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 Commonwealth of Independent States
1. I am a resident of ____________ [insert the name of country]. I am not a U.S. citizen.
2. IhaveacceptedaninvitationbyagovernmentalagencyorinstitutionintheUnitedStates, or by an educational or scientific research institution in the United States, to come to the United States for the primary purpose of teaching, engaging in research, or participating in scientific, technical, or professional conferences at ______________________ [insert the name of governmental agency or institution, educational or scientific institution, or organization sponsoring professional conference], which is a governmental agency or institution, an educational or scientific institution, or an organization sponsoring a professional conference. I will receive compensation for my teaching, research, or conference activities.
3. The teaching, research or conference compensation received the entire tax year (or for the period from _________ to ________) qualifies for exemption from withholding of federal tax under the tax treaty between the United States and the former Union of Soviet Socialist Republics. I have not previously claimed an income tax exemption under that treaty for income received as a teacher, researcher, conference participant, or student before the date of my arrival in the United States.
4. Any research I perform will not be undertaken primarily for the benefit of a private person or commercial enterprise of the United States or a foreign trade organization of ________________ [insert the name of country], unless the research is conducted on the basis of intergovernmental agreements on cooperations.
5. I arrived in the United States on _____________ [insert the date of your last arrival in the United States before beginning the teaching or research services for which exemption is claimed], The treaty exemption is available only for compensation received during a period of two years beginning on that date.
______________________________________ _____________________ Name (please print) Date
____________________________________________ Signature