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---
type: immigration-document
category: employment
person: Xuewei Jiang
date: 2020
provider: University of Southern California
source: jiang_ead_2020.pdf
---
# Employment Authorization Document (EAD) -- Jiang Xuewei
## Front Side
**UNITED STATES OF AMERICA -- EMPLOYMENT AUTHORIZATION**
| Field | Value |
|-------|-------|
| Surname | JIANG |
| Given Name | XUEWEI |
| USCIS # | 116-564-749 |
| Country of Birth | China, People's Republic |
| Category | C03B |
| Card # | C03B YSC2090171865 |
| Terms and Conditions | Post-Completion Opt |
| Date of Birth | 13 MAR 1993 |
| Sex | F |
| Valid From | 06/01/20 |
| Card Expires | 05/31/21 |
| NOT VALID FOR REENTRY TO U.S. | (printed on card) |
Note: "fingerprint not available" indicator present on card.
Photo: Female, front-facing.
## Back Side
| Field | Value |
|-------|-------|
| FORM I-766 | Rev (02-2016) |
| Card Number | 36576677 |
| Rev | 121 |
### Machine Readable Zone (MRZ)
```
IAUSA1165647493YSC2090171865<<3
JIANG<<XUEWEI<<<<<<<<<<<<<<<<<<
9303139F2105312CHN<<<<<<<<<<<<<<
```
If found, drop in any US Mailbox. USPS: Mail to USCIS, 7 Product Way, Lees Summit, MO 64002
This card is not evidence of U.S. citizenship or permanent residence, and may be revoked by the U.S. Government. The person identified is authorized to work in the U.S. for the validity of this card.
Photo: Female, smaller holographic image on back.

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---
type: tax-form
category: employment
person: Xuewei Jiang
date: 2020-05-29
provider: University of Southern California
source: jiang_glacier_tax_docs_2020.pdf
---
# GLACIER Tax Summary Report and Instructions -- Jiang Xuewei
## Page 1: Tax Summary Report (Signed)
**GLACIER -- Nonresident Alien Tax Compliance System**
Header: HOLD 4
### Summary of Information Entered Into GLACIER
| Field | Value |
|-------|-------|
| Name | Xuewei Jiang |
| SSN / ITIN | 092-99-3215 |
| Email Address | xueweijiang0313@gmail.com |
| Country of Tax Residence | China, People's Republic of |
| Country of Citizenship | China, People's Republic of |
| Current Immigration Status | F1 Student |
| Original Immigration Status | (blank) |
| Immigration Status Expiration | May 31, 2021 |
| Department Name | Marshall School of Business |
| USC ID Number | 8872791406 |
| Field | Value |
|-------|-------|
| Changed Immigration Status? | No |
| Immigration Status Change Date | (blank) |
| Date of Entry to U.S. | August 11, 2011 |
| Estimated Date of Departure | May 31, 2021 |
#### U.S. Presence Days
| Year | Days |
|------|------|
| 2015 | 297 Days |
| 2014 | 303 Days |
| 2013 | 332 Days |
| 2012 | 284 Days |
| 2011 | 143 Days |
### Tax Determinations and Results
Based on the data entered, GLACIER has made the following determinations:
| Field | Value |
|-------|-------|
| Tax Residency Status | Resident Alien for U.S. Tax Purposes |
| Residency Status Change Date | Not Applicable |
| Residency Status Start Date | Not Applicable |
### Compensation/Wages/Salary
| Field | Value |
|-------|-------|
| Applicable Tax Withholding Rate | As Requested on Form W-4 |
| Tax Treaty Exemption Status | Taxable |
| Tax Treaty Time Limit | Not Applicable |
| Tax Treaty Exemption Period | Not Applicable |
| Tax Treaty Dollar Limit | Not Applicable |
**TAX** (watermark/stamp)
| Field | Value |
|-------|-------|
| FICA Tax Status | Taxable (*Exempt if Student) |
| FICA Tax Start Date | (blank) |
### Required Forms and Document Copies
Attach the following Forms and Documents to the Tax Summary Report:
**Required Forms** (Please print, sign and submit with Tax Summary Report):
- Form W-4
**Required Document Copies** (Please copy and submit with Tax Summary Report):
- Form I-20
- Form I-94/I-94W Card
- Visa Sticker/Stamp (in Passport)
### Certification
I hereby declare that the information provided by me to The University of Southern California and/or entered into the GLACIER Online Tax Compliance System for purposes of making the tax determinations above is true and correct. If any of the information provided changes or if other relevant information becomes available, I will notify The University of Southern California as soon as possible so that this information and/or my U.S. tax status may be updated.
| Field | Value |
|-------|-------|
| Signature | (signed) |
| Date | 05/29/2020 |
052920
The information contained on this statement was generated using **GLACIER** Online Tax Compliance System.
(c) Copyright Arctic International LLC. All rights reserved.
