Revenue Procedure 87-8
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For Students or Trainees claiming exemption under Article 20(1) of the Income
Tax Treaty Between the United States and Lithuania.
Social Security Number:
I was a resident of Lithuania on the date of my arrival in the Unites States. I am not a
United States citizen. I have not been lawfully accorded the privilege of residing
permanently in the United States as an immigrant.
I am temporarily present in the United States for the primary
purpose of studying or securing training required to qualify me to practice a
profession or professional specialty at Buffalo State.
I will receive compensation for
personal services performed in the United States. This compensation
qualifies for exemption from withholding of federal tax under the tax treaty
between the United States and Lithuania in an amount not in
excess of $5,000
for any taxable year.
I have not previously claimed an income tax exemption under this treaty for income received as a
student, trainee, researcher, or teacher before the date of my arrival in the
United States without first returning to and resuming residence and physical
presence before returning to the United States as a student, trainee,
researcher, or teacher.
I arrived in the United States
(date of arrival). The treaty exemption is
available only for compensation received during a period of five (5) taxable years beginning with the
taxable year that includes my arrival date, and for such period of time as is
necessary to complete, as a full-time student, educational requirements as a
candidate for a post-graduate or professional degree from a recognized
I certify that the information I have provided
above is true, correct and complete and that the above statements apply to me.