a U.S. income tax treaty with a foreign country?      YesNo
    If “Yes”, enter the appropriate information in the columns below:

    (a) Country

    (b) Tax Treaty Article

    (c) Number of months
    claimed in prior tax years

    (d) Amount of exempt
    income in current tax year

    2. Were you subject to tax in a foreign country on any of the income shown in 1(d) above?      YesNo

    Information about academic institution you attended in 2020:

    Name of the director of your academic or specialized program:

    Scholarships or Fellowship Grants

    YesNo

    Wages, Salaries or Tips

    YesNo

    Interest or Dividend Income

    YesNo

    Distributions from IRA, Pension or Annuity

    YesNo

    Business Income

    YesNo

    Unemployment Compensation

    YesNo

    Capital gains or losses

    YesNo

    Any Other Income
    (gambling, lottery, prizes, awards, rents, royalties, etc.)

    YesNo

    Casualty or Theft Losses

    YesNo

    Student Loan Interest Paid

    YesNo

    State or Local Income Taxes

    YesNo

    U.S. Charitable Contributions

    YesNo

    Moving Expenses

    YesNo

    Business Expenses

    YesNo

    Child/Dependent Care Expenses

    YesNo

    IRA Contributions

    YesNo

    I would like for my refund and/or payment owed to be refunded / deducted for the following bank account:

    Name of Bank:

    Checking Account #

    Saving Account #

    Routing #

    Signature of Taxpayer:

    This site uses cookies and other technologies, so we can remember you and understand how you and the other visitors use the site. By clicking “Accept All Cookies”, you consent to the storing on your device all the technologies. Continuing to browse, cookies will be setup. Please understand how we maintain the site, and how we may collect and use visitor data.

    IRS Circular 230 Disclosure

    To ensure compliance with requirements imposed by the IRS, we inform you that any U.S. tax advice contained in this communication (including any attachments) is not intended or written to be used, and cannot be used, for the purpose of (i) avoiding penalties under the Internal Revenue Code or (ii) promoting, marketing or recommending to another party any transaction or matter addressed herein.

    This message is intended only for the designated recipient(s). It may contain confidential or proprietary information and may be subject to the attorney-client privilege or other confidentiality protections. If you are not a designated recipient, you may not review, copy or distribute this message. If you receive this in error, please notify the sender by reply e-mail and delete this message. Thank you.

    Please upload all tax documents:

    Please prove you are human by selecting the star.

      Instructions:
      • Please choose Your Best Plan and submit payment

      • Complete the New Client Intake Form for US Taxpayers

      • Complete the Non-Residential Form for Foreign Taxpayers

      • Submit the form to the Tax Expert

      • A Tax Expert will contact you via phone or email with additional information

      Last or Family Name:   

      First:   

      Middle Initial:   

      ITIN or Social Security #:   

      Visa #:   

      Passport #:   

      Date of Birth:   

      Telephone #:   

      e-mail Address:   

      Were you a U.S. citizen or resident alien the entire year?YesNo

      Were you ever a U.S. citizen?YesNo

      U.S. Local Street Address:

      City:   

      State:   

      Zip Code:   

      Foreign Residence Address:   

      Address Line 2:   

      Foreign Country:   

      Province/Country:   

      Postal Code:   

      Country of Citizenship:   

      Country that issued Passport:   

      Are you married? YesNo

      If “YES”, is your spouse in the U.S.? YesNo

      If "YES", is it recognized by the State where you will be filing? YesNo

      Are you a:

      U.S. National
      YesNo

      Resident of Canada
      YesNo

      Resident of Mexico
      YesNo

      Resident of South Korea
      YesNo

      Resident of India
      YesNo

      Dependent Information:

      First Name:

      Last or Family Name

      Date of Birth
      (mm/dd/yyyy)

      ITIN or SSN

      Relationship to you (son, daughter, none, etc.)

      Number of months lived with you in the U.S.

      U.S. citizen, U.S. residentalien, U.S. national, or a resident of Canada, Mexico, or South Korea

      Did person file joint return?

      Did child provide more than 50% of their own support?

      Did you provide more than 50% of their support?

      Did the person have Gross Income of $4,000 or more?

      What is the date you FIRST entered the United States?     