---
## Page 2: Tax Summary Report Instructions
**GLACIER -- Nonresident Alien Tax Compliance System**
### Tax Summary Report Instructions
**Congratulations -- You Have Completed Your Individual Record in GLACIER!**
**You are almost finished . . .**
- Review, sign and date each of the Required Forms (see list on previous page);
- Submit the Required Forms and a copy of each of the Required Documents (see list on previous page) following the instructions below.
**Please submit all Required Forms and Document Copies to:**
Your HR Payroll Analyst
Or Your Supervisor
The University of Southern California
Your School or Department
Los Angeles, CA 90089
Telephone: 213-740-8855
payroll@usc.edu
**All Required Forms and Document Copies must be submitted within 5 days; failure to submit all Required Forms and Document Copies on time may result in tax withheld from payments made to you.**
If any information in your Individual Record changes, you must access GLACIER and update your Individual Record as soon as possible.
If you have any questions, please contact the GLACIER Administrator listed above.
Thank you for your prompt attention to this matter.
### Additional Information, if any
Based on the information entered, you are a Resident Alien for Tax Purposes. As such, you may have tax withheld from your payments in the same manner as a U.S. citizen. You must print and complete the blank Form W-4 provided to you by GLACIER and submit the form with your Tax Summary Report to your GLACIER Institution Administrator or Payroll Department.
The information contained on this statement was generated using **GLACIER** Online Tax Compliance System.
(c) Copyright Arctic International LLC. All rights reserved.
---
## Page 3: Blank Form W-4 (2020)
Form W-4 (2020) -- Employee's Withholding Certificate
Department of the Treasury, Internal Revenue Service
OMB No. 1545-0074
(This is a blank/unfilled copy of the W-4 form provided by GLACIER for completion.)
### Step 1: Enter Personal Information
- (a) First name and middle initial / Last name
- (b) Social security number
- Address / City or town, state, and ZIP code
- (c) Filing status: Single or Married filing separately / Married filing jointly / Head of household
### Step 2: Multiple Jobs or Spouse Works
Instructions for completing if applicable, with options (a), (b), (c).
### Step 3: Claim Dependents
- Qualifying children under age 17 x $2,000
- Other dependents x $500
- Total (line 3): $ (blank)
### Step 4 (optional): Other Adjustments
- 4(a) Other income: $ (blank)
- 4(b) Deductions: $ (blank)
- 4(c) Extra withholding: $ (blank)
### Step 5: Sign Here
- Employee's signature / Date
- Employers Only: Employer's name and address / First date of employment / Employer identification number (EIN)
Cat. No. 10220Q, Form W-4 (2020)
---
## Page 4: U.S. Tax Information for Non-United States Citizens/Non-U.S. Permanent Resident Aliens
**For Information Only -- DO NOT SUBMIT THIS PAGE WITH YOUR FORMS -- Keep This Document For Your Files**
**ARCTIC INTERNATIONAL LLC -- International Tax Consulting**
### Why Am I Required to Provide Information in GLACIER?
The Internal Revenue Service ("IRS"), the U.S. government tax authority, has issued strict regulations regarding the taxation and reporting of payments made to non-United States citizens. As a result, payments made to you may be subject to U.S. income tax and reporting.
### Why Is My Tax Status Important?
In order to comply with the U.S. tax laws, your U.S. Tax Residency Status must be determined. The Substantial Presence Test is used to determine whether an individual is a Nonresident Alien or Resident Alien for purposes of U.S. tax withholding. GLACIER will calculate your U.S. Residency Status for Tax Purposes based on the information provided by you.
### What is the Difference between a Nonresident Alien and Resident Alien?
If you are a Nonresident Alien for Tax Purposes, you are subject to special tax withholding and reporting regulations; if you are a Resident Alien for Tax Purposes, you are taxed in the same manner as a U.S. Citizen.
### How Long Will I Be a Nonresident Alien?
Your Residency Status Change Date is the day on which your U.S. Residency Status for Tax Purposes will change, generally from Nonresident Alien for Tax Purposes to Resident Alien for Tax Purposes. The U.S. tax system is based on a calendar year period (January 1 -- December 31). In most cases, when your U.S. Residency Status for Tax Purposes changes, you will become a Resident Alien for Tax Purposes retroactive to the first day of the calendar year during which your status changed; this day is called the Residency Status Start Date.
### How Will I Be Taxed on Payments From U.S. Sources?
As a Nonresident Alien for Tax Purposes, U.S. tax law requires that you be taxed in the following manner:
- If you receive Dependent Compensation (salary or wages), you are generally required to complete Form W-4 as "Single" (regardless of your actual marital status) and "One" Personal Withholding Allowance (regardless of your actual number of dependents). Certain countries may have an exception to this requirement.
- If you receive a Scholarship or Fellowship (for which NO services are required), your scholarship or fellowship may consist of Nontaxable items (Tuition, Book Allowance, Required Registration Fees, and Mandatory Health Insurance) or Taxable items (including, but are not limited to, Room and Board, Stipend, Living Allowance, Travel Payment/Reimbursement). If you are present in the U.S. under an F, J, M, or Q immigration status, the applicable rate of tax withholding is 14 percent; if you are present in the U.S. under any other immigration status, the applicable rate of tax withholding is 30 percent.
