WESLEYAN UNIVERSITY
Foreign National Information Form (FNIF)
To be completed by foreign nationals receiving ANY form of payment from Wesleyan.
(This form is not applicable to Lawful Permanent Residents)

Please answer all applicable questions.  If you are required to meet with the Foreign National Tax Compliance Coordinator, you should bring to the appointment your social security card or ITIN, passport, I-94 Departure card, I-20, DS-2019, EAD, and/or any other applicable immigration documents.

Questions?
Wesleyan sponsored employees and students should contact the Payroll office at x2670 or payroll@wesleyan.edu.
All other foreign national visitors should contact Christine Rodrigue in Finance at x3502 or crodrigue@wesleyan.edu.


1. Last or Family Name

First Name

Email Address

2. U.S. Social Security Number or ITIN

3. WesID (if applicable)

4. Date of Birth (mm/dd/yy)


5. Local U.S. Address (if applicable):
 Street Number and Name

City, State, Zip

6. Foreign Residence Address:
Street Number and Name

City

Province/Region

Postal Code

Country


7. Country of Residence, if different than foreign residence address
 
Did tax residency from your home country end? If yes, when?
 
8. Country of Citizenship

9. Country that issued Passport

10. Passport Number

11. Passport Expiration Date (mm/dd/yy)

 

12. What is the actual date that you entered the U.S. for this CURRENT activity?
 (mm/dd/yy)

13. What is the actual date that you plan to exit the U.S. in your CURRENT Immigration Status for this CURRENT activity?
(mm/dd/yy)

14. Current Immigration Status:

15. If CURRENT immigration type is J-1, what is the subtype?  

16. What is the ACTUAL Primary Purpose of this CURRENT visit? 

17. If you are a student, what is your STUDENT TYPE?

18. Who is your contact at Wesleyan?  

19. Income Providing Activity:
(e.g. Researcher, Grad Assistant, Scholarship recipient, Speaker, etc.)

20. For CONSULTANTS/SELF-EMPLOYED Individuals ONLY:
a. If receiving an honorarium, is the activity to receive the honorarium to last for more than 9 days?     Yes          No
b. Will you receive an honorarium from more than 5 U.S. organizations in a 6 month period?     Yes          No
c. Do/will you have an office (fixed base) in the USA?     Yes          No
If yes, how many days in this calendar year did/will you have the office?

 

21. List below ALL U.S. immigration activity during the CURRENT AND TWO PREVIOUS years and ALL immigration activity since 1985 in F, J, M or Q status.
EXTREMELY IMPORTANT to determine your income tax status.

Example in red.

Date of Entry Date of Exit Visa Status J-1 Subtype  Primary                      Purpose                                       Taken Treaty Benefits?               
8/15/08 8/30/08 VWB N/A conference yes
9/1/98 8/31/99 J-1 Short term scholar conduct research no

I hereby certify that all of the above information is true and correct.  I understand that if my status changes from that which I have indicated on this form that I must submit a new Foreign National Information Form.