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Part I tax return you completed for Simone Dupont

1024 Publ 5876 (PDF) · 2026-10-03 edition · updated 2026-10-04 · United States

Foreign Student Comprehensive Practice 92

Foreign Student Comprehensive Practice 93

Form 1040-NR, Total amount from Form(s) W-2, box 1 Line

Question 11: To answer this question, refer to the Form 1040-NR tax return you completed for taxpayer Simone Dupont.

What amount is entered on the Total amount from Form(s) W-2, box 1 line of Form 1040-NR?

a. $3,050

b. $5,000

c. $7,225

d. $12,225

Form 1040-NR, Income Exempt by a Treaty

Question 12: To answer this question, refer to the Form 1040-NR tax return you completed for taxpayer Simone Dupont.

What amount is entered on Total income exempt by a treaty from Schedule OI (Form 1040-NR), item L, line 1(e)?

a. $125

b. $5,000

c. $14,500

d. $19,500

Form 1040-NR, Itemized Deductions Line

Question 13: To answer this question, refer to the Form 1040-NR tax return you completed for taxpayer Simone Dupont.

The Itemized deductions line on Form 1040-NR is used to list itemized deductions. What itemized deduction(s) can Simone claim on Form 1040-NR?

a. State taxes withheld

b. Federal taxes withheld

c. Standard deduction

d. None of the above

Form 1040-NR, Schedule NEC

Question 14: What is the tax rate Simone is subject to on her stock sale, as reported on Schedule NEC?

a. The treaty rate, 0%

b. 10%

c. 30%

d. None of the above

Form 1040-NR, amount from Schedule 2 (Form 1040) Line

Question 15: Is Simone required to report anything on the Amount from Schedule 2 (Form 1040) line?

a. Social Security tax

b. Medicare tax

c. Both Social Security and Medicare taxes

d. Neither tax

Foreign Student Comprehensive Practice 94

Form 1040-NR, Overpayment

Question 16: Does Simone have an overpayment of taxes?

a. Yes

b. No

Summary

You have completed a tax return for foreign student Simone Dupont using her tax documents and her approved nonresident alien intake and interview sheet Form 13614-NR.

Foreign Student Comprehensive Practice 95

Foreign Student Comprehensive Practice 96

Foreign Student Comprehensive Practice 97

Foreign Student Comprehensive Practice 98

Foreign Student Comprehensive Practice 99

Foreign Student Comprehensive Practice 100

Form 1042-S

Foreign Person’s U.S. Source Income Subject to Withholding

Go to www.irs.gov/Form1042S for instructions and the latest information.

