RCUH Policies and Procedures
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of the University of Hawai‘i
Human Resources Department
TAX TREATY STATEMENT FOR TEACHERS AND RESEARCHES 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 purpose of teaching or carrying on research at_________________________ [insert the name of the educational or research institution], which is a recognized educational or research institution. I will receive compensation for my teaching or research activities.
3. The teaching or research compensation received during the entire tax year (or during the period from _________ to ________) qualifies for exemption from withholding of federal tax under the tax treaty between the United States and _______________________ [insert the name of the country under whose treaty you claim exemption]. I have not previously claimed an income tax exemption under this treaty for income received as a teacher, researcher, or student before the date of my arrival in the United States.
4. Any research I perform will be undertaken in the general interest and not primarily for the private benefit of a specific person or persons.
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. In no event have I claimed an exemption under this treaty for income received as a teacher or researcher for more than five years.
______________________________________ _____________________ Name (please print) Date
__________________________________________ Signature