ࡱ> ?A> bjbj " ̟̟Tyyyyy1118i$$^########L%'b#y"#yy#jyy##="yy"\1^^U""\.#0^#]",P(P("y"11 ?:   Non-Employee Compensation Citizenship / Residency Statement Sponsored Programs Note: In compliance with the Internal Revenue Code and requirements of The State of California all recipients of non-employee compensation that may be subject to withholding must provide this form. ALL INFORMATION MUST BE COMPLETED BEFORE ANY PAYMENT CAN BE MADE! Name: ________________________________________________________________________ (As it appears on your Social Security Card) Mailing Address: ________________________________________________________________________ ________________________________________________________________________ City: ___________________________________ State: ___ Zip: _________________ Country: ___________________________________ Social Security Number (SSN): __________________________________________________ (As it appears on your Social Security Card) I swear under penalty of perjury that the following is true and correct: Please select one: _____ I am a US Citizen _____ I am a Permanent Resident Alien (Green Card) _____ I Am not a U.S. Citizen and I am not a Permanent Resident Alien; (= Non-Resident Alien)  NOTE: All Non-Resident Aliens must complete a web-based tax analysis (Glacier) before payments can be made. Please contact The University Corporation at 818-677-4695; we will assist you with the necessary forms.  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