TAX TREATY STATEMENT - TEACHER
Greece
Article Xll
1. I am a resident of Greece. I am not a United States citizen. I have not been lawfully
accorded the privilege of residing permanently in the United States as an immigrant.
2. I am a professor or teacher visiting the United States for the purpose of teaching at the
University of California,_________________, which is an educational institution. I will
receive compensation for my teaching activities.
3. The teaching compensation received during the entire taxable year (or during the period
from _____________________to___________________) qualifies for exemption from
withholding of federal tax under the tax treaty between the United States and Greece. I
have not previously claimed an income tax exemption under this treaty for income
received as a teacher or student before the date of my arrival in the United States.
4. I arrived in the United States on ___________________(the date of your last arrival in the
United States before beginning the teaching services). The treaty exemption is available
only for compensation receive during a period of three years beginning on that date.
Under penalties of perjury, I declare that this statement, to the best of my knowledge and belief, is
true, correct, and complete.
Signature of Nonresident Alien Employee:____________________________________________
Print Name:_________________________________________________Date:_______________
***YOU MUST COMPLETE NEW FORMS FOR EACH CALENDAR YEAR***
______________________________________________________________________________
WITHHOLDING AGENT CERTIFICATION
Name | Employer Identification Number
|
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Address (number and street)
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City, State, and Zip Code | Telephone Number
| ( )
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Under penalties of perjury, I certify that I have examined this form and any accompanying
statements, that I am satisfied that an exemption from withholding is warranted, and that I do not
know or have reason to know that the nonresident alien individual's compensation is not entitled to
the exemption or that the eligibility of the nonresident alien's compensation cannot be readily
determined.
Signature of Withholding Agent:________________________________Date:_______________
