Summary: ATTACHMENT TO FORM 8233
(For use by students of Tunisia who are claiming Tax Treaty exemption).
1. I was a resident of Tunisia on the date of my arrival in the United 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.
2. I am temporarily in the United States for the primary purpose of studying at The
University of Michigan.
3. I will receive compensation for personal services performed in the United States. This
compensation qualifies for exemption from withholding of Federal Income Tax under the
tax treaty between the United States and Germany in an amount not in excess of $4000
for any taxable year. I have not previously claimed an income tax exemption under this
treaty for income received as a student before the date of my arrival in the United States.
4. I arrived in the United States on ____________________ (date of last arrival in the
U.S. prior to beginning study at The University of Michigan). The treaty exemption is
available only for compensation paid during a period of four taxable years, beginning with
the taxable year that includes my arrival date.
Under penalties of perjury, I declare that the above statements are true, correct, and complete.
Soc. Sec. #_______________________Date:________________________________