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The University will use this information to determine the appropriate Federal tax withholding applicable to any payment(s) you receive. You must complete this form prior to receiving a payment from the University. In addition, if there is a change in your immigration status, you must complete a new form. The information requested below is confidential and will be used only to determine your correct tax withholding status. Please read the Instructions before completing this form.  \nIf you are an employee and have a Form I-20, DS2019, or Notice of Action, please attach it. If you are an independent contractor, attach a copy of your Form I-94 . If you are receiving payments from a source that did not sponsor your J visa, you must attach a copy of your approval notice from the sponsor.  \nDo not complete this form if you are a U.S CITIZEN or LAWFUL PERMANENT RESIDENT of the United States. If you are an employee, your Employment Eligibility Verification, Form I-9, must indicate that you are a U.S. citizen or lawful permanent resident.  \n\n| \u003Cbr>SECTION A. IDENTIFICATION OF PAYEE (see Instructions) |  |  |  |  |  |  |  |\n| --- | --- | --- | --- | --- | --- | --- | --- |\n| 1. Name (Last, First, Middle Initial) |  |  |  |  | 2. Employee ID. Number |  | 3. Taxpayer ID. Number\u003Cbr>􀂉SSN 􀂉ITIN 􀂉EIN |\n| 4. Department |  |  |  |  | 5. Email address |  |  |\n| 6. University Status. Check all that apply 􀂉 Faculty, Staff, or Student Employee 􀂉 Scholarship /Fellowship Recipient\u003Cbr>􀂉 Independent Contractor 􀂉 Working outside the U.S. (If you check this box, complete Section A and proceed to Section H) |  |  |  |  |  |  |  |\n| 7. Street Address In U.S. |  |  |  | 8. Permanent Residence Address |  |  |  |\n| Street Address Line 2 |  |  |  | Street Address Line 2 |  |  |  |\n| City, State, Zip Code |  | CA |  | City, Province, Country, Postal Code |  |  |  |\n| SECTION B. HEALTH INSURANCE INFORMATION |  |  |  |  |  |  |  |\n| 1. Name Of U.S. Health Insurance Carrier (See Instructions) |  |  |  |  |  |  |  |\n| SECTION C. IMMIGRATION STATUS INFORMATION |  |  |  |  |  |  |  |\n| 1. Visa Classification\u003Cbr>Do you have an F or J visa classification?\u003Cbr>􀂉 Yes. Complete C 2 and C 3 and proceed to section D. Step 1.\u003Cbr>􀂉 No. Proceed to section D. Step 1. |  |  | 2. Enter Original Date You Entered The U.S. (See Instructions) |  |  | 3. Enter Expiration Date of Current Visa (See Instructions) |  |\n| \u003Cbr>SECTION D. SUBSTANTIAL PRESENCE TEST |  |  |  |  |  |  |  |\n| The substantial presence test is used to determine whether a non-U.S. citizen should be classified for tax purposes as a resident alien or as a nonresident alien. The information below will assist you in determining your U.S. tax residency status. |  |  |  |  |  |  |  |\n| Step 1\u003Cbr>Check the statement that describes your status and follow the instructions after the statement.\u003Cbr>If neither statement fits your status, proceed to Step 2. | 􀂉 I will be in the U.S. less than 31 days in the entire calendar year for which residency is being determined. You are a nonresident alien for tax purposes. Do not complete Step 2, proceed to section G. |  |  |  |  |  |  |\n|  | 􀂉 I am a STUDENT on an F-1, J-1 , M-1, or Q-1 visa, and including the calendar year in which this form is being prepared, throughout my lifetime I have been physically present in the U.S. as an F-1, J-1, M-1, or Q-1 visa holder (whether as a student, teacher, researher, or trainee) for five or fewer calendar years. Physical presence in the U.S. in such visa status for any part of a calendar year constitutes a full calendar year of presence. List all years that you were present in the U.S. for all or any part of the calendar year in F-1, J-1, M-1, or Q-1 visa status whether as a student, teacher, researcher, or trainee status. Year","cbCaijBUK231wRRS","https://ap.wps.com/l/cbCaijBUK231wRRS","pdf",520526,7,"English","# SECTION A. IDENTIFICATION OF PAYEE\n# SECTION B. HEALTH INSURANCE INFORMATION\n# SECTION C. IMMIGRATION STATUS INFORMATION\n# SECTION D. SUBSTANTIAL PRESENCE TEST","[{\"question\":\"Who must complete the UC W-8BEN form?\",\"answer\":\"Foreign individuals receiving payments from the University of California must complete UC W-8BEN to support proper federal tax withholding. U.S. citizens and lawful permanent residents should not complete the form.\"},{\"question\":\"When is a new UC W-8BEN form required?\",\"answer\":\"A new form must be completed if the recipient’s immigration status changes.\"},{\"question\":\"What documents may need to be attached?\",\"answer\":\"Employees with a Form I-20, DS2019, or Notice of Action should attach it. Independent contractors should attach a copy of Form I-94, and certain recipients must attach an approval notice from the J visa sponsor.\"}]","UC W-8BEN - Certificate of Foreign Status for Federal Tax Withholding | PDF",1789785801]