Foreign Person’s U.S. Source Income Subject to Withholding

OMB No. 1545-0096

0 1 2 3 4 5 6 7 8 9
**1 **Income
code
16		 2Gross income
14500		 2Gross income
14500		 3 Chapter indicator. Enter “3” or “4”
3		 3 Chapter indicator. Enter “3” or “4”
3		 3 Chapter indicator. Enter “3” or “4”
3		 3 Chapter indicator. Enter “3” or “4”
3		 3 Chapter indicator. Enter “3” or “4”
3		 3 Chapter indicator. Enter “3” or “4”
3		 3 Chapter indicator. Enter “3” or “4”
3		 3 Chapter indicator. Enter “3” or “4”
3		 3 Chapter indicator. Enter “3” or “4”
3		 3 Chapter indicator. Enter “3” or “4”
3		 3 Chapter indicator. Enter “3” or “4”
3		 3 Chapter indicator. Enter “3” or “4”
3		 3 Chapter indicator. Enter “3” or “4”
3		 13eRecipient’s U.S. TIN, if any
XXX-XX-XXXX		 13eRecipient’s U.S. TIN, if any
XXX-XX-XXXX		 13eRecipient’s U.S. TIN, if any
XXX-XX-XXXX		 13eRecipient’s U.S. TIN, if any
XXX-XX-XXXX		 13fCh. 3 status code
16		 13fCh. 3 status code
16		 13fCh. 3 status code
16		 13fCh. 3 status code
16		 13fCh. 3 status code
16		 13fCh. 3 status code
16		 13fCh. 3 status code
16
**1 **Income
code
16		 2Gross income
14500		 2Gross income
14500		 3a Exemption code
04		 3a Exemption code
04		 3a Exemption code
04		 3a Exemption code
04		 3a Exemption code
04		 3a Exemption code
04		 3a Exemption code
04		 3a Exemption code
04		 3a Exemption code
04		 3a Exemption code
04		 4a Exemption code
 4a Exemption code
 4a Exemption code
 4a Exemption code
 4a Exemption code
 4a Exemption code
 4a Exemption code
 13gCh. 4 status code
 13gCh. 4 status code
 13gCh. 4 status code
 13gCh. 4 status code
 13gCh. 4 status code
 13gCh. 4 status code
 13gCh. 4 status code
**1 **Income
code
16		 2Gross income
14500		 2Gross income
14500		 3b Tax rate
.
0
00		 3b Tax rate
.
0
00		 3b Tax rate
.
0
00		 3b Tax rate
.
0
00		 3b Tax rate
.
0
00		 3b Tax rate
.
0
00		 3b Tax rate
.
0
00		 3b Tax rate
.
0
00		 3b Tax rate
.
0
00		 3b Tax rate
.
0
00		 4b Tax rate
.		 4b Tax rate
.		 4b Tax rate
.		 13hRecipient’s GIIN
 13hRecipient’s GIIN
 13iRecipient’s foreign tax identification
number, if any
 13iRecipient’s foreign tax identification
number, if any
 13iRecipient’s foreign tax identification
number, if any
 13iRecipient’s foreign tax identification
number, if any
 13iRecipient’s foreign tax identification
number, if any
 13iRecipient’s foreign tax identification
number, if any
 13iRecipient’s foreign tax identification
number, if any
 13iRecipient’s foreign tax identification
number, if any
 13jLOB code
5Withholding allowance
6Net income
14500		 6Net income
14500		 6Net income
14500		 6Net income
14500		 6Net income
14500		 6Net income
14500		 6Net income
14500		 6Net income
14500		 6Net income
14500		 6Net income
14500		 6Net income
14500		 6Net income
14500		 6Net income
14500		 6Net income
14500		 6Net income
14500		 6Net income
14500		 6Net income
14500		 6Net income
14500		 6Net income
14500		 6Net income
14500		 6Net income
14500		 6Net income
14500		 6Net income
14500		 6Net income
14500		 6Net income
14500		 6Net income
14500		 6Net income
14500
7a Federal tax withheld 7a Federal tax withheld 7a Federal tax withheld 7a Federal tax withheld 7a Federal tax withheld 7a Federal tax withheld 7a Federal tax withheld 7a Federal tax withheld 7a Federal tax withheld 7a Federal tax withheld 7a Federal tax withheld 7a Federal tax withheld 7a Federal tax withheld 7a Federal tax withheld 7a Federal tax withheld 7a Federal tax withheld 13kRecipient’s account number 13kRecipient’s account number 13kRecipient’s account number 13kRecipient’s account number 13kRecipient’s account number 13kRecipient’s account number 13kRecipient’s account number 13kRecipient’s account number 13kRecipient’s account number 13kRecipient’s account number 13kRecipient’s account number
7b Check if federal tax withheld was not deposited with the IRS because
escrow procedures were applied (see instructions) .
.
.
.
.
.
7b Check if federal tax withheld was not deposited with the IRS because
escrow procedures were applied (see instructions) .
.
.
.
.
.		 7b Check if federal tax withheld was not deposited with the IRS because
escrow procedures were applied (see instructions) .
.
.
.
.
.		 7b Check if federal tax withheld was not deposited with the IRS because
escrow procedures were applied (see instructions) .
.
.
.
.
.		 7b Check if federal tax withheld was not deposited with the IRS because
escrow procedures were applied (see instructions) .
.
.
.
.
.		 7b Check if federal tax withheld was not deposited with the IRS because
escrow procedures were applied (see instructions) .
.
.
.
.
.		 7b Check if federal tax withheld was not deposited with the IRS because
escrow procedures were applied (see instructions) .
.
.
.
.
.		 7b Check if federal tax withheld was not deposited with the IRS because
escrow procedures were applied (see instructions) .
.
.
.
.
.		 7b Check if federal tax withheld was not deposited with the IRS because
escrow procedures were applied (see instructions) .
.
.
.
.
.		 7b Check if federal tax withheld was not deposited with the IRS because
escrow procedures were applied (see instructions) .
.
.
.
.
.		 7b Check if federal tax withheld was not deposited with the IRS because
escrow procedures were applied (see instructions) .
.
.
.
.
.		 7b Check if federal tax withheld was not deposited with the IRS because
escrow procedures were applied (see instructions) .
.
.
.
.
.		 7b Check if federal tax withheld was not deposited with the IRS because
escrow procedures were applied (see instructions) .
.
.
.
.
.		 7b Check if federal tax withheld was not deposited with the IRS because
escrow procedures were applied (see instructions) .
.
.
.
.
.		 7b Check if federal tax withheld was not deposited with the IRS because
escrow procedures were applied (see instructions) .
.
.
.
.
.		 7b Check if federal tax withheld was not deposited with the IRS because
escrow procedures were applied (see instructions) .
.
.
.
.
.		 7b Check if federal tax withheld was not deposited with the IRS because
escrow procedures were applied (see instructions) .
.
.
.
.
.		 13l Recipient’s date of birth (YYYYMMDD)
2
0
0
3
0
4
1
5		 13l Recipient’s date of birth (YYYYMMDD)
2
0
0
3
0
4
1
5		 13l Recipient’s date of birth (YYYYMMDD)
2
0
0
3
0
4
1
5		 13l Recipient’s date of birth (YYYYMMDD)
2
0
0
3
0
4
1
5		 13l Recipient’s date of birth (YYYYMMDD)
2
0
0
3
0
4
1
5		 13l Recipient’s date of birth (YYYYMMDD)
2
0
0
3
0
4
1
5		 13l Recipient’s date of birth (YYYYMMDD)
2
0
0
3
0
4
1
5		 13l Recipient’s date of birth (YYYYMMDD)
2
0
0
3
0
4
1
5		 13l Recipient’s date of birth (YYYYMMDD)
2
0
0
3
0
4
1
5		 13l Recipient’s date of birth (YYYYMMDD)
2
0
0
3
0
4
1
5		 13l Recipient’s date of birth (YYYYMMDD)
2
0
0
3
0
4
1
5
7c Check if withholding occurred in subsequent year with respect to a
partnership interest .
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8 Tax withheld by other agents 8 Tax withheld by other agents 8 Tax withheld by other agents 8 Tax withheld by other agents 8 Tax withheld by other agents 8 Tax withheld by other agents 8 Tax withheld by other agents 8 Tax withheld by other agents 8 Tax withheld by other agents 8 Tax withheld by other agents 8 Tax withheld by other agents 8 Tax withheld by other agents 8 Tax withheld by other agents 8 Tax withheld by other agents 8 Tax withheld by other agents 8 Tax withheld by other agents 14a Primary Withholding Agent’s Name (if applicable) 14a Primary Withholding Agent’s Name (if applicable) 14a Primary Withholding Agent’s Name (if applicable) 14a Primary Withholding Agent’s Name (if applicable) 14a Primary Withholding Agent’s Name (if applicable) 14a Primary Withholding Agent’s Name (if applicable) 14a Primary Withholding Agent’s Name (if applicable) 14a Primary Withholding Agent’s Name (if applicable) 14a Primary Withholding Agent’s Name (if applicable) 14a Primary Withholding Agent’s Name (if applicable) 14a Primary Withholding Agent’s Name (if applicable)
