RCUH Policies and Procedures
Research Corporation
of the University of Hawai‘i
Human Resources Department
TAX TREATY STATEMENTS FOR STUDENTS Tunisia
1. I was a resident of Tunisia on the date of my arrival in the United States. 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 temporarily present in the United States for the purpose of full-time study, training, or research at _________________________________ [insert the name of the university or other accredited educational institution at which you study, train, or perform research].
3. I will receive compensation for services performed in the United States. This compensation qualifies for exemption from withholding of federal income tax under the tax treaty between the United States and Tunisia in an amount not in excess of $4,000 for any tax year.
4. I arrived in the United States on ______________________________ [insert the date of your last arrival in the United States before beginning study at the U.S. educational institution]. The treaty exemption is available only for compensation paid during a period of five tax years beginning with the tax year that includes my arrival date.
______________________________________ _____________________ Name (please print) Date
____________________________________________ Signature