Foreign National Information Form
BOTH SIDES of the Foreign National Information Form must be completed before you can receive any form of payment. All applicable questions below must be answered. A copy of both sides of your I-94 Form "Arrival and Departure Record", (a small white card inside your passport), copy of your U.S. VISA from your passport, and 1-20 or IAP66 must be attached to this form. This form must be returned before any check can be issued by the Payroll Office and must also be completed by anyone receiving tuition remission/scholarship.  If you do not yet have a Social Security number please attach receipt of the application for the social security number.
  (1)Last or family name:   First: Middle:
  (2)Social security #:   (3)WHOI ID #:
  (4)U.S. local street address:   (5)Foreign residence:
  (4)Address line 2:   (5)Address line 2:
  (4)Address line 3:   (5)Address line 3/City:
  (4)City:   (5)Postal code: Province/Region:
  (4)State: Zip:   (5)Foreign country:
  (6)Country of citizenship:   (7)Country that issued passport:
  (8)Passport #:   (9)Visa #:
  (not the control number that begins with a year)
  Please Provide a Non WHOI Email Address: 
 
  (10)Have you ever had another immigration status in the United States? Yes No  If yes, see page 2.
  (11)Immigration status: (check one)
 
U.S.Immigrant/Permanent Resident F-1 Student J-2 Spouse or Child of Exchange Visitor
J-1 Exchange Visitor H-1 Temporary Employee
Other:
  (12)If immigration status is J-1, what is the subtype? (check one)
 
01 Student 05 Professor 12 Research Scholar
02 Short Term Scholar Other:
  (13)What is the actual primary activity of the visit? (check one)
 
01 Studying in a Degree Program 05 Observing 09 Demonstrating Special Skills
02 Studying in a Non-Degree Program 06 Consulting 10 Clinical Activities
03 Teaching 07 Conducting Research 11 Temporary Employee
04 Lecturing 08 Training 12 Here with Spouse
  (14)What is the actual date you entered the United States? (Month/Day/Year) 
  (15)What is the start date of your immigration status for this primary activity? (Month/Day/Year) 
  (16)What is the end date of your immigration status primary activity? (Month/Day/Year) 
  (17)Income providing activity? (e.g. Visiting Investigator) 
  (18)What type of student? (check one)
 
Undergraduate Masters Doctoral Other:
  (19)Spouse in USA? Yes No    Number of dependents :
  (20)For consultants/self employeed individuals:
  Do you/will you have an office (fixed base) in the USA? Yes No
  If yes, how many days in this tax year did you/will you have office(fixed basis)?   Days
  (21)Counry of residence if different from foreign residence address :
  Did tax residency end? Yes No    If yes, when (Month/Day/Year) :
  Please list any VISA immigration activity in the last three calendar years and all F,J,M or Q VISAS since 1/1/85:
 
Date of Entry Date of Exit Visa Immigration Status J-1 Subtype Primary Activity Have You Taken Any Treaty Benefits
Yes No
Yes No
Yes No
Yes No
Yes No
 
How to Complete the foreign national Information form:
1. Name: List full name.
2. Social Security Number: Enter US social security number issued by the US Social Security Administration not your ID number. Do not list numbers not assigned by the United States Social Security, i.e. Canadian social security number. All employees must have a social security number in order to work. If none enter your ITIN issued by the IRS.
3. ID#: Enter your Employee/Student Identification Number.
4. Local Street Address: List your local US address.
5. Residence: List your non US address.
6. Country of Citizenship(s)
7. Country that Issued Passport: List Country in which you were issued your passport. Not the country where it was issued.
8. Passport #: Enter your passport number.
9. Visa #: Enter your Visa number.
10. Immigration Status: Check yes or no. If yes, complete the above VISA immigration activity section for the time you were present in the United States. Approximate if you do not know.
11. Immigration Status: Check the type of immigration status that you currently hold. If you check U.S. Immigrant/Permanent Resident, holder of a "green" card, you may proceed to the bottom of the form. Sign and date.
12. Immigration Status for J-1: Check the appropriate J-1 subtype.
13. Actual Primary Activity: Check one activity.
14. Actual Entry Date into the United States: Must include month, day, and year. Approximate if you do not know.
15. Start Date: Must include month, day, and year. Approximate if you do not know.
16. End Date: Must include month, day, and year. Approximate if you do not know.
17. Occupation: Describe in general the service you will perform.
18. Check the appropriate box.
19. Is your spouse in USA?: Check the appropriate box. Give number of other dependents in the USA?
20. Consultants/Self-employed Individuals: Check the appropriate box. This includes any office at any location specifically identified with you.
21. Tax residence is where you last paid taxes as a resident and can be different from legal residence. Do not include the USA.
May be reproduced with permission.