9 Overwithheld tax repaid to recipient pursuant to adjustment procedures (see instructions)
( )
9 Overwithheld tax repaid to recipient pursuant to adjustment procedures (see instructions)
( )		 9 Overwithheld tax repaid to recipient pursuant to adjustment procedures (see instructions)
( )		 9 Overwithheld tax repaid to recipient pursuant to adjustment procedures (see instructions)
( )		 9 Overwithheld tax repaid to recipient pursuant to adjustment procedures (see instructions)
( )		 9 Overwithheld tax repaid to recipient pursuant to adjustment procedures (see instructions)
( )		 9 Overwithheld tax repaid to recipient pursuant to adjustment procedures (see instructions)
( )		 9 Overwithheld tax repaid to recipient pursuant to adjustment procedures (see instructions)
( )		 9 Overwithheld tax repaid to recipient pursuant to adjustment procedures (see instructions)
( )		 9 Overwithheld tax repaid to recipient pursuant to adjustment procedures (see instructions)
( )		 9 Overwithheld tax repaid to recipient pursuant to adjustment procedures (see instructions)
( )		 9 Overwithheld tax repaid to recipient pursuant to adjustment procedures (see instructions)
( )		 9 Overwithheld tax repaid to recipient pursuant to adjustment procedures (see instructions)
( )		 9 Overwithheld tax repaid to recipient pursuant to adjustment procedures (see instructions)
( )		 9 Overwithheld tax repaid to recipient pursuant to adjustment procedures (see instructions)
( )		 9 Overwithheld tax repaid to recipient pursuant to adjustment procedures (see instructions)
( )		 9 Overwithheld tax repaid to recipient pursuant to adjustment procedures (see instructions)
( )		 14bPrimary Withholding Agent’s EIN 14bPrimary Withholding Agent’s EIN 14bPrimary Withholding Agent’s EIN 14bPrimary Withholding Agent’s EIN 15 Check if pro-rata basis reporting 15 Check if pro-rata basis reporting 15 Check if pro-rata basis reporting 15 Check if pro-rata basis reporting 15 Check if pro-rata basis reporting 15 Check if pro-rata basis reporting 15 Check if pro-rata basis reporting
10 Total withholding credit (combine boxes 7a, 8, and 9)
10 Total withholding credit (combine boxes 7a, 8, and 9) 10 Total withholding credit (combine boxes 7a, 8, and 9) 10 Total withholding credit (combine boxes 7a, 8, and 9) 10 Total withholding credit (combine boxes 7a, 8, and 9) 10 Total withholding credit (combine boxes 7a, 8, and 9) 10 Total withholding credit (combine boxes 7a, 8, and 9) 10 Total withholding credit (combine boxes 7a, 8, and 9) 10 Total withholding credit (combine boxes 7a, 8, and 9) 10 Total withholding credit (combine boxes 7a, 8, and 9) 10 Total withholding credit (combine boxes 7a, 8, and 9) 10 Total withholding credit (combine boxes 7a, 8, and 9) 10 Total withholding credit (combine boxes 7a, 8, and 9) 10 Total withholding credit (combine boxes 7a, 8, and 9) 10 Total withholding credit (combine boxes 7a, 8, and 9) 10 Total withholding credit (combine boxes 7a, 8, and 9) 10 Total withholding credit (combine boxes 7a, 8, and 9) **15a **Intermediary or flow-through entity’s EIN, if any **15a **Intermediary or flow-through entity’s EIN, if any **15a **Intermediary or flow-through entity’s EIN, if any **15a **Intermediary or flow-through entity’s EIN, if any **15a **Intermediary or flow-through entity’s EIN, if any 15b Ch. 3 status code 15b Ch. 3 status code 15b Ch. 3 status code 15b Ch. 3 status code 15c Ch. 4 status code 15c Ch. 4 status code
11 Tax paid by withholding agent (amounts not withheld) (see instructions)
11 Tax paid by withholding agent (amounts not withheld) (see instructions) 11 Tax paid by withholding agent (amounts not withheld) (see instructions) 11 Tax paid by withholding agent (amounts not withheld) (see instructions) 11 Tax paid by withholding agent (amounts not withheld) (see instructions) 11 Tax paid by withholding agent (amounts not withheld) (see instructions) 11 Tax paid by withholding agent (amounts not withheld) (see instructions) 11 Tax paid by withholding agent (amounts not withheld) (see instructions) 11 Tax paid by withholding agent (amounts not withheld) (see instructions) 11 Tax paid by withholding agent (amounts not withheld) (see instructions) 11 Tax paid by withholding agent (amounts not withheld) (see instructions) 11 Tax paid by withholding agent (amounts not withheld) (see instructions) 11 Tax paid by withholding agent (amounts not withheld) (see instructions) 11 Tax paid by withholding agent (amounts not withheld) (see instructions) 11 Tax paid by withholding agent (amounts not withheld) (see instructions) 11 Tax paid by withholding agent (amounts not withheld) (see instructions) 11 Tax paid by withholding agent (amounts not withheld) (see instructions) **15d **Intermediary or flow-through entity’s name **15d **Intermediary or flow-through entity’s name **15d **Intermediary or flow-through entity’s name **15d **Intermediary or flow-through entity’s name **15d **Intermediary or flow-through entity’s name **15d **Intermediary or flow-through entity’s name **15d **Intermediary or flow-through entity’s name **15d **Intermediary or flow-through entity’s name **15d **Intermediary or flow-through entity’s name **15d **Intermediary or flow-through entity’s name **15d **Intermediary or flow-through entity’s name
12aWithholding agent’s EIN
XX-XXXXXXX		 12aWithholding agent’s EIN
XX-XXXXXXX		 12aWithholding agent’s EIN
XX-XXXXXXX		 12aWithholding agent’s EIN
XX-XXXXXXX		 12aWithholding agent’s EIN
XX-XXXXXXX		 12aWithholding agent’s EIN
XX-XXXXXXX		 12aWithholding agent’s EIN
XX-XXXXXXX		 12b Ch. 3 status code
02		 12b Ch. 3 status code
02		 12b Ch. 3 status code
02		 12b Ch. 3 status code
02		 12b Ch. 3 status code
02		 12b Ch. 3 status code
02		 12b Ch. 3 status code
02		 12b Ch. 3 status code
02		 **12c **Ch. 4 status code **12c **Ch. 4 status code **12c **Ch. 4 status code **12c **Ch. 4 status code **12c **Ch. 4 status code **12c **Ch. 4 status code **12c **Ch. 4 status code **12c **Ch. 4 status code **12c **Ch. 4 status code **12c **Ch. 4 status code **12c **Ch. 4 status code **12c **Ch. 4 status code
12aWithholding agent’s EIN
XX-XXXXXXX		 12aWithholding agent’s EIN
XX-XXXXXXX		 12aWithholding agent’s EIN
XX-XXXXXXX		 12aWithholding agent’s EIN
XX-XXXXXXX		 12aWithholding agent’s EIN
XX-XXXXXXX		 12aWithholding agent’s EIN
XX-XXXXXXX		 12aWithholding agent’s EIN
XX-XXXXXXX		 12b Ch. 3 status code
02		 12b Ch. 3 status code
02		 12b Ch. 3 status code
02		 12b Ch. 3 status code
02		 12b Ch. 3 status code
02		 12b Ch. 3 status code
02		 12b Ch. 3 status code
02		 12b Ch. 3 status code
02		 **12c **Ch. 4 status code **15e **Intermediary or flow-through entity’s GIIN **15e **Intermediary or flow-through entity’s GIIN **15e **Intermediary or flow-through entity’s GIIN **15e **Intermediary or flow-through entity’s GIIN **15e **Intermediary or flow-through entity’s GIIN **15e **Intermediary or flow-through entity’s GIIN **15e **Intermediary or flow-through entity’s GIIN **15e **Intermediary or flow-through entity’s GIIN **15e **Intermediary or flow-through entity’s GIIN **15e **Intermediary or flow-through entity’s GIIN **15e **Intermediary or flow-through entity’s GIIN
12dWithholding agent’s name

