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tax-form tax Yanxin Lu 2018-12-31 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