International Tax Office - Business Visitor Questionnaire

PLEASE DO NOT COMPLETE THIS FORM IF YOU ARE A US CITIZEN OR PERMANENT RESIDENT

THIS FORM SHOULD ONLY BE COMPLETED BY FOREIGN INDIVIDUALS.

Name Name Title First Middle Last Suffix
Gender
Address Outside USA Address Outside USA
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Address Inside USA (if any) Address Inside USA (if any)
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
No Address in USA
Phone Phone - ### - ### ####
Email
Do you have a U.S.-issued Social Security (SSN) or Individual Taxpayer ID (ITIN) Number?

Do you have a U.S.-issued Social Security (SSN) or Individual Taxpayer ID (ITIN) Number? Yes No
Employer Name or Name of Affiliated University, Organization, or Company
Country(ies) of Citizenship
Country of Birth
Country of Last Tax Residence
Current Visa Status in USA or Visa Status you expect to have when you arrive in USA
B1 or B2 Visitor?

B1 or B2 Visitor? I have a B-1/B-2 Visa I will apply for a B-1/B-2 Visa at US Consulate in the City and Country Provided Below
Purpose of visit to Vanderbilt University

Purpose of visit to Vanderbilt University 18th International Conference in Approximation Theory (Attendee) 18th International Conference in Approximation Theory (Speaker) BCBC Conference (Attendee) BCBC Conference (Speaker) Financial Markets Research Center Conference 2019 META Contract (ISIS) Payee NCGOA Conference (Attendee) NCGOA Conference (Speaker) Shanks Conference (Speaker) Shanks Conference (Attendee) useR! Conference (Speaker) useR! Conference (Attendee) Vanderbilt/NIMH Silvio O. Conte Center for Neuroscience Research VIGH: Research Development & Ethics Program Visiting for Other Purpose (explain below)
Vanderbilt Department you will visit
Department Contact Name Department Contact Name First Last
Department Contact Email Address
What kind of payment will you receive?

What kind of payment will you receive? Clinical or Research Participant Payment Over $50.00 Consultant Fee Copyright Royalty Honorarium Industrial Royalty Living Expenses or Maintenance Payment Performance Fee Prize or Award Speaker Fee Travel Award Travel Costs Reimbursement Visitor Needing VUnetID Only
Dates you will visit Vanderbilt (MM/DD/YYYY to MM/DD/YYYY)
Medical Students: Please provide the name of your Medical School and Years of Study
Visitors in F-1 or J-1 Status, please provide initial date of entry into USA Visitors in F-1 or J-1 Status, please provide initial date of entry into USA / MM / DD YYYY
Please provide total days in USA in last five (5) years.
2019
2018
2017
2016
2015
DOCUMENTATION

Please upload your documentation if any of the following apply to you.
Visitors entering as Canadian citizen visitors (without a visa or visa status)

Upload the following materials:
Passport biographical data page

Attach Files
Visitors entering using the Visa Waiver Program (VWP)

Upload the following materials:
Passport biographical data page

Attach Files
ESTA approval receipt from CBP/DHS

Attach Files
Please upload a copy of your entry stamp (WB/WT/VW) for this visit from your passport

Attach Files
Visitors entering with a visa or visa status

Upload the following materials
Passport biographical data page

Attach Files
Visa stamp (if applicable)

Attach Files
I-94, if already in the USA (if not in the USA, please provide I-94 upon arrival at Vanderbilt)

Attach Files
Current I-20(F-1) or Current DS2019(J-1)

Attach Files
Note

J-1 Visitors Receiving Honorariums, Speaker Fees or Payment for Services:
J-1 visitors receiving honorariums, speaker fees or payment for services must have pre-approval from their Responsible Officer (RO). Payment cannot be issued without pre-approval from the sponsoring institution's RO. Please forward the pre-approval letter directly to ITO.

Receipts Required:
Please remember to keep all receipts if you are receiving a travel reimbursement.

International Tax Office - Business Visitor Questionnaire

International Tax Office - Business Visitor Questionnaire

DOCUMENTATION

Visitors entering as Canadian citizen visitors (without a visa or visa status)

Visitors entering using the Visa Waiver Program (VWP)

Visitors entering with a visa or visa status

Note