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obsidian-yanxin/documents/tax/2015/lu_1042_baylor_2015.md
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tax-form tax Xuewei Jiang 2015-12-31 lu_1042_baylor_2015.pdf

Form 1042-S - Baylor University (2015)

Foreign Person's U.S. Source Income Subject to Withholding

Key Information

Field Value
Income code 20
Gross income $1,975
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 $0
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

Withholding Agent

Field Value
Name Baylor University, Mark C. Falsone
EIN 74-1159753
Ch. 3 status code 20
Address P.O. Box 97042
City/State/ZIP Waco, TX 76798-7042

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 891545196
Date of birth 03/13/1993
Address 1-1-401, Huangtai South Road 79#
City/Country Jinan, Shandong, China, People's Republic of 250014

Copies

  • Copy D for Recipient (page 1) and Copy B for Recipient (page 1 top half)
  • Copy C for Recipient (page 2)