Personal Tax Summary GENERAL INFO First Name Olena Last Name Tanchyk Country of Ukraine Passport/Citizenship Current Immigrant Status J1 - Student Your SSN/ITIN N/A Applied for SSN/ITIN Yes Entity / affiliate Institute of Foreign Taxpayer ID 3195603923 International Education Sevis ID N0032222875 RESIDENCY INFORMATION US tax residency status Non-resident Date First in USA 03/09/2019 First day in USA on J1 - Student 08/10/2021 Last day in USA on J1 - Student 06/22/2022 SPT results Substantial Presence Test not met Residency starting date N/A Immigration status change date 03/09/2019 Degree candidate No OPT/CPT participant No Primary Purpose of Visit Student Occupation at University (Institution) Student Tax Residence Ukraine FICA tax Exempt FICA tax exemption finishes 06/22/2022 FUTA tax Exempt FUTA tax exemption N/A finishes TAX TREATY AND INCOME TAX DETAILS Full-time Student Yes PERSONAL AND CONTACT DETAILS Date of Birth 06/29/1987 Marital Status Single/Married Nonresident Alien Day Phone (480) 791-5892 Email Address [email protected] SUPPORTING DOCUMENTS (COPIES) Visa J1 - Student copy Passport copy, only pages with stamps and ID page DS-2019 copy I confirm that the following information is correct and up to date Name: Olena Tanchyk Signature: Date: 02/17/2022