 12dWithholding agent’s name

 12dWithholding agent’s name

 12dWithholding agent’s name

 12dWithholding agent’s name

 12dWithholding agent’s name

 12dWithholding agent’s name

 12dWithholding agent’s name

 12dWithholding agent’s name

 12dWithholding agent’s name

 12dWithholding agent’s name

 12dWithholding agent’s name

 12dWithholding agent’s name

 12dWithholding agent’s name

 12dWithholding agent’s name

 12dWithholding agent’s name

 15fCountry code 15gForeign tax identification number, if any 15gForeign tax identification number, if any 15gForeign tax identification number, if any 15gForeign tax identification number, if any 15gForeign tax identification number, if any 15gForeign tax identification number, if any 15gForeign tax identification number, if any 15gForeign tax identification number, if any 15gForeign tax identification number, if any 15gForeign tax identification number, if any
12eWithholding agent’s Global Intermediary Identification Number (GIIN) 12eWithholding agent’s Global Intermediary Identification Number (GIIN) 12eWithholding agent’s Global Intermediary Identification Number (GIIN) 12eWithholding agent’s Global Intermediary Identification Number (GIIN) 12eWithholding agent’s Global Intermediary Identification Number (GIIN) 12eWithholding agent’s Global Intermediary Identification Number (GIIN) 12eWithholding agent’s Global Intermediary Identification Number (GIIN) 12eWithholding agent’s Global Intermediary Identification Number (GIIN) 12eWithholding agent’s Global Intermediary Identification Number (GIIN) 12eWithholding agent’s Global Intermediary Identification Number (GIIN) 12eWithholding agent’s Global Intermediary Identification Number (GIIN) 12eWithholding agent’s Global Intermediary Identification Number (GIIN) 12eWithholding agent’s Global Intermediary Identification Number (GIIN) 12eWithholding agent’s Global Intermediary Identification Number (GIIN) 12eWithholding agent’s Global Intermediary Identification Number (GIIN) 12eWithholding agent’s Global Intermediary Identification Number (GIIN) 15hAddress (number and street) 15hAddress (number and street) 15hAddress (number and street) 15hAddress (number and street) 15hAddress (number and street) 15hAddress (number and street) 15hAddress (number and street) 15hAddress (number and street) 15hAddress (number and street) 15hAddress (number and street) 15hAddress (number and street)
12fCountry code 12fCountry code 12gForeign tax identification number, if any 12gForeign tax identification number, if any 12gForeign tax identification number, if any 12gForeign tax identification number, if any 12gForeign tax identification number, if any 12gForeign tax identification number, if any 12gForeign tax identification number, if any 12gForeign tax identification number, if any 12gForeign tax identification number, if any 12gForeign tax identification number, if any 12gForeign tax identification number, if any 12gForeign tax identification number, if any 12gForeign tax identification number, if any 12gForeign tax identification number, if any 15iCity or town, state or province, country, ZIP or foreign postal code 15iCity or town, state or province, country, ZIP or foreign postal code 15iCity or town, state or province, country, ZIP or foreign postal code 15iCity or town, state or province, country, ZIP or foreign postal code 15iCity or town, state or province, country, ZIP or foreign postal code 15iCity or town, state or province, country, ZIP or foreign postal code 15iCity or town, state or province, country, ZIP or foreign postal code 15iCity or town, state or province, country, ZIP or foreign postal code 15iCity or town, state or province, country, ZIP or foreign postal code 15iCity or town, state or province, country, ZIP or foreign postal code 15iCity or town, state or province, country, ZIP or foreign postal code
12hAddress (number and street)
221 WHITNEY AVENUE		 12hAddress (number and street)
221 WHITNEY AVENUE		 12hAddress (number and street)
221 WHITNEY AVENUE		 12hAddress (number and street)
221 WHITNEY AVENUE		 12hAddress (number and street)
221 WHITNEY AVENUE		 12hAddress (number and street)
221 WHITNEY AVENUE		 12hAddress (number and street)
221 WHITNEY AVENUE		 12hAddress (number and street)
221 WHITNEY AVENUE		 12hAddress (number and street)
221 WHITNEY AVENUE		 12hAddress (number and street)
221 WHITNEY AVENUE		 12hAddress (number and street)
221 WHITNEY AVENUE		 12hAddress (number and street)
221 WHITNEY AVENUE		 12hAddress (number and street)
221 WHITNEY AVENUE		 12hAddress (number and street)
221 WHITNEY AVENUE		 12hAddress (number and street)
221 WHITNEY AVENUE		 12hAddress (number and street)
221 WHITNEY AVENUE		 16aPayer’s name 16aPayer’s name 16aPayer’s name 16aPayer’s name 16aPayer’s name 16aPayer’s name 16bPayer’s TIN 16bPayer’s TIN 16bPayer’s TIN 16bPayer’s TIN 16bPayer’s TIN
12iCity or town, state or province, country, ZIP or foreign postal code
YOUR TOWN, YS XXXXX		 12iCity or town, state or province, country, ZIP or foreign postal code
YOUR TOWN, YS XXXXX		 12iCity or town, state or province, country, ZIP or foreign postal code
YOUR TOWN, YS XXXXX		 12iCity or town, state or province, country, ZIP or foreign postal code
YOUR TOWN, YS XXXXX		 12iCity or town, state or province, country, ZIP or foreign postal code
YOUR TOWN, YS XXXXX		 12iCity or town, state or province, country, ZIP or foreign postal code
YOUR TOWN, YS XXXXX		 12iCity or town, state or province, country, ZIP or foreign postal code
YOUR TOWN, YS XXXXX		 12iCity or town, state or province, country, ZIP or foreign postal code
YOUR TOWN, YS XXXXX		 12iCity or town, state or province, country, ZIP or foreign postal code
YOUR TOWN, YS XXXXX		 12iCity or town, state or province, country, ZIP or foreign postal code
YOUR TOWN, YS XXXXX		 12iCity or town, state or province, country, ZIP or foreign postal code
YOUR TOWN, YS XXXXX		 12iCity or town, state or province, country, ZIP or foreign postal code
YOUR TOWN, YS XXXXX		 12iCity or town, state or province, country, ZIP or foreign postal code
YOUR TOWN, YS XXXXX		 12iCity or town, state or province, country, ZIP or foreign postal code
YOUR TOWN, YS XXXXX		 12iCity or town, state or province, country, ZIP or foreign postal code
YOUR TOWN, YS XXXXX		 12iCity or town, state or province, country, ZIP or foreign postal code
YOUR TOWN, YS XXXXX		 16cPayer’s GIIN 16cPayer’s GIIN 16cPayer’s GIIN 16cPayer’s GIIN 16dCh. 3 status code 16dCh. 3 status code 16dCh. 3 status code 16dCh. 3 status code 16eCh. 4 status code 16eCh. 4 status code 16eCh. 4 status code
13aRecipient’s name
SIMONE DUPONT		 13aRecipient’s name
SIMONE DUPONT		 13aRecipient’s name
SIMONE DUPONT		 13aRecipient’s name
SIMONE DUPONT		 13aRecipient’s name
SIMONE DUPONT		 13aRecipient’s name
SIMONE DUPONT		 13aRecipient’s name
SIMONE DUPONT		 13aRecipient’s name
SIMONE DUPONT		 13aRecipient’s name
SIMONE DUPONT		 13aRecipient’s name
SIMONE DUPONT		 13b Recipient’s country code 13b Recipient’s country code 13b Recipient’s country code 13b Recipient’s country code 13b Recipient’s country code 13b Recipient’s country code 17aState income tax withheld 17aState income tax withheld 17aState income tax withheld 17bPayer’s state tax no. 17bPayer’s state tax no. 17bPayer’s state tax no. 17bPayer’s state tax no. 17cName of state 17cName of state 17cName of state 17cName of state
13cAddress (number and street)

250 CHURCH STREET
13dCity or town, state or province, country, ZIP or foreign postal code
YOUR TOWN, YS XXXXX

Foreign Student Comprehensive Practice 101

OMB No. 1545-0096

Form 1042-S

Foreign Person’s U.S. Source Income Subject to Withholding

Foreign Person’s U.S. Source Income Subject to Withholding

Go to www.irs.gov/Form1042S for instructions and the latest information.

0 1 2 3 4 5 6 7 8 9
**1 **Income
code
16		 2Gross income
5000		 2Gross income
5000		 3 Chapter indicator. Enter “3” or “4”

3		 3 Chapter indicator. Enter “3” or “4”

3		 3 Chapter indicator. Enter “3” or “4”

3		 3 Chapter indicator. Enter “3” or “4”

3		 3 Chapter indicator. Enter “3” or “4”

3		 3 Chapter indicator. Enter “3” or “4”

3		 3 Chapter indicator. Enter “3” or “4”

3		 3 Chapter indicator. Enter “3” or “4”

3		 3 Chapter indicator. Enter “3” or “4”

3		 3 Chapter indicator. Enter “3” or “4”

3		 3 Chapter indicator. Enter “3” or “4”

3		 3 Chapter indicator. Enter “3” or “4”

3		 3 Chapter indicator. Enter “3” or “4”

