Form 13614-NR — Nonresident Alien Intake and Interview Sheet

Official source: IRS Forms, Instructions & Publications (https://www.irs.gov/pub/irs-pdf/f13614nr.pdf), retrieved 2026-10-03. U.S. Government work (17 U.S.C. § 105).

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(October 2026)

Department of the Treasury - Internal Revenue Service

OMB Number

1545-1964

Last or family name First Middle initial

Visa # Passport #

Date of birth: / / Telephone # E-mail address (mm/dd/yyyy)

Were you a U.S. citizen or resident alien the entire year? Yes No Were you ever a U.S. citizen? Yes No

U.S. local street address

City State Zip code

Foreign residence address

Address line 2

Foreign country Province/County Postal code

Country of citizenship Country that issued passport

Are you married? Yes No If “YES”, is your spouse in the U.S.? Yes No

If "YES", is it recognized by the state where you will be filing? Yes No

Are you a U.S. National

Yes No

Resident of Canada

Yes No

Resident of Mexico

Yes No

Resident of South Korea

Yes No

Resident of India

Yes No

Dependent Information (Only if "Yes" is checked in one of the categories above)

Did person file joint return?

Did person

provide more than 50% of their own support?

Did person

Did you provide more than 50% of their support?

U.S. citizen, U.S. resident alien,

U.S. national, or a resident of Canada, Mexico, or

South Korea

Did the person have Gross

more?

Number of months lived

with you in

the U.S. in 2026

Income of

$5,300 or

Date of birth (mm/dd/yyyy)

Relationship

to you (son,

daughter, none, etc.)

First name

Last or family name

What is the date you FIRST entered the United States on a non-visitor Visa? / /

Entry Immigration Status - Check one

U.S. Immigrant/Permanent resident F-1 Student F-2 Spouse or child of student

H-1 Temporary employee *J-1 Exchange visitor J-2 Spouse or child of exchange visitor

Other (list)

Current Immigration Status - Check one

U.S. Immigrant/Permanent resident F-1 Student F-2 Spouse or child of student

H-1 Temporary employee *J-1 Exchange visitor J-2 Spouse or child of exchange visitor

Other (list)

Have you ever changed your visa type or U.S. immigration status? Yes No

If “Yes”, indicate the date and nature of the change. / /

Enter the type of U.S. visa you held during these years

2020 2021 2022 2023 2024 2025

• If Immigration status is J-1, what is the subtype? Check one

01 Student

02 Short term scholar

05 Professor 12 Research scholar

Other (list)

What is the actual primary activity of the visit? Check one

01 Studying in a degree program

02 Studying in a non-degree program

03 Teaching

04 Lecturing

05 Observing

06 Consulting

07 Conducting research

08 Training

09 Demonstrating special skills

10 Clinical activities

11 Temporary employment

12 Here with spouse

Catalog Number 39748B www.irs.gov Form 13614-NR (Rev. 10-2026)

Check the years you were present in the United States as a teacher, trainee, student or as an accompanying spouse or dependent of a person in such status for any part of the year. 2020 2021 2022 2023 2024 2025

Have you ever been present in the U.S. PRIOR to 2020 on a teacher, trainee, student visa, or as their accompanying spouse or dependent? Yes No If so, what years and visa type

How many days (including vacations, nonworkdays and partial days) were you present in the U.S. during

2024 2025 2026

List the dates you entered and left the United States during 2026

If “Yes”, enter the appropriate information in the columns below

(a) Country (b) Tax treaty article (c) Number of months claimed in prior tax years

(d) Amount of exempt income in current tax year

2. Were you subject to tax in a foreign country on any of the income shown in 1(d) above? Yes No

Information about academic institution you attended in 2026

Name Telephone number

Address

Name of your academic/specialized program director

Address

Telephone number

If you are due a refund, would you like Direct Deposit Yes No

If you have a balance due, would you like to make a payment directly from your bank account Yes No