Form W-8BEN Information

Form W-8BEN will remain in effect until a change in circumstances makes any information on the form incorrect (address, resident status, etc.).  A social security number is required on the form.  Without a valid W-8BEN form on file, federal tax will be withheld.

Tips when completing Form W-8BEN

Line 1: Enter your LAST name, then FIRST name.

Line 2: Leave blank.

Line 3: Check the “Individual” box.

Line 4: Enter your permanent residence address. Generally, this would be your address in your home country or in the country where you filed income taxes before entering the USA.. This CANNOT be an address in the United States.

Line 5: Enter your current address. This MUST be an address in the USA.

Line 6: Enter your social security number and check the box for SSN.

Line 7: Leave blank.

Line 8: Leave blank.

Line 9: 9a: Check the box and enter your country of residence.

   9b: Leave blank
   9c: Leave blank
   9d: Leave blank
   9e: Leave blank


Line 10: This must be completed.

1. Enter tax treaty article under which exemption can be claimed
2. Enter % rate of withholding which would be 0%.
3. Enter type of income. Examples would be “Fellowship Stipend” or “Scholarship Stipend”
4. Explain reason why you meet the terms of the agreement. Acceptable answers include “full-time student at Michigan Technological University who was a permanent resident of (your country) before coming to the United States” or “Researcher at Michigan Technological University who was a permanent resident of (your country) before coming to the United States.

Line 11: Leave blank.

Part IV: Be sure to sign and date.

Form W-8BEN:  http://www.irs.gov/pub/irs-pdf/fw8ben.pdf
Instructions to Form W-8BEN:  http://www.irs.gov/pub/irs-pdf/iw8ben.pdf

If you need assistance, please call or e-mail the contact below with any questions or to set up an appointment.

        Sara Marcotte, Accountant
        487-2449
        sjmarcot@mtu.edu