3		 13eRecipient’s U.S. TIN, if any
012-34-5678		 13eRecipient’s U.S. TIN, if any
012-34-5678		 13eRecipient’s U.S. TIN, if any
012-34-5678		 13eRecipient’s U.S. TIN, if any
012-34-5678		 13fCh. 3 status code
16		 13fCh. 3 status code
16		 13fCh. 3 status code
16		 13fCh. 3 status code
16		 13fCh. 3 status code
16		 13fCh. 3 status code
16		 13fCh. 3 status code
16
**1 **Income
code
16		 2Gross income
5000		 2Gross income
5000		 3a Exemption code
4		 3a Exemption code
4		 3a Exemption code
4		 3a Exemption code
4		 3a Exemption code
4		 3a Exemption code
4		 3a Exemption code
4		 3a Exemption code
4		 3a Exemption code
4		 3a Exemption code
4		 4a Exemption code 4a Exemption code 4a Exemption code 4a Exemption code 4a Exemption code 4a Exemption code 4a Exemption code 13gCh. 4 status code 13gCh. 4 status code 13gCh. 4 status code 13gCh. 4 status code 13gCh. 4 status code 13gCh. 4 status code 13gCh. 4 status code
**1 **Income
code
16		 2Gross income
5000		 2Gross income
5000		 3b Tax rate
.
0.0000		 3b Tax rate
.
0.0000		 3b Tax rate
.
0.0000		 3b Tax rate
.
0.0000		 3b Tax rate
.
0.0000		 3b Tax rate
.
0.0000		 3b Tax rate
.
0.0000		 3b Tax rate
.
0.0000		 3b Tax rate
.
0.0000		 3b Tax rate
.
0.0000		 4b Tax rate
.		 4b Tax rate
.		 4b Tax rate
.		 13hRecipient’s GIIN 13hRecipient’s GIIN 13iRecipient’s foreign tax identification
number, if any		 13iRecipient’s foreign tax identification
number, if any		 13iRecipient’s foreign tax identification
number, if any		 13iRecipient’s foreign tax identification
number, if any		 13iRecipient’s foreign tax identification
number, if any		 13iRecipient’s foreign tax identification
number, if any		 13iRecipient’s foreign tax identification
number, if any		 13iRecipient’s foreign tax identification
number, if any		 13jLOB code
5Withholding allowance 5Withholding allowance 5Withholding allowance 5Withholding allowance 5Withholding allowance 5Withholding allowance 5Withholding allowance 5Withholding allowance 5Withholding allowance 5Withholding allowance 5Withholding allowance 5Withholding allowance 5Withholding allowance 5Withholding allowance 5Withholding allowance 5Withholding allowance 5Withholding allowance 5Withholding allowance 5Withholding allowance 5Withholding allowance 5Withholding allowance 5Withholding allowance 5Withholding allowance 5Withholding allowance 5Withholding allowance 5Withholding allowance 5Withholding allowance
6Net income 6Net income 6Net income 6Net income 6Net income 6Net income 6Net income 6Net income 6Net income 6Net income 6Net income 6Net income 6Net income 6Net income 6Net income 6Net income 6Net income 6Net income 6Net income 6Net income 6Net income 6Net income 6Net income 6Net income 6Net income 6Net income 6Net income
7a Federal tax withheld 7a Federal tax withheld 7a Federal tax withheld 7a Federal tax withheld 7a Federal tax withheld 7a Federal tax withheld 7a Federal tax withheld 7a Federal tax withheld 7a Federal tax withheld 7a Federal tax withheld 7a Federal tax withheld 7a Federal tax withheld 7a Federal tax withheld 7a Federal tax withheld 7a Federal tax withheld 7a Federal tax withheld 13kRecipient’s account number 13kRecipient’s account number 13kRecipient’s account number 13kRecipient’s account number 13kRecipient’s account number 13kRecipient’s account number 13kRecipient’s account number 13kRecipient’s account number 13kRecipient’s account number 13kRecipient’s account number 13kRecipient’s account number
7b Check if federal tax withheld was not deposited with the IRS because
escrow procedures were applied (see instructions) .
.
.
.
.
.
7b Check if federal tax withheld was not deposited with the IRS because
escrow procedures were applied (see instructions) .
.
.
.
.
.		 7b Check if federal tax withheld was not deposited with the IRS because
escrow procedures were applied (see instructions) .
.
.
.
.
.		 7b Check if federal tax withheld was not deposited with the IRS because
escrow procedures were applied (see instructions) .
.
.
.
.
.		 7b Check if federal tax withheld was not deposited with the IRS because
escrow procedures were applied (see instructions) .
.
.
.
.
.		 7b Check if federal tax withheld was not deposited with the IRS because
escrow procedures were applied (see instructions) .
.
.
.
.
.		 7b Check if federal tax withheld was not deposited with the IRS because
escrow procedures were applied (see instructions) .
.
.
.
.
.		 7b Check if federal tax withheld was not deposited with the IRS because
escrow procedures were applied (see instructions) .
.
.
.
.
.		 7b Check if federal tax withheld was not deposited with the IRS because
escrow procedures were applied (see instructions) .
.
.
.
.
.		 7b Check if federal tax withheld was not deposited with the IRS because
escrow procedures were applied (see instructions) .
.
.
.
.
.		 7b Check if federal tax withheld was not deposited with the IRS because
escrow procedures were applied (see instructions) .
.
.
.
.
.		 7b Check if federal tax withheld was not deposited with the IRS because
escrow procedures were applied (see instructions) .
.
.
.
.
.		 7b Check if federal tax withheld was not deposited with the IRS because
escrow procedures were applied (see instructions) .
.
.
.
.
.		 7b Check if federal tax withheld was not deposited with the IRS because
escrow procedures were applied (see instructions) .
.
.
.
.
.		 7b Check if federal tax withheld was not deposited with the IRS because
escrow procedures were applied (see instructions) .
.
.
.
.
.		 7b Check if federal tax withheld was not deposited with the IRS because
escrow procedures were applied (see instructions) .
.
.
.
.
.		 7b Check if federal tax withheld was not deposited with the IRS because
escrow procedures were applied (see instructions) .
.
.
.
.
.		 13l Recipient’s date of birth (YYYYMMDD)
2
0
0
3
0
4
1
5		 13l Recipient’s date of birth (YYYYMMDD)
2
0
0
3
0
4
1
5		 13l Recipient’s date of birth (YYYYMMDD)
2
0
0
3
0
4
1
5		 13l Recipient’s date of birth (YYYYMMDD)
2
0
0
3
0
4
1
5		 13l Recipient’s date of birth (YYYYMMDD)
2
0
0
3
0
4
1
5		 13l Recipient’s date of birth (YYYYMMDD)
2
0
0
3
0
4
1
5		 13l Recipient’s date of birth (YYYYMMDD)
2
0
0
3
0
4
1
5		 13l Recipient’s date of birth (YYYYMMDD)
2
0
0
3
0
4
1
5		 13l Recipient’s date of birth (YYYYMMDD)
2
0
0
3
0
4
1
5		 13l Recipient’s date of birth (YYYYMMDD)
2
0
0
3
0
4
1
5		 13l Recipient’s date of birth (YYYYMMDD)
2
0
0
3
0
4
1
5
7c Check if withholding occurred in subsequent year with respect to a
partnership interest .
.
.
.
.
.
.
.
.
.
.
.
.
.
8 Tax withheld by other agents 8 Tax withheld by other agents 8 Tax withheld by other agents 8 Tax withheld by other agents 8 Tax withheld by other agents 8 Tax withheld by other agents 8 Tax withheld by other agents 8 Tax withheld by other agents 8 Tax withheld by other agents 8 Tax withheld by other agents 8 Tax withheld by other agents 8 Tax withheld by other agents 8 Tax withheld by other agents 8 Tax withheld by other agents 8 Tax withheld by other agents 8 Tax withheld by other agents 14a Primary Withholding Agent’s Name (if applicable) 14a Primary Withholding Agent’s Name (if applicable) 14a Primary Withholding Agent’s Name (if applicable) 14a Primary Withholding Agent’s Name (if applicable) 14a Primary Withholding Agent’s Name (if applicable) 14a Primary Withholding Agent’s Name (if applicable) 14a Primary Withholding Agent’s Name (if applicable) 14a Primary Withholding Agent’s Name (if applicable) 14a Primary Withholding Agent’s Name (if applicable) 14a Primary Withholding Agent’s Name (if applicable) 14a Primary Withholding Agent’s Name (if applicable)
9 Overwithheld tax repaid to recipient pursuant to adjustment procedures (see instructions)
( )
9 Overwithheld tax repaid to recipient pursuant to adjustment procedures (see instructions)
( )		 9 Overwithheld tax repaid to recipient pursuant to adjustment procedures (see instructions)
( )		 9 Overwithheld tax repaid to recipient pursuant to adjustment procedures (see instructions)
( )		 9 Overwithheld tax repaid to recipient pursuant to adjustment procedures (see instructions)
( )		 9 Overwithheld tax repaid to recipient pursuant to adjustment procedures (see instructions)
( )		 9 Overwithheld tax repaid to recipient pursuant to adjustment procedures (see instructions)
( )		 9 Overwithheld tax repaid to recipient pursuant to adjustment procedures (see instructions)
( )		 9 Overwithheld tax repaid to recipient pursuant to adjustment procedures (see instructions)
( )		 9 Overwithheld tax repaid to recipient pursuant to adjustment procedures (see instructions)
( )		 9 Overwithheld tax repaid to recipient pursuant to adjustment procedures (see instructions)
( )		 9 Overwithheld tax repaid to recipient pursuant to adjustment procedures (see instructions)
( )		 9 Overwithheld tax repaid to recipient pursuant to adjustment procedures (see instructions)
( )		 9 Overwithheld tax repaid to recipient pursuant to adjustment procedures (see instructions)
( )		 9 Overwithheld tax repaid to recipient pursuant to adjustment procedures (see instructions)
( )		 9 Overwithheld tax repaid to recipient pursuant to adjustment procedures (see instructions)
( )		 9 Overwithheld tax repaid to recipient pursuant to adjustment procedures (see instructions)
( )		 14bPrimary Withholding Agent’s EIN 14bPrimary Withholding Agent’s EIN 14bPrimary Withholding Agent’s EIN 14bPrimary Withholding Agent’s EIN 15 Check if pro-rata basis reporting 15 Check if pro-rata basis reporting 15 Check if pro-rata basis reporting 15 Check if pro-rata basis reporting 15 Check if pro-rata basis reporting 15 Check if pro-rata basis reporting 15 Check if pro-rata basis reporting
10 Total withholding credit (combine boxes 7a, 8, and 9)
10 Total withholding credit (combine boxes 7a, 8, and 9) 10 Total withholding credit (combine boxes 7a, 8, and 9) 10 Total withholding credit (combine boxes 7a, 8, and 9) 10 Total withholding credit (combine boxes 7a, 8, and 9) 10 Total withholding credit (combine boxes 7a, 8, and 9) 10 Total withholding credit (combine boxes 7a, 8, and 9) 10 Total withholding credit (combine boxes 7a, 8, and 9) 10 Total withholding credit (combine boxes 7a, 8, and 9) 10 Total withholding credit (combine boxes 7a, 8, and 9) 10 Total withholding credit (combine boxes 7a, 8, and 9) 10 Total withholding credit (combine boxes 7a, 8, and 9) 10 Total withholding credit (combine boxes 7a, 8, and 9) 10 Total withholding credit (combine boxes 7a, 8, and 9) 10 Total withholding credit (combine boxes 7a, 8, and 9) 10 Total withholding credit (combine boxes 7a, 8, and 9) 10 Total withholding credit (combine boxes 7a, 8, and 9) **15a **Intermediary or flow-through entity’s EIN, if any **15a **Intermediary or flow-through entity’s EIN, if any **15a **Intermediary or flow-through entity’s EIN, if any **15a **Intermediary or flow-through entity’s EIN, if any **15a **Intermediary or flow-through entity’s EIN, if any 15b Ch. 3 status code 15b Ch. 3 status code 15b Ch. 3 status code 15b Ch. 3 status code 15c Ch. 4 status code 15c Ch. 4 status code