- If you receive an Honorarium, Guest Speaker Fee, Consultant Fees, Royalty, or any other type of income, the applicable rate of tax withholding is 30 percent.
### Can I Be Exempt From Tax Withholding?
The U.S. maintains income tax treaties with approximately 68 countries. Certain taxable payments made to you may be exempt from U.S. tax based on an income tax treaty entered into between the U.S. and your country of tax residence. The existence of a tax treaty does not automatically ensure an exemption from tax withholding; rather, you must satisfy the requirements for the exemption set forth in the tax treaty and provide all applicable forms and documents to the Institution Administrator. If you qualify for a tax treaty exemption, you must complete and submit Form W-8BEN (for all non-service scholarships and fellowships, or royalty payments) and/or Form 8233 (for all compensation or payments for services).
### What If I Do Not Submit My Forms and Documents?
If you do not complete the information in GLACIER and/or submit the required forms and documents in a timely fashion, the maximum amount of tax will be withheld from all payments made to you. To find out where to submit your forms, please refer to the instruction page that printed with your forms and you will find the name of the person and the address; please DO NOT send your forms to the GLACIER Support Center.
### Where Can I Get More Information?
If you have additional questions, please contact the GLACIER Administrator at your institution. If you do not know who is your institution's GLACIER Administrator, please contact the person at your institution who asked you to complete GLACIER. Please note that the GLACIER Administrator for your institution is NOT located at the GLACIER Support Center.
(c) 2015 Arctic International LLC All Rights Reserved. For use in connection with the GLACIER Online Tax Compliance System.

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---
type: immigration-document
category: employment
person: Xuewei Jiang
date: 2020-03-11
provider: University of Southern California
source: jiang_i20_2020.pdf
---
# I-20, Certificate of Eligibility for Nonimmigrant Student Status -- Jiang Xuewei
Department of Homeland Security
U.S. Immigration and Customs Enforcement
OMB NO. 1653-0038
## Page 1
**SEVIS ID: N0008342296**
| Field | Value |
|-------|-------|
| Surname/Primary Name | JIANG |
| Given Name | XUEWEI |
| Preferred Name | XUEWEI JIANG |
| Passport Name | (blank) |
| Country of Birth | CHINA |
| Country of Citizenship | CHINA |
| City of Birth | JINAN |
| Date of Birth | 13 MARCH 1993 |
| Form Issue Reason | CONTINUED ATTENDANCE |
| Admission Number | 490459797A2 |
| Class of Admission | **F-1** ACADEMIC AND LANGUAGE |
### School Information
| Field | Value |
|-------|-------|
| School Name | University of Texas at Austin |
| School Address | ISSS, International Office, P.O. Box A, Austin, TX 78713 |
| School Official to Contact Upon Arrival | Andrew Jacob, International Student Advisor |
| School Code and Approval Date | SNA214F00332000, 25 JANUARY 2003 |
### Program of Study
| Field | Value |
|-------|-------|
| Education Level | DOCTORATE |
| Major 1 | Financial Mathematics 27.0305 |
| Major 2 | None 00.0000 |
| Program English Proficiency | Required |
| English Proficiency Notes | Student is proficient |
| Earliest Admission Date | (blank) |
| Start of Classes | 13 AUGUST 2015 |
| Program Start/End Date | 13 AUGUST 2015 -- 23 MAY 2020 |
### Financials
**Estimated Average Costs For: 9 Months**
| Item | Amount |
|------|--------|
| Tuition and Fees | $ 9,500 |
| Living Expenses | $ 17,000 |
| Expenses of Dependents (0) | $ (blank) |
| Other | $ (blank) |
| **TOTAL** | **$ 26,500** |
**Student's Funding For: 9 Months**
| Source | Amount |
|--------|--------|
| Personal Funds | $ 0 |
| Fellowship/TA | $ 26,500 |
| Funds From Another Source | $ (blank) |
| On-Campus Employment | $ (blank) |
| **TOTAL** | **$ 26,500** |
### Remarks
(blank)
### School Attestation
I certify under penalty of perjury that all information provided above was entered before I signed this form and is true and correct. I executed this form in the United States after review and evaluation in the United States by me or other officials of the school of the student's application, transcripts, or other records of courses taken and proof of financial responsibility, which were received at the school prior to the execution of this form. The school has determined that the above named student's qualifications meet all standards for admission to the school and he/she student will be required to pursue a full program of study as defined by 8 CFR 214.2(f)(6). I am a designated school official of the above named school and am authorized to issue this form.
