---
type: "1042"
category: tax
person: Xuewei Jiang
date: 2015-12-31
source: lu_1042_ut_2015.jpg
---

# Form 1042-S - University of Texas at Austin (2015)

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

## Key Information

| Field | Value |
|---|---|
| Income code | 20 |
| Gross income | $4,250 |
| Chapter 3 indicator | X |
| Exemption code (3a) | 04 |
| Exemption code (4a) | 16 |
| Tax rate (3b) | 0.00% |
| Tax rate (4b) | 0.00% |
| Federal tax withheld | $0 |
| Net income | (blank) |
| Tax withheld by other agents | $0 |
| Total withholding credit | $0 |
| Tax paid by withholding agent | $0 |
| Amount repaid to recipient | $0 |
| State income tax withheld | $0 |
| State | TX |
| Amended | Yes |
| Pro-Rata Basis Reporting | Yes |

## Withholding Agent

| Field | Value |
|---|---|
| Name | The University of Texas at Austin |
| EIN | 74-6000203 |
| Ch. 3 status code | 02 |
| Address | Payroll Services, Box 7849 |
| City/State/ZIP | Austin, TX 78713-7849 |

## Recipient

| Field | Value |
|---|---|
| Name | Xuewei Jiang |
| U.S. TIN | 092-99-3215 |
| Foreign ID | 092993215 |
| Ch. 3 status code | 16 |
| Country code | CH |
| Account number | x,888 |
| Date of birth | (not visible) |
| Recipient's country code | CH |
| Address | 1300 Crossing Pl, Apt 1934 |
| City/State/ZIP | Austin, TX 78741-1852 |