---
type: tax-form
category: tax
person: xuewei-jiang
date: 2020-01-01
source: "[[jiang_1042s_2020.pdf]]"
---

# Form 1042-S — Foreign Person's U.S. Source Income Subject to Withholding 2020

## Unique Form Identifier

2004204558

## Income Information

| Box | Description | Value |
|-----|-------------|-------|
| 1 | Income code | 20 (Compensation during studying and training) |
| 2 | Gross income | $5,000 |
| 3 | Chapter indicator | 3 |
| 3a | Exemption code | 04 (Exempt under tax treaty) |
| 3b | Tax rate | 00.00 |
| 4a | Exemption code | 15 (Payee not subject to chapter 4 withholding) |
| 4b | Tax rate | 00.00 |
| 5 | Withholding allowance | (blank) |
| 6 | Net income | (blank) |

## Withholding

| Box | Description | Value |
|-----|-------------|-------|
| 7a | Federal tax withheld | $0 |
| 7b | Escrow procedures applied | No |
| 7c | Withholding in subsequent year | No |
| 8 | Tax withheld by other agents | (blank) |
| 9 | Overwithheld tax repaid | (blank) |
| 10 | Total withholding credit | $0 |
| 11 | Tax paid by withholding agent | (blank) |

## Withholding Agent (Box 12)

| Field | Value |
|-------|-------|
| 12a EIN | 746000203 |
| 12b Ch. 3 status code | 20 (Tax Exempt Organization) |
| 12c Ch. 4 status code | 02 (U.S. Withholding Agent - Other) |
| 12d Name | THE UNIVERSITY OF TEXAS AT AUSTIN |
| 12e GIIN | (blank) |
| 12f Country code | (blank) |
| 12g Foreign tax ID | (blank) |
| 12h Address | PAYROLL SERVICES, PO BOX 7849 |
| 12i City/State/ZIP | AUSTIN, TX 78713-7849 |

## Recipient (Box 13)

| Field | Value |
|-------|-------|
| 13a Name | XUEWEI JIANG |
| 13b Country code | CH |
| 13c Address | 2110 SPEEDWAY STOP B6600 |
| 13d City/State/ZIP | AUSTIN, TX US 78712-1276 |
| 13e U.S. TIN | XXX-XX-3215 |
| 13f Ch. 3 status code | 16 (Individual) |
| 13g Ch. 4 status code | (blank) |
| 13h GIIN | (blank) |
| 13i Foreign tax ID | (blank) |
| 13j LOB code | (blank) |
| 13k Account number | XJ888 |
| 13l Date of birth | (blank) |

## State Tax Withheld (Box 17)

| Field | Value |
|-------|-------|
| 17a State income tax withheld | (blank) |
| 17b Payer's state tax no. | (blank) |
| 17c Name of state | (blank) |