| Field | Value |
|-------|-------|
| Signature of | Andrew Jacob, International Student Advisor |
| Date Issued | 11 March 2020 |
| Place Issued | Austin, TX |
### Student Attestation
I have read and agreed to comply with the terms and conditions of my admission and those of any extension of stay. I certify that all information provided on this form refers specifically to me and is true and correct to the best of my knowledge. I certify that I seek to enter or remain in the United States temporarily, and solely for the purpose of pursuing a full program of study at the school named above. I also authorize the named school to release any information from my records needed by DHS pursuant to 8 CFR 214.3(g) to determine my nonimmigrant status. Parent or guardian, and student, must sign if student is under 18.
| Field | Value |
|-------|-------|
| Signature of | XUEWEI JIANG |
| Date | 03/11/2020 |
ICE Form I-20 (04/30/2021) -- Page 1 of 3
---
## Page 2: Employment Authorizations
**SEVIS ID: N0008342296 (F-1)**
**NAME: XUEWEI JIANG**
### Employment Authorizations
| Type | Full/Part-Time | Status | Start Date | End Date |
|------|---------------|--------|------------|----------|
| POST-COMPLETION OPT | FULL TIME | REQUESTED | 01 JUNE 2020 | 31 MAY 2021 |
### Change of Status/Cap-Gap Extension
(blank)
### Authorized Reduced Course Load
(blank)
### Current Session Dates
| Field | Value |
|-------|-------|
| Current Session Start Date | 21 JANUARY 2020 |
| Current Session End Date | 23 MAY 2020 |
### Travel Endorsement
This page, when properly endorsed, may be used for re-entry of the student to attend the same school after a temporary absence from the United States. Each endorsement is valid for one year.
| Designated School Official | Title | Signature | Date Issued | Place Issued |
|---------------------------|-------|-----------|-------------|-------------|
| Andrew Vijay Jacob | International Student Advisor | (signed) | 03/11/2020 | Austin, TX |
ICE Form I-20 (04/30/2021) -- Page 2 of 3
---
## Page 3: Instructions to Students / Instructions to Schools
### Instructions to Students
**STUDENT ATTESTATION.** You should read everything on this page carefully. Be sure that you understand the terms and conditions concerning your admission and stay in the United States as a nonimmigrant student before signing the student attestation on page 1 of the Form I-20 A-B. The law provides severe penalties for knowingly and willfully falsifying or concealing a material fact, or using any false document in the submission of this form.
**FORM I-20.** The Form I-20 (this form) is the primary document to show that you have been admitted to school in the United States and that you are authorized to apply for admission to the United States in F-1 class of admission. You must have your Form I-20 with you at all times. If you lose your Form I-20, you must request a new one from your designated school official (DSO) at the school named on your Form I-20.
**VISA APPLICATION.** You must give this Form I-20 to the U.S. consular officer at the time you apply for a visa (unless you are exempt from visa requirements). If you have a Form I-20 from more than one school, be sure to present the Form I-20 from the school you plan to attend. Your visa will include the name of that school, and you must attend that school upon entering the United States. You must also provide evidence of support for tuition and fees and living expenses while you are in the United States.
**ADMISSION.** When you enter the United States, you must present the following documents to the officer at the port of entry: 1) a Form I-20; 2) a valid F-1 visa (unless you are exempt from visa requirements); 3) a valid passport; and 4) evidence of support for tuition and fees and living expenses while you are in the United States. The agent should return all documents to you before you leave the inspection area.
**REPORT TO SCHOOL NAMED ON YOUR FORM I-20 AND VISA.** Upon your first entry to the United States, you must report to the DSO at the school named on your Form I-20 and your F-1 visa (unless you are exempt from visa requirements). If you decide to attend another school before you enter the United States, you must present a Form I-20 from the new school to a U.S. consular officer for a new F-1 visa that names the new school. Failure to enroll in the school, by the program start date on your Form I-20 may result in the loss of your student status and subject you to deportation.
**EMPLOYMENT.** Unlawful employment in the United States is a reason for terminating your F-1 status and deporting you from the United States. You may be employed on campus at your school. You may be employed off-campus in curricular practical training (CPT) if you have written permission from your DSO. You may apply to U.S. Citizenship and Immigration Services (USCIS) for off-campus employment authorization in three circumstances: 1) employment with an international organization; 2) severe and unexpected economic hardship; and 3) optional practical training (OPT) related to your degree. You must have written authorization from USCIS before you begin work. Contact your DSO for details. Your spouse or child (F-2 classification) may not work in the United States.
**PERIOD OF STAY.** You may remain in the United States while taking a full course of study or during authorized employment after your program. F-1 status ends and you are required to leave the United States on the earliest of the following dates: 1) the program end date on your Form I-20 plus 60 days; 2) the end date of your OPT plus 60 days; or 3) the termination of your program for any other reason. Contact your DSO for details.
**EXTENSION OF PROGRAM.** If you cannot complete the education program by the program end date on page 1 of your Form I-20, you should contact your DSO at least 15 days before the program end date to request an extension.
