All applicable questions must be answered.
TAX: If you wish to claim exemption from US income taxes because of your country of permanent residence has a tax treaty with the United States, you must complete IRS form 8233 and the appropriate revenue procedure. (Available through Payroll.)
INSURANCE: I understand that I am responsible for obtaining health insurance for myself and my dependents.
I hereby certify under the penalties of perjury that all the above information is true and correct. I understand that if my status changes from that which I have indicated on this form, I must submit a new International Student & Scholar Information Request Form to the Office for International Students & Scholars.