Research Corporation of the University of Hawaiʻi

Research Corporation
of the University of Hawai‘i
Human Resources Department
TAX TREATY STATEMENT FOR TEACHERS AND RESEARCHES Netherlands
1. I am a resident of the Netherlands. I am not a U.S. citizen. I have not been lawfully accorded the privilege of residing permanently in the United States as an immigrant.
2. I am visiting the United States for the purpose of teaching or engaging in research at _______________________ [insert the name of the educational institution at which you teach or perform research] for a period not exceeding two years. I will receive compensation for my teaching or research activities.
3. The compensation received during the entire tax year (or during the period from ________ to ________ ) for these activities qualifies for exemption from withholding of federal tax under the tax treaty between the United States and Netherlands. I have not previously claimed an income tax exemption under that treaty for income received as a teacher, researcher, or student before the date of my arrival in the United States.
4. Any research I perform will be undertaken in the public interest and not primarily for the benefit of a specific person or persons.
5. I arrived in the United States on ___________ [insert the date of your last arrival into the United States before beginning the teaching or research services for which exemption is claimed]. The treaty exemption is available for compensation received during a period of two years beginning on that date only if my visit does not exceed 2 years.
______________________________________ _____________________ Name (please print) Date
__________________________________________ Signature