**SCHOOL TRANSFER.** To transfer schools, first notify the DSO at the school you are attending of your plan to transfer, then obtain a Form I-20 from the DSO at the school you plan to attend. Return the Form I-20 to the new school to the DSO at that school within 15 days after beginning attendance at the new school. The DSO will then report the transfer to the Department of Homeland Security (DHS). You must enroll in the new school at the next session start date. The DSO at the new school must update your registration in SEVIS.
**NOTICE OF ADDRESS.** When you arrive in the United States, you must report your U.S. address to your DSO. If you move, you must notify your DSO of your new address within 10 days of the change of address. The DSO will update SEVIS with your new address.
**REENTRY.** F-1 students may leave the United States and return within a period of five months. To return, you must have: 1) a valid passport; 2) a valid F-1 student visa (unless you are exempt from visa requirements); and 3) your Form I-20, page 2, properly endorsed for reentry by your DSO. If you have been out of the United States for more than five months, contact your DSO.
**AUTHORIZATION TO RELEASE INFORMATION BY SCHOOL.** DHS requires your school to provide DHS with your name, country of birth, current address, immigration status, and certain other information on a regular basis or upon request. Your signature on the Form I-20 authorizes the named school to release such information from your records.
**PENALTY.** To maintain your nonimmigrant student status, you must: 1) remain a full-time student at your authorized school; 2) engage only in authorized employment; and 3) keep your passport valid. Failure to comply with these regulations will result in the loss of your student status and subject you to deportation.
### Instructions to Schools
**ISSUANCE OF FORM I-20.** DSOs may issue a Form I-20 for any nonimmigrant your school has accepted for a full course of study if that person: 1) plans to apply to enter the United States in F-1 status; 2) is in the United States as an F-1 nonimmigrant and plans to transfer to your school; or 3) is in the United States and will apply to change nonimmigrant status to F-1. DSOs may also issue the Form I-20 to the spouse or child (under the age of 21) of an F-1 student to use to enter or remain in the United States as an F-2 dependent. DSOs must sign where indicated at the bottom of page 1 of the Form I-20 to attest that the form is completed and issued in accordance with regulations.
**ENDORSEMENT OF PAGE 2 FOR REENTRY.** If there have been no substantive changes in information, DSOs may endorse page 2 of the Form I-20 for the student and/or the F-2 dependents to reenter the United States. If there have been substantive changes, the DSO should issue and sign a new Form I-20 that includes those changes.
**RECORDKEEPING.** DHS may request information concerning the student's immigration status for various reasons. DSOs should retain all evidence of academic ability and financial resources on which admission was based, until SEVIS shows the student's record completed or terminated.
**AUTHORITY FOR COLLECTING INFORMATION.** Authority for collecting the information on this and related student forms is contained in 8 U.S.C. 1101 and 1184. The Department of State and DHS use this information to determine eligibility for the benefits requested. The law provides severe penalties for knowingly and willfully falsifying or concealing a material fact, or using any false document in the submission of this form.
**REPORTING BURDEN.** U.S. Immigration and Customs Enforcement collects this information as part of its agency mission under the Department of Homeland Security. The estimated average time to review the instructions, search existing data sources, gather and maintain the needed data, and complete and review the collection of information is 30 minutes (1.50 hours) per response. An agency may not conduct or sponsor, and a person is not required to respond to an information collection unless a form displays a currently valid OMB Control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: Office of the Chief Information Officer/Forms Management Branch, U.S. Immigration and Customs Enforcement, 801 I Street NW Stop 5800, Washington, DC 20536-5800. Do not send the form to this address.
ICE Form I-20 (04/30/2021) -- Page 3 of 3

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---
type: immigration-document
category: employment
person: Xuewei Jiang
date: 2020-02-14
provider: University of Southern California
source: jiang_i94_2020.pdf
---
# I-94 Arrival/Departure Record -- Jiang Xuewei
Printed from: I94 - Official Website (https://i94.cbp.dhs.gov/I94/#/recent-results)
Date printed: 5/29/20, 2:40 PM
Page 1 of 3
## U.S. Customs and Border Protection
**For: XUEWEI JIANG**
### Most Recent I-94
| Field | Value |
|-------|-------|
| Admission (I-94) Record Number | 490459797A2 |
| Most Recent Date of Entry | 2020 February 14 |
| Class of Admission | F1 |
| Admit Until Date | D/S |
### Details provided on the I-94 Information form
| Field | Value |
|-------|-------|
| Last/Surname | JIANG |
| First (Given) Name | XUEWEI |
| Birth Date | 1993 March 13 |
| Passport Number | G49056249 |
| Country of Issuance | China |
## For Your Info
Effective April 26, 2013, DHS began automating the admission process. An alien lawfully admitted or paroled into the U.S. is no longer required to be in possession of a preprinted Form I-94.
A record of admission printed from the CBP website constitutes a lawful record of admission. *See 8 CFR S 1.4(d).*
---
### Notices (from original document)
- Effective April 26, 2013, DHS began automating the admission process. An alien lawfully admitted or paroled into the U.S. is no longer required to be in possession of a preprinted Form I-94. A record of admission printed from the CBP website constitutes a lawful record of admission. See 8 CFR S 1.4(d).
