Note: Form 8233 begins on the next page.

A new EFax number is available to file Form 8233.

A new EFax number 877-824-9781 is available to file Form 8233 within the 

United States. Fax number 267-466-1365 (not toll free) listed in the Instructions 

for Form 8233 (Rev. October 2016) under Part IV, Withholding Agent's 

Responsibilities, can still be used by domestic and international filers.
Form 8233

(Rev. March 2009)

Department of the Treasury 

Internal Revenue Service 

Exemption From Withholding on Compensation 

for Independent (and Certain Dependent) Personal 

Services of a Nonresident Alien Individual 

▶ See separate instructions.

OMB No. 1545-0795

Who Should 

Use This Form? 

Note: For 

definitions of terms 

used in this section 

and detailed 

instructions on 

required 

withholding forms 

for each type of 

income, see 

Definitions on 

pages 1 and 2 of 

the instructions. 

IF you are a nonresident alien individual who is 

receiving . . . 

THEN, if you are the beneficial owner of that 

income, use this form to claim . . . 

Compensation for independent personal 

services performed in the United States 

A tax treaty withholding exemption 

(Independent personal services, Business 

profits) for part or all of that compensation 

and/or to claim the daily personal exemption 

amount. 

Compensation for dependent personal 

services performed in the United States 

A tax treaty withholding exemption for part or 

all of that compensation. 

Note: Do not use Form 8233 to claim the daily 

personal exemption amount. 

Noncompensatory scholarship or fellowship 

income and personal services income from 

the same withholding agent 

A tax treaty withholding exemption for part or 

all of both types of income. 

DO NOT Use 

This Form. . . 

IF you are a beneficial owner who is . . . INSTEAD, use . . . 

Receiving compensation for dependent 

personal services performed in the United 

States and you are not claiming a tax treaty 

withholding exemption for that compensation 

Form W-4 (See page 2 of the Instructions 

for Form 8233 for how to complete Form 

W-4.) 

Receiving noncompensatory scholarship or 

fellowship income and you are not receiving 

any personal services income from the same 

withholding agent 

Form W-8BEN or, if elected by the 

withholding agent, Form W-4 for the 

noncompensatory scholarship or 

fellowship income 

Claiming only foreign status or treaty benefits 

with respect to income that is not 

compensation for personal services 

Form W-8BEN 

This exemption is applicable for compensation for calendar year , or other tax year beginning 

and ending . 

Part I Identification of Beneficial Owner (See instructions.) 

1 Name of individual who is the beneficial owner 2 U.S. taxpayer identifying number 3 Foreign tax identifying number, if any (optional) 

4 Permanent residence address (street, apt. or suite no., or rural route). Do not use a P.O. box. 

City or town, state or province. Include postal code where appropriate. Country (do not abbreviate) 

5 Address in the United States (street, apt. or suite no., or rural route). Do not use a P.O. box. 

City or town, state, and ZIP code 

Note: Citizens of Canada or Mexico are not required to complete lines 7a and 7b. 

6 U.S. visa type 7a Country issuing passport 7b Passport number 

8 Date of entry into the United States 9a Current nonimmigrant status 9b Date your current nonimmigrant status expires 

10 If you are a foreign student, trainee, professor/teacher, or researcher, check this box . . . . . . . . . . . . . . . . ▶

Caution: See the line 10 instructions for the required additional statement you must attach. 

For Privacy Act and Paperwork Reduction Act Notice, see separate instructions. Cat. No. 62292K Form 8233 (Rev. 3-2009) 
Form 8233 (Rev. 3-2009) Page 2 

Part II Claim for Tax Treaty Withholding Exemption and/or Personal Exemption Amount 

11 Compensation for independent (and certain dependent) personal services: 

a Description of personal services you are providing 

b Total compensation you expect to be paid for these services in this calendar or tax year $ 

12 If compensation is exempt from withholding based on a tax treaty benefit, provide: 

a Tax treaty and treaty article on which you are basing exemption from withholding 

b Total compensation listed on line 11b above that is exempt from tax under this treaty $ 

c Country of permanent residence 

Note: Do not complete lines 13a through 13c unless you also received compensation for personal services from the same 

withholding agent. 

13 Noncompensatory scholarship or fellowship income: 

a Amount $ 

b Tax treaty and treaty article on which you are basing exemption from withholding 

c Total income listed on line 13a above that is exempt from tax under this treaty $ 

14 Sufficient facts to justify the exemption from withholding claimed on line 12 and/or line 13 (see instructions) 

Note: Lines 15 through 18 are to be completed only for certain independent personal services (see instructions). 

15 Number of personal exemptions 

claimed ▶

16 How many days will you perform services in 

the United States during this tax year? ▶

17 Daily personal exemption amount claimed (see instructions) ▶

18 Total personal exemption amount claimed. Multiply line 16 by line 17 ▶

Part III Certification 

Under penalties of perjury, I declare that I have examined the information on this form and to the best of my knowledge and belief it is true, 

correct, and complete. I further certify under penalties of perjury that: 

• I am the beneficial owner (or am authorized to sign for the beneficial owner) of all the income to which this form relates. 

• The beneficial owner is not a U.S. person. 

• The beneficial owner is a resident of the treaty country listed on line 12a and/or 13b above within the meaning of the income tax treaty 

between the United States and that country. 

Furthermore, I authorize this form to be provided to any withholding agent that has control, receipt, or custody of the income of which I am the 

beneficial owner or any withholding agent that can disburse or make payments of the income of which I am the beneficial owner. 

Sign Here Signature of beneficial owner (or individual authorized to sign for beneficial owner) Date 

Part IV Withholding Agent Acceptance and Certification 

Name Employer identification number 

Address (number and street) (Include apt. or suite no. or P.O. box, if applicable.) 

City, state, and ZIP code Telephone number 

Under penalties of perjury, I certify that I have examined this form and any accompanying statements, that I am satisfied that an exemption from 

withholding is warranted, and that I do not know or have reason to know that the nonresident alien individual is not entitled to the exemption or 

that the nonresident alien’s eligibility for the exemption cannot be readily determined. 

Signature of withholding agent ▶ Date ▶

Form 8233 (Rev. 3-2009) 

▶