ALIEN INFORMATION REQUEST
FORM INSTRUCTIONS

1. Name - Enter the name using the format of Last or Surname, First or Given Name, Middle Name or Initial
2. Country of Citizenship - Enter the Country of Citizenship
3. PSU ID - Enter the nine digit PSU ID #
4. PSU Employment Position - Enter the employment position title
5. Email Address - Enter the PSU email address of the individual
6. College or department where employed - Enter the name of the college or department where employed
7. Social Security Number - Enter the Social Security number of the individual, or Applied For, or Will Apply For. As an employee you are required under law to provide PSU with a United States Social Security Number
8. Local Resident Street Address - Enter your local residence street address
9. Local Resident City - Enter your local residence city, state, and zip code portion of the address
10. Permanent Foreign Residence Street Address - Enter your permanent residence street address
11. Permanent Foreign Residence City - Enter your permanent residence city, country, and postal code portion of the address
12. Current Visa Type/Class - Check one of the following seven (7) visa options:
1. Permanent Resident/Immigrant (go directly to Part III)
2. F-1 Student
3. J-1 Exchange Student (Provide DS2019)
4. J-1 Exchange Visitor (not student visa) (Provide DS2019)
5. J-2, H-4, or G-4 Spouse/Dependent of Exchange visitor/student (attach copy of employment authorization card - EAD Card)
6. H- 1B Temporary employee of distinguished merit and/or ability
7. DACA - Provide copy of documents and/or EAD card (copy)(go directly to Part III)
8. Other - please specify in the next section of form
13. Current I-94 - Reading your most recent I-94 document or Homeland Security I-94 Visa Stamp in your passport, select the most recent date of entry or Valid From date
14. Data collection table - Data collected in Section C determines your USA tax residency status (NRA (Non-Resident Alien) or RA (Resident Alien) for Part III. List all USA entries and departures beginning with your very first entry into the USA on the first line of the table. Write the visa/travel type beside each date. If applicable, include all 797 Notice of Change I-94 dates and visa/class. The table consists of three columns and 5 rows. Use page 2 of this form to record additional information
1. Column 1 - Date entered USA
2. Column 2 - Date department USA
3. Column 3 - Visa Class/Travel Document Type
15. Residency Status - Select one of the three resident status options:
1. I am a PERMANENT RESIDENT of the United Stated under U.S. Immigration Laws. Please ATTACH (upload into WorkLion or mail (DO NOT email)) a copy of your I-94 document along with a completed, signed, and dated IRS Form W-9 (page 1 only)
2. I am a RESIDENT of the United States FOR TAX PURPOSES. I have met the Substantial Presence Test for residency. ATTACH (upload into WorkLion or mail (DO NOT email)) a copy of your I-94 document along with a completed, signed, and dated IRS Form W-9. For DACA - attach copy of EAD card along with a completed, signed, and dated IRS Form W-9 (page 1 only)
3. I am a NON-RESIDENT of the United States FOR TAX PURPOSES. I have NOT met the Substantial Presence Test for residency. ATTACH (upload into WorkLion or mail (DO NOT email)) a copy of your I-94 document
16. To claim exemptions form U.S. federal income tax, please complete the IRS 8233 form and the appropriate Revenue Procedure form (87-8 for students and trainees or 87-9 for teachers and researchers). Upload into WorkLion or mail (DO NOT email)). These documents must be submitted each tax year to receive exemption
17. Signature - A digital ID can now be used to sign the document. See the instruction for completing the digital ID process on the Alien Information Request Form instructions
18. Date - Enter the date the form was signed
19. For PAYROLL USE Only - Do not write in this section



Page 2 (if needed)

20. Enter your name exactly as it appears on Page 1
21. Enter your PSU ID #
22. Continue entering dates of entry, departure, and Class of admission/travel type. The dates of entry must appear in order of oldest (first) to newest (current)

Upload the all required documents into WorkLion using the instructions on the Foreign National employee Information page on the Payroll website. Original hard-copy of the required forms may be mailed to Payroll Office, 101 James M. Elliott Building, 120 S. Burrowes Street, State College, PA 16801

NOTE: The Alien Information Request Form and the other required documents contain personally-identifiable information (PII). DO NOT send as an attachment to an email. Uploading the documents into WorkLion is safe and secure.