- If an employer, local, state or federal agency requests admission information, present your admission (I-94) number along with any additional required documents requested by that employer or agency.
- Note: For security reasons, we recommend that you close your browser after you have finished retrieving your I-94 number.

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---
type: identity-document
category: employment
person: Xuewei Jiang
date: 2011-03-04
provider: University of Southern California
source: jiang_passport_2011.jpeg
---
# People's Republic of China Passport -- Jiang Xuewei (Old Passport)
**中华人民共和国 护照 / PEOPLE'S REPUBLIC OF CHINA PASSPORT**
## Request Page (Left Side)
中华人民共和国外交部请各国军政机关对持照人予以通行的便利和必要的协助。
*The Ministry of Foreign Affairs of the People's Republic of China requests all civil and military authorities of foreign countries to allow the bearer of this passport to pass freely and afford assistance in case of need.*
## Data Page (Right Side)
| Field | Value |
|-------|-------|
| 护照 / PASSPORT | |
| 类型 / Type | P |
| 国家码 / Country Code | CHN |
| 护照号码 / Passport No. | G49056249 |
| 姓 / Surname | 姜 / JIANG |
| 名 / Given Names | 薛伟 / XUEWEI |
| 性别 / Sex | 女 / F |
| 出生地点 / Place of Birth | 山东 / SHANDONG |
| 出生日期 / Date of Birth | 13 MAR 1993 |
| 签发日期 / Date of Issue | 04 MAR 2011 |
| 签发地点 / Place of Issue | 山东 / SHANDONG |
| 有效期至 / Date of Expiry | 03 MAR 2021 |
| 签发机关 / Authority | 公安部出入境管理局 / Exit & Entry Administration, Ministry of Public Security |
Serial number on right edge: 67882217
## Machine Readable Zone (MRZ)
```
POCHNJIANG<<XUEWEI<<<<<<<<<<<<<<<<<<<<<<<<
G490562499CHN9303139F21030319203701<<<<<<52
```
Photo: Female, black hair, front-facing.
Note: This is the older passport (issued 2011, expired March 2021). The renewed passport (EJ4954380, issued July 2021) is filed separately in id/jiang/.

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---
type: tax-form
category: employment
person: Xuewei Jiang
date: 2020-05-29
provider: University of Southern California
source: jiang_signed_tax_docs_2020.pdf
---
# GLACIER Tax Summary Report (Unsigned Copy) -- Jiang Xuewei
This document is a 4-page GLACIER tax package, identical in content to jiang_glacier_tax_docs_2020.pdf except the Tax Summary Report certification section is unsigned (blank signature and date fields).
## Page 1: Tax Summary Report (Unsigned)
**GLACIER -- Nonresident Alien Tax Compliance System**
Header: HOLD 4
### Summary of Information Entered Into GLACIER
| Field | Value |
|-------|-------|
| Name | Xuewei Jiang |
| SSN / ITIN | 092-99-3215 |
| Email Address | xueweijiang0313@gmail.com |
| Country of Tax Residence | China, People's Republic of |
| Country of Citizenship | China, People's Republic of |
| Current Immigration Status | F1 Student |
| Original Immigration Status | (blank) |
| Immigration Status Expiration | May 31, 2021 |
| Department Name | Marshall School of Business |
| USC ID Number | 8872791406 |
| Field | Value |
|-------|-------|
| Changed Immigration Status? | No |
| Immigration Status Change Date | (blank) |
| Date of Entry to U.S. | August 11, 2011 |
| Estimated Date of Departure | May 31, 2021 |
#### U.S. Presence Days
| Year | Days |
|------|------|
| 2015 | 297 Days |
| 2014 | 303 Days |
| 2013 | 332 Days |
| 2012 | 284 Days |
| 2011 | 143 Days |
### Tax Determinations and Results
Based on the data entered, GLACIER has made the following determinations:
| Field | Value |
|-------|-------|
| Tax Residency Status | Resident Alien for U.S. Tax Purposes |
| Residency Status Change Date | Not Applicable |
| Residency Status Start Date | Not Applicable |
### Compensation/Wages/Salary
| Field | Value |
|-------|-------|
| Applicable Tax Withholding Rate | As Requested on Form W-4 |
| Tax Treaty Exemption Status | Taxable |
| Tax Treaty Time Limit | Not Applicable |
| Tax Treaty Exemption Period | Not Applicable |
| Tax Treaty Dollar Limit | Not Applicable |
**TAX** (watermark/stamp)
| Field | Value |
|-------|-------|
| FICA Tax Status | Taxable (*Exempt if Student) |
| FICA Tax Start Date | (blank) |
### Required Forms and Document Copies
**Required Forms:**
- Form W-4
**Required Document Copies:**
- Form I-20
- Form I-94/I-94W Card
- Visa Sticker/Stamp (in Passport)
### Certification
I hereby declare that the information provided by me to The University of Southern California and/or entered into the GLACIER Online Tax Compliance System for purposes of making the tax determinations above is true and correct. If any of the information provided changes or if other relevant information becomes available, I will notify The University of Southern California as soon as possible so that this information and/or my U.S. tax status may be updated.
| Field | Value |
|-------|-------|
| Signature | (blank -- unsigned) |
| Date | (blank) |
052920
The information contained on this statement was generated using **GLACIER** Online Tax Compliance System.
