Reason you are submitting Form W-7.
Read the instuctions for the box you check. Caution: If you check box b, c, d, e, or g, you must file a tax return with Form W-7 unless you meet one of the exceptions (see instructions).

a Nonresident alien required to obtain ITIN to claim tax treaty benefit
b Nonresident alien filing a U.S. tax return and not eligible for an SSN
c U.S. resident alien (based on days present in the the United States) filing a U.S. return and not eligible for an SSN
d Dependent of U.S. citizen/resident alien
e Spouse of U.S. citizen/resident alien
f Nonresident alien student, professor, or researcher filing a U.S. tax return and not eligible for an SSN
g Dependent/spouse of a nonresident alien visa holder
h Other (see instructions)

If you checked d or e, enter the name and SSN/ITIN of U.S. citizen/resident alien (see instructions):

Additional information for a and f: Enter treaty country: and treaty article number .

Name
(see instructions) Name at birth if different:

1a

First name

Middle name

Last name

1b

First name

Middle name

Last name

2 Applicant's foreign address
(see instructions)

Street address, apartment number, or rural route number. Do not use a P.O. box number

City or town, state or province, and country. Include ZIP code or postal code where appropriate.

3 Mailing address
(if different from above)

Street address, apartment number, or rural route number. Do not use a P.O. box number

City or town, state or province, and country. Include ZIP code or postal code where appropriate.

4 Birth information

Date of birth (MM/DD/YYYY)


Country of Birth

City and state

5 Gender

Male
Female

Other Information

6a Country(ies) of citizenship

6b Foreign tax I.D. number (if any)

6c Type of U.S. visa (if any), number, and expiration date

6d Identification document(s) submitted (see instructions)

Passport
Driver's License/State I.D.
USCIS documentation
Other

Issued by:

No.:

Exp. date (MM/DD/YYYY):

Entry date in U.S. (MM/DD/YYYY):

6e Have you previously received a U.S. temporary Taxpayer Identification Numver (TIN) or Employer Identification Number (EIN)?

No/Do not know. Skip line 6f.
Yes. Complete line 6f.

6f

Enter: TIN or EIN and
Name under which it was issued

6g

Name of college/university or company (see instructions):

City and state

Length of stay

date (MM/DD/YYYY)

Name of Delegate, if applicable

Delegate's relationship to applicant:

Parent
Court-appointed guardian
Power of attorney