      Entry Immigration Status - Check one:

      U.S. Immigrant/Permanent Resident

      F-1 Student

      F-2 Spouse or child of Student

      H-1 Temporary Employee

      *J-1 Exchange Visitor

      J-2 Spouse or child of Exchange Visitor

      Current Immigration Status - Check one:

      U.S. Immigrant/Permanent Resident

      F-1 Student

      F-2 Spouse or child of Student

      H-1 Temporary Employee

      *J-1 Exchange Visitor

      J-2 Spouse or child of Exchange Visitor

      Have you ever changed your visa type or U.S. immigration status?   YesNo
      If “Yes”, indicate the date and nature of the change.  

      Enter the type of U.S. visa you held during these years:

      * If Immigration status is J-1, what is the subtype? Check one:

      01 Student

      05 Professor

      12 Research Scholar

      02 Short Term Scholar

      What is the actual primary activity of the visit? Check one:

      01 Studying in a Degree Program

      04 Lecturing

      07 Conducting Research

      10 Clinical Activities

      02 Studying in a Non-Degree Program

      05 Observing

      08 Training

      11 Temporary Employment

      03 Teaching

      06 Consulting

      09 Demonstrating Special Skills

      12 Here with Spouse

      Check the years you were present in the United States as a teacher, trainee, or student for any part of the year.

      2014

      2015

      2016

      2017

      2018

      2019

      2020

      2021

      Were you present in the U.S. on a teacher, trainee or student visa for any part of more than any 5 calendar years?      YesNo

      How many days (including vacations, nonworkdays and partial days) were you present in the U.S. during:

      List the dates you entered and left the United States during 2021:

      Did you file a U.S. income tax return for any year before 2021?     YesNo
      If “Yes”, give latest year MM/DD/YYYY
      Form number filed

      During 2021, did you apply to be a green card holder (lawful permanent resident) of the United States?     YesNo

      Do you have an application pending to change your status to lawful permanent resident?      YesNo

      1. Are you claiming the benefits of a U.S. income tax treaty with a foreign country?      YesNo
      If “Yes”, enter the appropriate information in the columns below:

      (a) Country

      (b) Tax Treaty Article

      (c) Number of months
      claimed in prior tax years

      (d) Amount of exempt
      income in current tax year

      2. Were you subject to tax in a foreign country on any of the income shown in 1(d) above?      YesNo

      Information about academic institution you attended in 2021:

      Name of the director of your academic or specialized program:

      Scholarships or Fellowship Grants

      YesNo

      Wages, Salaries or Tips

      YesNo

      Interest or Dividend Income

      YesNo

      Distributions from IRA, Pension or Annuity

      YesNo

      Business Income

      YesNo

      Unemployment Compensation

      YesNo

      Capital gains or losses

      YesNo

      Any Other Income
      (gambling, lottery, prizes, awards, rents, royalties, etc.)

      YesNo

      Casualty or Theft Losses

      YesNo

      Student Loan Interest Paid

      YesNo

      State or Local Income Taxes

      YesNo

      U.S. Charitable Contributions

      YesNo

      Moving Expenses

      YesNo

      Business Expenses

      YesNo

      Child/Dependent Care Expenses

      YesNo

      IRA Contributions

      YesNo

      I would like for my refund and/or payment owed to be refunded / deducted for the following bank account:

      Name of Bank:

      Checking Account #

      Saving Account #

      Routing #

      Signature of Taxpayer:

      This site uses cookies and other technologies, so we can remember you and understand how you and the other visitors use the site. By clicking “Accept All Cookies”, you consent to the storing on your device all the technologies. Continuing to browse, cookies will be setup. Please understand how we maintain the site, and how we may collect and use visitor data.

      IRS Circular 230 Disclosure

      To ensure compliance with requirements imposed by the IRS, we inform you that any U.S. tax advice contained in this communication (including any attachments) is not intended or written to be used, and cannot be used, for the purpose of (i) avoiding penalties under the Internal Revenue Code or (ii) promoting, marketing or recommending to another party any transaction or matter addressed herein.

      This message is intended only for the designated recipient(s). It may contain confidential or proprietary information and may be subject to the attorney-client privilege or other confidentiality protections. If you are not a designated recipient, you may not review, copy or distribute this message. If you receive this in error, please notify the sender by reply e-mail and delete this message. Thank you.

      Please upload all tax documents:

      Please prove you are human by selecting the flag.