11 Tax paid by withholding agent (amounts not withheld) (see instructions)
11 Tax paid by withholding agent (amounts not withheld) (see instructions) 11 Tax paid by withholding agent (amounts not withheld) (see instructions) 11 Tax paid by withholding agent (amounts not withheld) (see instructions) 11 Tax paid by withholding agent (amounts not withheld) (see instructions) 11 Tax paid by withholding agent (amounts not withheld) (see instructions) 11 Tax paid by withholding agent (amounts not withheld) (see instructions) 11 Tax paid by withholding agent (amounts not withheld) (see instructions) 11 Tax paid by withholding agent (amounts not withheld) (see instructions) 11 Tax paid by withholding agent (amounts not withheld) (see instructions) 11 Tax paid by withholding agent (amounts not withheld) (see instructions) 11 Tax paid by withholding agent (amounts not withheld) (see instructions) 11 Tax paid by withholding agent (amounts not withheld) (see instructions) 11 Tax paid by withholding agent (amounts not withheld) (see instructions) 11 Tax paid by withholding agent (amounts not withheld) (see instructions) 11 Tax paid by withholding agent (amounts not withheld) (see instructions) 11 Tax paid by withholding agent (amounts not withheld) (see instructions) **15d **Intermediary or flow-through entity’s name **15d **Intermediary or flow-through entity’s name **15d **Intermediary or flow-through entity’s name **15d **Intermediary or flow-through entity’s name **15d **Intermediary or flow-through entity’s name **15d **Intermediary or flow-through entity’s name **15d **Intermediary or flow-through entity’s name **15d **Intermediary or flow-through entity’s name **15d **Intermediary or flow-through entity’s name **15d **Intermediary or flow-through entity’s name **15d **Intermediary or flow-through entity’s name
12aWithholding agent’s EIN 12aWithholding agent’s EIN 12aWithholding agent’s EIN 12aWithholding agent’s EIN 12aWithholding agent’s EIN 12aWithholding agent’s EIN 12aWithholding agent’s EIN 12b Ch. 3 status code 12b Ch. 3 status code 12b Ch. 3 status code 12b Ch. 3 status code 12b Ch. 3 status code 12b Ch. 3 status code 12b Ch. 3 status code 12b Ch. 3 status code **12c **Ch. 4 status code **12c **Ch. 4 status code **12c **Ch. 4 status code **12c **Ch. 4 status code **12c **Ch. 4 status code **12c **Ch. 4 status code **12c **Ch. 4 status code **12c **Ch. 4 status code **12c **Ch. 4 status code **12c **Ch. 4 status code **12c **Ch. 4 status code **12c **Ch. 4 status code
12aWithholding agent’s EIN 12aWithholding agent’s EIN 12aWithholding agent’s EIN 12aWithholding agent’s EIN 12aWithholding agent’s EIN 12aWithholding agent’s EIN 12aWithholding agent’s EIN 12b Ch. 3 status code 12b Ch. 3 status code 12b Ch. 3 status code 12b Ch. 3 status code 12b Ch. 3 status code 12b Ch. 3 status code 12b Ch. 3 status code 12b Ch. 3 status code **12c **Ch. 4 status code **15e **Intermediary or flow-through entity’s GIIN **15e **Intermediary or flow-through entity’s GIIN **15e **Intermediary or flow-through entity’s GIIN **15e **Intermediary or flow-through entity’s GIIN **15e **Intermediary or flow-through entity’s GIIN **15e **Intermediary or flow-through entity’s GIIN **15e **Intermediary or flow-through entity’s GIIN **15e **Intermediary or flow-through entity’s GIIN **15e **Intermediary or flow-through entity’s GIIN **15e **Intermediary or flow-through entity’s GIIN **15e **Intermediary or flow-through entity’s GIIN
12dWithholding agent’s name 12dWithholding agent’s name 12dWithholding agent’s name 12dWithholding agent’s name 12dWithholding agent’s name 12dWithholding agent’s name 12dWithholding agent’s name 12dWithholding agent’s name 12dWithholding agent’s name 12dWithholding agent’s name 12dWithholding agent’s name 12dWithholding agent’s name 12dWithholding agent’s name 12dWithholding agent’s name 12dWithholding agent’s name 12dWithholding agent’s name 15fCountry code 15gForeign tax identification number, if any 15gForeign tax identification number, if any 15gForeign tax identification number, if any 15gForeign tax identification number, if any 15gForeign tax identification number, if any 15gForeign tax identification number, if any 15gForeign tax identification number, if any 15gForeign tax identification number, if any 15gForeign tax identification number, if any 15gForeign tax identification number, if any
12eWithholding agent’s Global Intermediary Identification Number (GIIN) 12eWithholding agent’s Global Intermediary Identification Number (GIIN) 12eWithholding agent’s Global Intermediary Identification Number (GIIN) 12eWithholding agent’s Global Intermediary Identification Number (GIIN) 12eWithholding agent’s Global Intermediary Identification Number (GIIN) 12eWithholding agent’s Global Intermediary Identification Number (GIIN) 12eWithholding agent’s Global Intermediary Identification Number (GIIN) 12eWithholding agent’s Global Intermediary Identification Number (GIIN) 12eWithholding agent’s Global Intermediary Identification Number (GIIN) 12eWithholding agent’s Global Intermediary Identification Number (GIIN) 12eWithholding agent’s Global Intermediary Identification Number (GIIN) 12eWithholding agent’s Global Intermediary Identification Number (GIIN) 12eWithholding agent’s Global Intermediary Identification Number (GIIN) 12eWithholding agent’s Global Intermediary Identification Number (GIIN) 12eWithholding agent’s Global Intermediary Identification Number (GIIN) 12eWithholding agent’s Global Intermediary Identification Number (GIIN) 15hAddress (number and street) 15hAddress (number and street) 15hAddress (number and street) 15hAddress (number and street) 15hAddress (number and street) 15hAddress (number and street) 15hAddress (number and street) 15hAddress (number and street) 15hAddress (number and street) 15hAddress (number and street) 15hAddress (number and street)
12fCountry code 12fCountry code 12gForeign tax identification number, if any 12gForeign tax identification number, if any 12gForeign tax identification number, if any 12gForeign tax identification number, if any 12gForeign tax identification number, if any 12gForeign tax identification number, if any 12gForeign tax identification number, if any 12gForeign tax identification number, if any 12gForeign tax identification number, if any 12gForeign tax identification number, if any 12gForeign tax identification number, if any 12gForeign tax identification number, if any 12gForeign tax identification number, if any 12gForeign tax identification number, if any 15iCity or town, state or province, country, ZIP or foreign postal code 15iCity or town, state or province, country, ZIP or foreign postal code 15iCity or town, state or province, country, ZIP or foreign postal code 15iCity or town, state or province, country, ZIP or foreign postal code 15iCity or town, state or province, country, ZIP or foreign postal code 15iCity or town, state or province, country, ZIP or foreign postal code 15iCity or town, state or province, country, ZIP or foreign postal code 15iCity or town, state or province, country, ZIP or foreign postal code 15iCity or town, state or province, country, ZIP or foreign postal code 15iCity or town, state or province, country, ZIP or foreign postal code 15iCity or town, state or province, country, ZIP or foreign postal code
12hAddress (number and street) 12hAddress (number and street) 12hAddress (number and street) 12hAddress (number and street) 12hAddress (number and street) 12hAddress (number and street) 12hAddress (number and street) 12hAddress (number and street) 12hAddress (number and street) 12hAddress (number and street) 12hAddress (number and street) 12hAddress (number and street) 12hAddress (number and street) 12hAddress (number and street) 12hAddress (number and street) 12hAddress (number and street) 16aPayer’s name 16aPayer’s name 16aPayer’s name 16aPayer’s name 16aPayer’s name 16aPayer’s name 16bPayer’s TIN 16bPayer’s TIN 16bPayer’s TIN 16bPayer’s TIN 16bPayer’s TIN
12iCity or town, state or province, country, ZIP or foreign postal code 12iCity or town, state or province, country, ZIP or foreign postal code 12iCity or town, state or province, country, ZIP or foreign postal code 12iCity or town, state or province, country, ZIP or foreign postal code 12iCity or town, state or province, country, ZIP or foreign postal code 12iCity or town, state or province, country, ZIP or foreign postal code 12iCity or town, state or province, country, ZIP or foreign postal code 12iCity or town, state or province, country, ZIP or foreign postal code 12iCity or town, state or province, country, ZIP or foreign postal code 12iCity or town, state or province, country, ZIP or foreign postal code 12iCity or town, state or province, country, ZIP or foreign postal code 12iCity or town, state or province, country, ZIP or foreign postal code 12iCity or town, state or province, country, ZIP or foreign postal code 12iCity or town, state or province, country, ZIP or foreign postal code 12iCity or town, state or province, country, ZIP or foreign postal code 12iCity or town, state or province, country, ZIP or foreign postal code 16cPayer’s GIIN 16cPayer’s GIIN 16cPayer’s GIIN 16cPayer’s GIIN 16dCh. 3 status code 16dCh. 3 status code 16dCh. 3 status code 16dCh. 3 status code 16eCh. 4 status code 16eCh. 4 status code 16eCh. 4 status code
13aRecipient’s name
SIMONE DUPONT		 13aRecipient’s name
SIMONE DUPONT		 13aRecipient’s name
SIMONE DUPONT		 13aRecipient’s name
SIMONE DUPONT		 13aRecipient’s name
SIMONE DUPONT		 13aRecipient’s name
SIMONE DUPONT		 13aRecipient’s name
SIMONE DUPONT		 13aRecipient’s name
SIMONE DUPONT		 13aRecipient’s name
SIMONE DUPONT		 13aRecipient’s name
SIMONE DUPONT		 13b Recipient’s country code 13b Recipient’s country code 13b Recipient’s country code 13b Recipient’s country code 13b Recipient’s country code 13b Recipient’s country code 17aState income tax withheld
0		 17aState income tax withheld
0		 17aState income tax withheld
0		 17bPayer’s state tax no. 17bPayer’s state tax no. 17bPayer’s state tax no. 17bPayer’s state tax no. 17cName of state 17cName of state 17cName of state 17cName of state
13cAddress (number and street)
250 CHURCH STREET
13dCity or town, state or province, country, ZIP or foreign postal code
TALLAHASSEE FL 32304