(c) Copyright Arctic International LLC. All rights reserved.
---
## Page 2: Tax Summary Report Instructions
(Identical to the instructions in jiang_glacier_tax_docs_2020.pdf -- see that file for full text.)
**Please submit all Required Forms and Document Copies to:**
Your HR Payroll Analyst / Or Your Supervisor
The University of Southern California
Your School or Department
Los Angeles, CA 90089
Telephone: 213-740-8855
payroll@usc.edu
### Additional Information, if any
Based on the information entered, you are a Resident Alien for Tax Purposes. As such, you may have tax withheld from your payments in the same manner as a U.S. citizen. You must print and complete the blank Form W-4 provided to you by GLACIER and submit the form with your Tax Summary Report to your GLACIER Institution Administrator or Payroll Department.
---
## Page 3: Blank Form W-4 (2020)
(Identical blank W-4 form as in jiang_glacier_tax_docs_2020.pdf -- unfilled.)
---
## Page 4: U.S. Tax Information for Non-United States Citizens
(Identical informational page from Arctic International LLC as in jiang_glacier_tax_docs_2020.pdf.)

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---
type: tax-form
category: employment
person: Xuewei Jiang
date: 2020-05-29
provider: University of Southern California
source: jiang_usc_final_signed_tax_2020.pdf
---
# GLACIER Tax Documents -- Final Signed Package -- Jiang Xuewei
This is the final signed submission package containing the GLACIER Tax Summary Report (signed), instructions, signed W-4, and tax information page.
## Page 1: Tax Summary Report (Signed)
**GLACIER -- Nonresident Alien Tax Compliance System**
Header: HOLD 4
### Summary of Information Entered Into GLACIER
| Field | Value |
|-------|-------|
| Name | Xuewei Jiang |
| SSN / ITIN | 092-99-3215 |
| Email Address | xueweijiang0313@gmail.com |
| Country of Tax Residence | China, People's Republic of |
| Country of Citizenship | China, People's Republic of |
| Current Immigration Status | F1 Student |
| Original Immigration Status | (blank) |
| Immigration Status Expiration | May 31, 2021 |
| Department Name | Marshall School of Business |
| USC ID Number | 8872791406 |
| Field | Value |
|-------|-------|
| Changed Immigration Status? | No |
| Immigration Status Change Date | (blank) |
| Date of Entry to U.S. | August 11, 2011 |
| Estimated Date of Departure | May 31, 2021 |
#### U.S. Presence Days
| Year | Days |
|------|------|
| 2015 | 297 Days |
| 2014 | 303 Days |
| 2013 | 332 Days |
| 2012 | 284 Days |
| 2011 | 143 Days |
### Tax Determinations and Results
Based on the data entered, GLACIER has made the following determinations:
| Field | Value |
|-------|-------|
| Tax Residency Status | Resident Alien for U.S. Tax Purposes |
| Residency Status Change Date | Not Applicable |
| Residency Status Start Date | Not Applicable |
### Compensation/Wages/Salary
| Field | Value |
|-------|-------|
| Applicable Tax Withholding Rate | As Requested on Form W-4 |
| Tax Treaty Exemption Status | Taxable |
| Tax Treaty Time Limit | Not Applicable |
| Tax Treaty Exemption Period | Not Applicable |
| Tax Treaty Dollar Limit | Not Applicable |
**TAX** (watermark/stamp)
| Field | Value |
|-------|-------|
| FICA Tax Status | Taxable (*Exempt if Student) |
| FICA Tax Start Date | (blank) |
### Required Forms and Document Copies
**Required Forms:**
- Form W-4
**Required Document Copies:**
- Form I-20
- Form I-94/I-94W Card
- Visa Sticker/Stamp (in Passport)
### Certification
| Field | Value |
|-------|-------|
| Signature | (signed) |
| Date | 05/29/2020 |
052920
---
## Page 2: Tax Summary Report Instructions
(Same GLACIER instructions page. See jiang_glacier_tax_docs_2020.md for full text.)
Submit to:
Your HR Payroll Analyst / Or Your Supervisor
The University of Southern California
Los Angeles, CA 90089
Telephone: 213-740-8855
payroll@usc.edu
### Additional Information
Based on the information entered, you are a Resident Alien for Tax Purposes. As such, you may have tax withheld from your payments in the same manner as a U.S. citizen.