        Instructions:
        • Please choose Your Best Plan and submit payment

        • Complete the New Client Intake Form for US Taxpayers

        • Complete the Non-Residential Form for Foreign Taxpayers

        • Submit the form to the Tax Expert

        • A Tax Expert will contact you via phone or email with additional information

        Last or Family Name:   

        First:   

        Middle Initial:   

        ITIN or Social Security #:   

        Visa #:   

        Passport #:   

        Date of Birth:   

        Telephone #:   

        e-mail Address:   

        Were you a U.S. citizen or resident alien the entire year?YesNo

        Were you ever a U.S. citizen?YesNo

        U.S. Local Street Address:

        City:   

        State:   

        Zip Code:   

        Foreign Residence Address:   

        Address Line 2:   

        Foreign Country:   

        Province/Country:   

        Postal Code:   

        Country of Citizenship:   

        Country that issued Passport:   

        Are you married? YesNo

        If “YES”, is your spouse in the U.S.? YesNo

        If "YES", is it recognized by the State where you will be filing? YesNo

        Are you a:

        U.S. National
        YesNo

        Resident of Canada
        YesNo

        Resident of Mexico
        YesNo

        Resident of South Korea
        YesNo

        Resident of India
        YesNo

        Dependent Information:

        First Name:

        Last or Family Name

        Date of Birth
        (mm/dd/yyyy)

        ITIN or SSN

        Relationship to you (son, daughter, none, etc.)

        Number of months lived with you in the U.S.

        U.S. citizen, U.S. residentalien, U.S. national, or a resident of Canada, Mexico, or South Korea

        Did person file joint return?

        Did child provide more than 50% of their own support?

        Did you provide more than 50% of their support?

        Did the person have Gross Income of $4,000 or more?

        What is the date you FIRST entered the United States?     

        Entry Immigration Status - Check one:

        U.S. Immigrant/Permanent Resident

        F-1 Student

        F-2 Spouse or child of Student

        H-1 Temporary Employee

        *J-1 Exchange Visitor

        J-2 Spouse or child of Exchange Visitor

        Current Immigration Status - Check one:

        U.S. Immigrant/Permanent Resident

        F-1 Student

        F-2 Spouse or child of Student

        H-1 Temporary Employee

        *J-1 Exchange Visitor

        J-2 Spouse or child of Exchange Visitor

        Have you ever changed your visa type or U.S. immigration status?   YesNo
        If “Yes”, indicate the date and nature of the change.  

        Enter the type of U.S. visa you held during these years:

        * If Immigration status is J-1, what is the subtype? Check one:

        01 Student

        05 Professor

        12 Research Scholar

        02 Short Term Scholar

        What is the actual primary activity of the visit? Check one:

        01 Studying in a Degree Program

        04 Lecturing

        07 Conducting Research

        10 Clinical Activities

        02 Studying in a Non-Degree Program

        05 Observing

        08 Training

        11 Temporary Employment

        03 Teaching

        06 Consulting

        09 Demonstrating Special Skills

        12 Here with Spouse

        Check the years you were present in the United States as a teacher, trainee, or student for any part of the year.

        2014

        2015

        2016

        2017

        2022

        2019

        2020

        2021

        2022

        Were you present in the U.S. on a teacher, trainee or student visa for any part of more than any 5 calendar years?      YesNo

        How many days (including vacations, nonworkdays and partial days) were you present in the U.S. during:

        List the dates you entered and left the United States during 2022:

        Did you file a U.S. income tax return for any year before 2022?     YesNo
        If “Yes”, give latest year MM/DD/YYYY
        Form number filed

        During 2022, did you apply to be a green card holder (lawful permanent resident) of the United States?     YesNo

        Do you have an application pending to change your status to lawful permanent resident?      YesNo

        1. Are you claiming the benefits of a U.S. income tax treaty with a foreign country?      YesNo
        If “Yes”, enter the appropriate information in the columns below:

        (a) Country

        (b) Tax Treaty Article

        (c) Number of months
        claimed in prior tax years

        (d) Amount of exempt
        income in current tax year

        2. Were you subject to tax in a foreign country on any of the income shown in 1(d) above?      YesNo

        Information about academic institution you attended in 2022:

        Name of the director of your academic or specialized program:

        Scholarships or Fellowship Grants

        YesNo

        Wages, Salaries or Tips

        YesNo

        Interest or Dividend Income

        YesNo

        Distributions from IRA, Pension or Annuity

        YesNo

        Business Income

        YesNo

        Unemployment Compensation

        YesNo

        Capital gains or losses

        YesNo

        Any Other Income
        (gambling, lottery, prizes, awards, rents, royalties, etc.)

