---
type: tax-form
category: tax
person: Yanxin Lu
date: 2018-12-31
source: lu_1042c_2018.pdf
---

# Form 1042-S - Rice University (2018)

Foreign Person's U.S. Source Income Subject to Withholding - Copy C for Recipient

## Key Information

| Field | Value |
|---|---|
| Unique Form Identifier | 0010000610 |
| Income code | 20 |
| Gross income | $5,000 |
| Chapter indicator | 3 |
| Exemption code (3a) | 04 |
| Exemption code (4a) | 16 |
| Tax rate (3b) | 0.00% |
| Tax rate (4b) | 0.00% |
| Federal tax withheld (7a) | $0 |
| Tax withheld by other agents (8) | $0 |
| Overwithheld tax repaid (9) | $0 |
| Total withholding credit (10) | $0 |
| Tax paid by withholding agent (11) | $0 |
| State income tax withheld (17a) | $0 |
| State (17c) | TX |

## Withholding Agent

| Field | Value |
|---|---|
| Name | William Marsh Rice University |
| EIN (12a) | 74-1109620 |
| Ch. 3 status code (12b) | 20 |
| Ch. 4 status code (12c) | 24 |
| Address | Payroll - MS 71, PO Box 1892 |
| City/State/ZIP | Houston, TX 77251-1892 |

## Recipient

| Field | Value |
|---|---|
| Name (13a) | Yanxin Lu |
| Country code (13b) | CH |
| Ch. 3 status code (13f) | 16 |
| U.S. TIN (13e) | 636-29-3464 |
| Account number (13k) | S01179519 |
| Date of birth (13l) | 19891017 |
| Address | 2-1-102 East 1st Panyu Olympic, Shiliang Rd 9 |
| City/Country | Guangzhou, China, People's Republic of 511400 |