---
## Page 3: Form W-4 (2020) -- Signed
**Employee's Withholding Certificate**
Department of the Treasury, Internal Revenue Service
OMB No. 1545-0074
### Step 1: Enter Personal Information
| Field | Value |
|-------|-------|
| (a) First name and middle initial | Xuewei |
| Last name | Jiang |
| (b) Social security number | 092-99-3215 |
| Address | 1000 Escalon Ave. Apt. K2087 |
| City or town, state, and ZIP code | Sunnyvale, CA 94085 |
(c) Filing Status:
- [ ] Single or Married filing separately
- [x] Married filing jointly (or Qualifying widow(er))
- [ ] Head of household
### Step 2: Multiple Jobs or Spouse Works
(Not filled in)
### Step 3: Claim Dependents
| Field | Value |
|-------|-------|
| Total (line 3) | $ 3 |
### Step 4 (optional): Other Adjustments
| Field | Value |
|-------|-------|
| 4(a) Other income | $ (blank) |
| 4(b) Deductions | $ (blank) |
| 4(c) Extra withholding | $ (blank) |
### Step 5: Sign Here
| Field | Value |
|-------|-------|
| Employee's signature | (signed -- cursive signature) |
| Date | 05/29/2020 |
### Employers Only
(blank)
Cat. No. 10220Q, Form W-4 (2020)
---
## Page 4: U.S. Tax Information for Non-United States Citizens
(Same Arctic International LLC informational page. See jiang_glacier_tax_docs_2020.md for full text.)
(c) 2015 Arctic International LLC All Rights Reserved. For use in connection with the GLACIER Online Tax Compliance System.

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---
type: immigration-document
category: employment
person: Xuewei Jiang
date: 2015-06-27
provider: University of Southern California
source: jiang_visa_f1_2015.jpeg
---
# United States F-1 Visa -- Jiang Xuewei
## Visa Sticker (Left Page)
**UNITED STATES OF AMERICA VISA**
| Field | Value |
|-------|-------|
| Issuing Post Name | BEIJING |
| Surname | JIANG |
| Given Name | XUEWEI |
| Visa Type / Class | R / F1 |
| Control Number | 201517765120010 |
| Sex | F |
| Birth Date | 13MAR1993 |
| Nationality | CHIN |
| Issue Date | 27JUN2015 |
| Expiration Date | 24JUN2020 |
| Entries | M (Multiple) |
| Annotation | UNIVERSITY OF TEXAS AT AUSTIN |
## Machine Readable Zone (MRZ)
```
VNUSAJIANG<<XUEWEI<<<<<<<<<<<<<<<<<<<<<<<<
G490562499CHN9303139F2006246F1BEJ23GG41371389
** J 794 265 8 100
```
Photo: Female, front-facing.
## Passport Stamps (Right Page)
### U.S. Admission Stamp
- **DEPARTMENT OF HOMELAND SECURITY**
- **ADMITTED** / **LAX** / **6805**
- **AUG 10 2016**
- Class: **F-1**
- Until: **D/S**
### Chinese Entry/Exit Stamps
- **2015-08-10** -- Red stamp, CHINA entry/exit (中华人民共和国)
- **2016-08-10** -- Red stamp, CHINA entry/exit (中华人民共和国)
- Additional red stamps with codes: 001010831C0010632/001010632, D853
Note: Passport number G49056249 (old passport, expired March 2021).

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---
type: tax-form
category: employment
person: Xuewei Jiang
date: 2020-05-29
provider: University of Southern California
source: jiang_w4_usc_2020.pdf
---
# Form W-4 -- Employee's Withholding Certificate (2020) -- Signed Copy
Form W-4 (2020)
Department of the Treasury, Internal Revenue Service
OMB No. 1545-0074
## Step 1: Enter Personal Information
| Field | Value |
|-------|-------|
| (a) First name and middle initial | Xuewei |
| Last name | Jiang |
| (b) Social security number | 092-99-3215 |
| Address | 1000 Escalon Ave. Apt. K2087 |
| City or town, state, and ZIP code | Sunnyvale, CA 94085 |
(c) Filing Status:
- [ ] Single or Married filing separately
- [x] Married filing jointly (or Qualifying widow(er))
- [ ] Head of household
## Step 2: Multiple Jobs or Spouse Works
(Not filled in)
## Step 3: Claim Dependents
| Field | Value |
|-------|-------|
| Qualifying children under age 17 x $2,000 | (blank) |
| Other dependents x $500 | (blank) |
| Total (line 3) | $ |
Note: Box shows "3" with "$" but amount field appears blank/unclear.
## Step 4 (optional): Other Adjustments
| Field | Value |
|-------|-------|
| 4(a) Other income | $ (blank) |
| 4(b) Deductions | $ (blank) |
| 4(c) Extra withholding | $ (blank) |
## Step 5: Sign Here
| Field | Value |
|-------|-------|
| Employee's signature | (signed -- cursive signature) |
| Date | 05/29/2020 |
## Employers Only
| Field | Value |
|-------|-------|
| Employer's name and address | (blank) |
| First date of employment | (blank) |
| Employer identification number (EIN) | (blank) |
Cat. No. 10220Q
Form W-4 (2020)

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