Foreign Student Comprehensive Practice 102

Taxpayer Overview – Part II: Zichen Liu

Our second taxpayer is Zichen Liu.

Use the following information to prepare a Form 1040-NR.

Use the following information to prepare a Form 1040-NR. Zichen Liu, a permanent resident of the People’s Republic of China (Visa number 84920417), came to the United States to study on an F-1 visa on August 1, 2021.

He has remained in the country since then and is a full-time student. Zichen, born 06/01/2002, is single. He began working at the University Bookstore on 09/01/2023. He did not file the proper withholding and treaty forms with the university payroll office. Therefore, he was issued a Form W-2, but we will allow the treaty benefit on his return. Zichen sold some stock he purchased in December 2021, he did not provide a Form W-8BEN to the brokerage company and they issued him a Form 1099-B.

Zichen is a citizen and resident of the People’s Republic of China. If he is entitled to a refund, he wants it mailed to him. He doesn’t want to designate anyone else to discuss this return with the IRS. He did not take any affirmative steps to apply for permanent residency in the United States. He will not be taxed in his home country on the income he has from the United States.

Using the following Form W-2 and Form 1099-B, complete Zichen’s Federal income tax return. (He would also need to file a Form 8843, but assume that he has already completed that on his own.)

Using the following information (Form W-2) and Form 1099-B, complete Zhang’s Federal income tax return. (He would also need to file a Form 8843, but assume that he has already completed that on his own.)

Foreign Student Comprehensive Practice 103

Foreign Student Comprehensive Practice 104

Foreign Student Comprehensive Practice 105

Foreign Student Comprehensive Practice 106

Next, review his documents and complete his Form 1040-NR.

Completing the Return

Form 1040-NR, Total amount from Form(s) W-2, box 1 Line

Question 17: To answer this question, refer to the Form 1040-NR tax return you completed for taxpayer Zichen Liu.

What amount is entered on the Total amount from Form(s) W-2, box 1 line of Form 1040-NR?

a. $0

b. $40

c. $400

d. $4,000

Form 1040-NR, Income Exempt by a Treaty

Question 18: To answer this question, refer to the Form 1040-NR tax return you completed for taxpayer Zichen Liu..