        YesNo

        Casualty or Theft Losses

        YesNo

        Student Loan Interest Paid

        YesNo

        State or Local Income Taxes

        YesNo

        U.S. Charitable Contributions

        YesNo

        Moving Expenses

        YesNo

        Business Expenses

        YesNo

        Child/Dependent Care Expenses

        YesNo

        IRA Contributions

        YesNo

        I would like for my refund and/or payment owed to be refunded / deducted for the following bank account:

        Name of Bank:

        Checking Account #

        Saving Account #

        Routing #

        Signature of Taxpayer:

        This site uses cookies and other technologies, so we can remember you and understand how you and the other visitors use the site. By clicking “Accept All Cookies”, you consent to the storing on your device all the technologies. Continuing to browse, cookies will be setup. Please understand how we maintain the site, and how we may collect and use visitor data.

        IRS Circular 230 Disclosure

        To ensure compliance with requirements imposed by the IRS, we inform you that any U.S. tax advice contained in this communication (including any attachments) is not intended or written to be used, and cannot be used, for the purpose of (i) avoiding penalties under the Internal Revenue Code or (ii) promoting, marketing or recommending to another party any transaction or matter addressed herein.

        This message is intended only for the designated recipient(s). It may contain confidential or proprietary information and may be subject to the attorney-client privilege or other confidentiality protections. If you are not a designated recipient, you may not review, copy or distribute this message. If you receive this in error, please notify the sender by reply e-mail and delete this message. Thank you.

        Please upload all tax documents:

        Please prove you are human by selecting the heart.

          Instructions:
          • Please choose Your Best Plan and submit payment

          • Complete the New Client Intake Form for US Taxpayers

          • Complete the Non-Residential Form for Foreign Taxpayers

          • Submit the form to the Tax Expert

          • A Tax Expert will contact you via phone or email with additional information

          Last or Family Name:   

          First:   

          Middle Initial:   

          ITIN or Social Security #:   

          Visa #:   

          Passport #:   

          Date of Birth:   

          Telephone #:   

          e-mail Address:   

          Were you a U.S. citizen or resident alien the entire year?YesNo

          Were you ever a U.S. citizen?YesNo

          U.S. Local Street Address:

          City:   

          State:   

          Zip Code:   

          Foreign Residence Address:   

          Address Line 2:   

          Foreign Country:   

          Province/Country:   

          Postal Code:   

          Country of Citizenship:   

          Country that issued Passport:   

          Are you married? YesNo

          If “YES”, is your spouse in the U.S.? YesNo

          If "YES", is it recognized by the State where you will be filing? YesNo

          Are you a:

          U.S. National
          YesNo

          Resident of Canada
          YesNo

          Resident of Mexico
          YesNo

          Resident of South Korea
          YesNo

          Resident of India
          YesNo

          Dependent Information:

          First Name:

          Last or Family Name

          Date of Birth
          (mm/dd/yyyy)

          ITIN or SSN

          Relationship to you (son, daughter, none, etc.)

          Number of months lived with you in the U.S.

          U.S. citizen, U.S. residentalien, U.S. national, or a resident of Canada, Mexico, or South Korea

          Did person file joint return?

          Did child provide more than 50% of their own support?

          Did you provide more than 50% of their support?

          Did the person have Gross Income of $4,000 or more?

          What is the date you FIRST entered the United States?     

          Entry Immigration Status - Check one:

          U.S. Immigrant/Permanent Resident

          F-1 Student

          F-2 Spouse or child of Student

          H-1 Temporary Employee

          *J-1 Exchange Visitor

          J-2 Spouse or child of Exchange Visitor

          Current Immigration Status - Check one:

          U.S. Immigrant/Permanent Resident

          F-1 Student

          F-2 Spouse or child of Student

          H-1 Temporary Employee

          *J-1 Exchange Visitor

          J-2 Spouse or child of Exchange Visitor

          Have you ever changed your visa type or U.S. immigration status?   YesNo
          If “Yes”, indicate the date and nature of the change.  

