.13 COMMONWEALTH OF INDEPENDENT STATES (except Kazakhstan, Russia, and Ukraine)

I am a  [insert name of C.I.S. member]. I am not a United States citizen. I have not been lawfully accorded the privilege of residing permanently in the United States as an immigrant.

I have accepted an invitation by a governmental agency or institution in the United States, or by an educational or scientific research institution in the United States, to come to the United States for the purpose of teaching, engaging in research, or participating in scientific, technical or professional conferences at Michigan State University, which is a governmental agency or institution, an educational or scientific institution, or an organization sponsoring a professional conference. I will receive compensation for my teaching, research, or conference activities.

The teaching, research, or conference compensation received during the entire tax year (or during the period ) qualifies for exemption from withholding of federal tax under the tax treaty between the United States and the former Union of Soviet Socialist Republics. I have not previously claimed an income tax exemption under that treaty for income received as a teacher, researcher, conference participant, or student before the date of my arrival in the United States.

Any research I perform will not be undertaken primarily for the benefit of a private person or commercial enterprise of the United States or a [insert the name of C.I.S. member], unless the research is conducted on the basis of intergovernmental agreements on cooperation.

I (insert the date of your last arrival in the United States before beginning the teaching, research, or conference services for which exemption is claimed). The treaty exemption is available only for compensation received during a period of two years beginning on that date.

Signature __________________________________________     Date _____________________

Michigan State University