What amount is entered on the Total income exempt by a treaty from Schedule OI (Form 1040-NR), item L, line 1(e)?

a. $300

b. $1000

c. $3,000

d. $4,000

Form 1040-NR, Schedule NEC

Question 19: To answer this question, refer to the Form 1040-NR tax return you completed for taxpayer Zichen Liu..

What is the tax rate for Zichen Liu’s Capital Gain from his stock sale?

a. 0%

b. 10%

c. 15%

d. 30%

Form 1040-NR, Schedule NEC

Question 20: To answer this question, refer to the Form 1040-NR tax return you completed for taxpayer Zichen Liu.

What is the amount of tax on Zichen Liu’s stock sale?

a. $0.00

b. $30

c. $120

d. $300

Foreign Student Comprehensive Practice 107

Summary

You have completed a return for foreign student Zichen Liu and answered questions based on that return.

Foreign Student Comprehensive Practice 108

Foreign Student Comprehensive Practice 109

Foreign Student Comprehensive Practice 110

Foreign Student Comprehensive Practice 111

Foreign Student Comprehensive Practice 112

Taxpayer Overview – Part III: Isla Williams

Completing Form 8843

Our third taxpayer is Isla Williams. Here is basic information about her:

She is a citizen and permanent resident of New Zealand; her address is 21 Greens Road RD 2, Ruawai 0592, New Zealand.

She is in F-1 immigration status and came to the U.S. to study (for the first time) on December 11, 2022. She went home on May 21, 2023, and returned to the U.S. on August 10, 2023.

She is enrolled in the School of Engineering at State College, her advisor is Dr. B. Johns – address and telephone number: State College, 2302 State Ave, Atlanta, GA, 30331, (404) 338-9874

Isla’s Social Security number is XXX-XX-XXXX. Her passport number is 7839267 and it was issued by her home country of New Zealand. She has not taken any steps to apply for permanent residency.

Foreign Student Comprehensive Practice 113

Foreign Student Comprehensive Practice 114

Foreign Student Comprehensive Practice 115

Summary

You have completed Form 8843 for foreign student Isla Williams.

Foreign Student Comprehensive Practice 116

Foreign Student Comprehensive Practice 117

In this lesson, you completed two Forms 1040-NR and one Form 8843 for foreign students. You worked with their wages, scholarships, tax treaty benefits, exemption from Social Security and Medicare taxes, and other issues, and gained information from their approved nonresident alien intake and interview sheets, Form W-2, and Form 1042-S.

EXERCISE Answers

Question 1: B, Simone is a nonresident alien because she is in F-1 immigration status and has been in the U.S. for less than 5 years so she is exempt from the substantial presence test.

Question 2: D, Simone must file a tax return because, as shown on her intake sheet, she is claiming a tax treaty benefit.

Question 3: C, Simone must report the income on Form 1040-NR, U.S. Non resident Alien Income Tax Return, Schedule NEC, Tax on Income Not Effectively Connected With a U.S. Trade or Business.

Question 4: A, Simone is an exempt individual and needs to file the Form 1040-NR.

Question 5: A, Form 8233 allows her employer to avoid withholding federal income tax on her earnings until the applicable treaty benefit amount is exceeded.

Question 6: B, Form 8843 will allow her to exclude the time she spends in the U.S. on her F-1 immigration status from future applications of the substantial presence test.

Question 7: A, Simone is single so she should use the Single filing status.

Question 8: A, Code 16 indicates her scholarship or fellowship grants are covered by tax treaty benefits.

Question 9: B, According to the list of countries with treaty benefits for studying income, the amount of exempt income is $5,000.

Question 10: A, A nonresident alien must report all U.S. source income, even when it is exempt by treaty from U.S. taxes.

Question 11: C, The Total amount from Form(s) W-2, box 1 line lists the $7,225 reported on Simone’s Form W-2.

Question 12: D, Total income exempt by treaty from Schedule OI is $19,500, this amount is also reported on her two Forms 1042-S.

Question 13: A, The only itemized deduction is the $125 of state tax withholding shown on her Form W-2.

Question 14: A, The treaty rate, 0%. Please refer to Publication 4011, Tax Treaties Taxation Rate - Capital Gains (from Sales of U.S. Stocks) for additional information.

Question 15: D, Because Simone holds an F-1 visa, her sources of income are not liable for Social Security and Medicare taxes.

Question 16: A, Simone has overpaid and will receive a refund of $188.

Question 17: A, Line 1a is zero because the amount he earned is less than the treaty benefit allowed. Therefore, the line is left blank.

Question 18: D, $4,000 is excluded by the treaty.

Question 19: D, The People’s Republic of China has a 30% tax rate under treaty article 12.

Question 20: C, The correct amount of his capital gains tax is $120. Zichen capital gains are subject to a 30% tax rate.

Foreign Student Comprehensive Practice 118

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Link & Learn Taxes

is web-based training designed specifically for VITA/TCE volunteers. Each volunteer’s ability to prepare complete and accurate returns is vital to the credibility and integrity of the program. Link & Learn Taxes, as part of the complete volunteer training kit, provides the path to achieving this high level of quality service.

Link & Learn Taxes and Publication 4012, VITA/TCE Volunteer Resource Guide, work together to help volunteers learn and practice.

Link & Learn Taxes for 2024 includes:

• Access to all VITA/TCE courses

• Easy identification of the VITA/TCE courses with the course icons

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As you progress through a lesson, the content for Basic, Advanced, Military, or International will dis play, depending on the level of certification you selected

• PowerPoint presentations that can be customized to fit your classroom needs

• VITA/TCE Central to provide centralized access for training materials and reference links

• The Practice Lab

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Gives volunteers practice with an early version of the IRS-provided tax preparation software

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Lets volunteers complete test practice problems

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Lets volunteers prepare test scenario returns for the test/retest

FSA (Facilitated Self Assistance) empowers taxpayers to prepare their own returns with the assistance of a certified volunteer. Taxpayers complete their own returns using interview-based software supplied by leaders in the tax preparation industry. Volunteers assist taxpayers with tax law questions.

Virtual VITA/TCE model includes any site where face-to-face activities are not used during the tax preparation process. That is, the intake specialist, IRS-tax law certified preparer (who prepares the return) and/or the quality reviewer are not face-to-face with the taxpayer. By incorporating this flexibility partners can provide taxpayers with more convenient locations to file their taxes.

For more information contact your SPEC Relationship Manager to see if you should start a FSA or Virtual VITA site in your community.

Your online resource for volunteer and taxpayer assistance

Partner and Volunteer Resource Center www.irs.gov/Individuals/Partner-and-Volunteer-Resource-Center

• What’s Hot!

• Site Coordinator’s Corner

Quality and Tax Alerts for IRS Volunteer Programs www.irs.gov/individuals/quality-and-tax-alerts-for-irs-volunteer-programs

• Volunteer Tax Alerts Volunteer Training Resources www.irs.gov/Individuals/Volunteer-Training-Resources

Outreach Connection www.irs.gov/Individuals/Outreach-Corner

Interactive Tax Assistant (ITA) www.irs.gov/help/ita

Online Services and Tax Information for Individuals www.irs.gov/Individuals

• Document upload tool

• Your account

• IRS Free File

• Where’s My Refund

• Pay Directly From Your Bank Account

• Get Your Tax Records

• Identity Protection Pin (IP PIN)

• Tax Withholding Estimator

• Taxpayer Assistance Center Locator

eBooks Want to view our training products on your mobile or tablet devices? Click here to access our eBooks: www.irs.gov/individuals/site-coordinator-corner

Mobile App Another device to use for additional information is IRS2Go. Click here to download IRS2Go mobile app: www.irs.gov/newsroom/irs2goapp.

and much more!

Your direct link to tax information 24/7: www.irs.gov

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