Research Corporation of the University of Hawaiʻi

Research Corporation
of the University of Hawai‘i
Human Resources Department
TAX TREATY STATEMENTS FOR STUDENTS Slovenia and Venezuela
1. I was a resident of ___________________________ [insert the name of the country under whose treaty you claim exemption] 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 primary purpose of studying or training at ______________________________________________________ [insert the name of the university or other accredited educational institution at which you study or train].
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 _________________________ [insert the name of the country under whose treaty you claim exemption] in an amount not in excess of $5,000 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 taxable year that includes my arrival date, and for such period of time as is necessary to complete, as a full-time student, educational requirements as a candidate for a postgraduate or professional degree from a recognized educational institution.
______________________________________ _____________________ Name (please print) Date
____________________________________________ Signature