          Enter the type of U.S. visa you held during these years:

          * If Immigration status is J-1, what is the subtype? Check one:

          01 Student

          05 Professor

          12 Research Scholar

          02 Short Term Scholar

          What is the actual primary activity of the visit? Check one:

          01 Studying in a Degree Program

          04 Lecturing

          07 Conducting Research

          10 Clinical Activities

          02 Studying in a Non-Degree Program

          05 Observing

          08 Training

          11 Temporary Employment

          03 Teaching

          06 Consulting

          09 Demonstrating Special Skills

          12 Here with Spouse

          Check the years you were present in the United States as a teacher, trainee, or student for any part of the year.

          2014

          2015

          2016

          2017

          2028

          2019

          2020

          2021

          2022

          2023

          Were you present in the U.S. on a teacher, trainee or student visa for any part of more than any 5 calendar years?      YesNo

          How many days (including vacations, nonworkdays and partial days) were you present in the U.S. during:

          List the dates you entered and left the United States during 2023:

          Did you file a U.S. income tax return for any year before 2022?     YesNo
          If “Yes”, give latest year MM/DD/YYYY
          Form number filed

          During 2023, did you apply to be a green card holder (lawful permanent resident) of the United States?     YesNo

          Do you have an application pending to change your status to lawful permanent resident?      YesNo

          1. Are you claiming the benefits of a U.S. income tax treaty with a foreign country?      YesNo
          If “Yes”, enter the appropriate information in the columns below:

          (a) Country

          (b) Tax Treaty Article

          (c) Number of months
          claimed in prior tax years

          (d) Amount of exempt
          income in current tax year

          2. Were you subject to tax in a foreign country on any of the income shown in 1(d) above?      YesNo

          Information about academic institution you attended in 2023:

          Name of the director of your academic or specialized program:

          Scholarships or Fellowship Grants

          YesNo

          Wages, Salaries or Tips

          YesNo

          Interest or Dividend Income

          YesNo

          Distributions from IRA, Pension or Annuity

          YesNo

          Business Income

          YesNo

          Unemployment Compensation

          YesNo

          Capital gains or losses

          YesNo

          Any Other Income
          (gambling, lottery, prizes, awards, rents, royalties, etc.)

          YesNo

          Casualty or Theft Losses

          YesNo

          Student Loan Interest Paid

          YesNo

          State or Local Income Taxes

          YesNo

          U.S. Charitable Contributions

          YesNo

          Moving Expenses

          YesNo

          Business Expenses

          YesNo

          Child/Dependent Care Expenses

          YesNo

          IRA Contributions

          YesNo

          I would like for my refund and/or payment owed to be refunded / deducted for the following bank account:

          Name of Bank:

          Checking Account #

          Saving Account #

          Routing #

          Signature of Taxpayer:

          This site uses cookies and other technologies, so we can remember you and understand how you and the other visitors use the site. By clicking “Accept All Cookies”, you consent to the storing on your device all the technologies. Continuing to browse, cookies will be setup. Please understand how we maintain the site, and how we may collect and use visitor data.

          IRS Circular 230 Disclosure

          To ensure compliance with requirements imposed by the IRS, we inform you that any U.S. tax advice contained in this communication (including any attachments) is not intended or written to be used, and cannot be used, for the purpose of (i) avoiding penalties under the Internal Revenue Code or (ii) promoting, marketing or recommending to another party any transaction or matter addressed herein.

          This message is intended only for the designated recipient(s). It may contain confidential or proprietary information and may be subject to the attorney-client privilege or other confidentiality protections. If you are not a designated recipient, you may not review, copy or distribute this message. If you receive this in error, please notify the sender by reply e-mail and delete this message. Thank you.

          Please upload all tax documents:

          Please prove you are human by selecting the plane.

            Instructions:
            • Please choose Your Best Plan and submit payment

            • Complete the New Client Intake Form for US Taxpayers

            • Complete the Non-Residential Form for Foreign Taxpayers

            • Submit the form to the Tax Expert

            • A Tax Expert will contact you via phone or email with additional information

            Last or Family Name:   

            First:   

            Middle Initial:   

            ITIN or Social Security #:   

            Visa #:   

            Passport #:   

            Date of Birth:   

            Telephone #:   

            e-mail Address:   

            Were you a U.S. citizen or resident alien the entire year?YesNo

            Were you ever a U.S. citizen?YesNo

            U.S. Local Street Address:

            City:   

            State:   

            Zip Code:   

            Foreign Residence Address:   

            Address Line 2:   

            Foreign Country:   

            Province/Country:   

            Postal Code:   

            Country of Citizenship:   

            Country that issued Passport:   

            Are you married? YesNo

            If “YES”, is your spouse in the U.S.? YesNo

            If "YES", is it recognized by the State where you will be filing? YesNo

            Are you a:

            U.S. National
            YesNo

            Resident of Canada
            YesNo

            Resident of Mexico
            YesNo

            Resident of South Korea
            YesNo

            Resident of India
            YesNo

            Dependent Information:

            First Name:

            Last or Family Name

            Date of Birth
            (mm/dd/yyyy)

            ITIN or SSN

            Relationship to you (son, daughter, none, etc.)

            Number of months lived with you in the U.S.

            U.S. citizen, U.S. residentalien, U.S. national, or a resident of Canada, Mexico, or South Korea

            Did person file joint return?

            Did child provide more than 50% of their own support?

            Did you provide more than 50% of their support?

            Did the person have Gross Income of $4,000 or more?

            What is the date you FIRST entered the United States?     

            Entry Immigration Status - Check one:

            U.S. Immigrant/Permanent Resident

            F-1 Student

            F-2 Spouse or child of Student

            H-1 Temporary Employee

            *J-1 Exchange Visitor

            J-2 Spouse or child of Exchange Visitor

            Current Immigration Status - Check one:

            U.S. Immigrant/Permanent Resident

            F-1 Student

            F-2 Spouse or child of Student

            H-1 Temporary Employee

            *J-1 Exchange Visitor

            J-2 Spouse or child of Exchange Visitor

            Have you ever changed your visa type or U.S. immigration status?   YesNo
            If “Yes”, indicate the date and nature of the change.  

            Enter the type of U.S. visa you held during these years:

            * If Immigration status is J-1, what is the subtype? Check one:

            01 Student

            05 Professor

            12 Research Scholar

            02 Short Term Scholar

            What is the actual primary activity of the visit? Check one:

            01 Studying in a Degree Program

            04 Lecturing

            07 Conducting Research

            10 Clinical Activities

            02 Studying in a Non-Degree Program

            05 Observing

            08 Training

            11 Temporary Employment

            03 Teaching

            06 Consulting

            09 Demonstrating Special Skills

            12 Here with Spouse

            Check the years you were present in the United States as a teacher, trainee, or student for any part of the year.

            2014

            2015

            2016

            2017

            2028

            2019

            2020

            2021

            2022

            2023

            2024

            Were you present in the U.S. on a teacher, trainee or student visa for any part of more than any 5 calendar years?      YesNo

            How many days (including vacations, nonworkdays and partial days) were you present in the U.S. during:

            List the dates you entered and left the United States during 2023:

            Did you file a U.S. income tax return for any year before 2022?     YesNo
            If “Yes”, give latest year MM/DD/YYYY
            Form number filed

            During 2024, did you apply to be a green card holder (lawful permanent resident) of the United States?     YesNo

            Do you have an application pending to change your status to lawful permanent resident?      YesNo

            1. Are you claiming the benefits of a U.S. income tax treaty with a foreign country?      YesNo
            If “Yes”, enter the appropriate information in the columns below:

            (a) Country

            (b) Tax Treaty Article

            (c) Number of months
            claimed in prior tax years

            (d) Amount of exempt
            income in current tax year

            2. Were you subject to tax in a foreign country on any of the income shown in 1(d) above?      YesNo

            Information about academic institution you attended in 2024:

            Name of the director of your academic or specialized program:

            Scholarships or Fellowship Grants

            YesNo

            Wages, Salaries or Tips

            YesNo

            Interest or Dividend Income

            YesNo

            Distributions from IRA, Pension or Annuity

            YesNo

            Business Income

            YesNo

            Unemployment Compensation

            YesNo

            Capital gains or losses

            YesNo

            Any Other Income
            (gambling, lottery, prizes, awards, rents, royalties, etc.)

            YesNo

            Casualty or Theft Losses

            YesNo

            Student Loan Interest Paid

            YesNo

            State or Local Income Taxes

            YesNo

            U.S. Charitable Contributions

            YesNo

            Moving Expenses

            YesNo

            Business Expenses

            YesNo

            Child/Dependent Care Expenses

            YesNo

            IRA Contributions

            YesNo

            I would like for my refund and/or payment owed to be refunded / deducted for the following bank account:

            Name of Bank:

            Checking Account #

            Saving Account #

            Routing #

            Signature of Taxpayer:

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