FIRST - Copy B of each Form W-2 - attach to the front of Form 1040NR-EZ

THEN - Form 1040NR-EZ

THEN - Form 8843

Notes: If you received a Form 1098-T, do not attach it to your Form 1040NR-EZ.

Submitting Your U.S. Tax documents
Congratulations! Based on the info entered into GLACIER Tax Prep (GTP), you are due a tax refund!
It may take up to 14 weeks after you mail your tax return to receive your refund. Check your tax refund status at
https://sa.www4.irs.gov/irfof/lang/en/irfofgetstatus.jsp Do not contact the GTP Support Center regarding your tax refund because we have
no information about when your refund will be made.
You must PRINT, SIGN, and MAIL your Form 1040NR-EZ (your tax return) and all required attachments. Nonresident Aliens are
NOT ALLOWED to electronically file an income tax return. The IRS does not allow GTP to submit your tax documents for you.
Sign and date your tax return - it is not considered a valid tax return until it is signed!
Because you are due a refund, MAIL your signed and dated tax documents to the following address -
no street address is needed.

Department of the Treasury

Internal Revenue Service Center
Austin, TX 73301-0215
USA
Dont forget anything! Make sure you attach all the necessary documents in the following order:

Based on your situation, you MUST submit your signed and dated tax documents on or before April 15, 2014.
MAKE and KEEP A COPY OF YOUR SIGNED AND DATED Form 1040NR-EZ AND DOCUMENTS! You must keep the copy of your
signed tax return and documents for three calendar years after the year in which you file. Keep the copy of your tax return even after you
leave the U.S., you may be asked to show proof that you complied with U.S. tax laws when applying for future entry to the U.S.
You may also be required to file a STATE tax return for each state in which you lived or worked during 2013.

GTP does not
complete state tax forms; please review the tax information on the websites of the states in which you lived and/or worked during 2013 for
more information.

THANK YOU for using GTP!

Please tell us what you think about GTP. Send your comments to [email protected]
ARCTIC INTERNATIONAL LLC 2014. All rights reserved.
Form 1040NR-EZ
Department of the Treasury
Internal Revenue Service
U.S. Income Tax Return for Certain
Nonresident Aliens With No Dependents

Information about Form 1040NR-EZ and its instructions is at www.irs.gov/form1040nrez.
OMB No. 1545-0074
2013
Please print
or type.
See
separate
instructions.
Your first name and initial Last name Identifying number (see instructions)
Present home address (number, street, and apt. no., or rural route). If you have a P.O. box, see instructions.
City, town or post office, state, and ZIP code. If you have a foreign address, also complete spaces below (see instructions).
Foreign country name Foreign province/state/county Foreign postal code
Filing Status
Check only one box.
1 Single nonresident alien 2 Married nonresident alien
Attach
Form(s)
W-2 or
1042-S
here.
Also
attach
Form(s)
1099-R if
tax was
withheld.
3 Wages, salaries, tips, etc. Attach Form(s) W-2 . . . . . . . . . . . . . 3
4 Taxable refunds, credits, or offsets of state and local income taxes . . . . . . 4
5 Scholarship and fellowship grants. Attach Form(s) 1042-S or required statement . . 5
6 Total income exempt by a treaty from page 2, Item J(1)(e) . 6
7 Add lines 3, 4, and 5 . . . . . . . . . . . . . . . . . . . . . 7
8 Scholarship and fellowship grants excluded . . . . . 8
9 Student loan interest deduction . . . . . . . . . 9
10 Subtract the sum of line 8 and line 9 from line 7. This is your adjusted gross income . 10
11 Itemized deductions (see instructions) . . . . . . . . . . . . . . . 11
12 Subtract line 11 from line 10 . . . . . . . . . . . . . . . . . . . 12
13 Exemption (see instructions) . . . . . . . . . . . . . . . . . . . 13
14 Taxable income. Subtract line 13 from line 12. If line 13 is more than line 12, enter -0- 14
15 Tax. Find your tax in the tax table in the instructions . . . . . . . . . . . 15
16 Unreported social security and Medicare tax from Form: a 4137 b 8919 16
17 Add lines 15 and 16. This is your total tax . . . . . . . . . . . . .

17
18a Federal income tax withheld from Form(s) W-2 and 1099-R 18a
b Federal income tax withheld from Form(s) 1042-S . . . 18b
19 2013 estimated tax payments and amount applied from 2012 return 19
20 Credit for amount paid with Form 1040-C . . . . . 20
21 Add lines 18a through 20. These are your total payments . . . . . . . .

21
Refund
Direct
deposit?
See
instructions.
22 If line 21 is more than line 17, subtract line 17 from line 21. This is the amount you overpaid 22
23a Amount of line 22 you want refunded to you. If Form 8888 is attached, check here

23a
b Routing number c Type: Checking Savings
d Account number
e If you want your refund check mailed to an address outside the United States not
shown above, enter that address here:
24 Amount of line 22 you want applied to your 2014 estimated tax

24
Amount
You Owe
25 Amount you owe. Subtract line 21 from line 17. For details on how to pay, see instructions

25
26 Estimated tax penalty (see instructions) . . . . . . . 26
Third
Party
Designee
Do you want to allow another person to discuss this return with the IRS (see instructions)? Yes. Complete the following. No
Designees
name

Phone
no.

Personal identification
number (PIN)
Sign
Here
Keep a copy of
this return for
your records.
Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to the best of my knowledge
and belief, they are true, correct, and accurately list all amounts and sources of U.S. source income I received during the tax year. Declaration of
preparer (other than taxpayer) is based on all information of which preparer has any knowledge.

Your signature Date

Your occupation in the United States If the IRS sent you an Identity Protection
PIN, enter it
here (see inst.)
Paid
Preparer
Use Only
Print/Type preparers name Preparer's signature Date
Check if
self-employed
PTIN
Firms name

Firm's address

Firm's EIN

Phone no.
For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see instructions. Cat. No. 21534N Form 1040NR-EZ (2013)
Han G Trinh 839717891
1115 8th Avenue Box 4438
Grinnell, IA 50112

917 25
0 00
00
0 00
0
917 25
0 00
0 00
917 25
1 77
48 915
3900 00
0 00
0 00
0 00
91 71
0 00
0 00
91 71
91
91
71
71
7 0 3 0 0 0 2 2 8

1 7 0 1 7 8 4 4 1 7
Student
033020141942
Form 1040NR-EZ (2013) Page 2
Schedule OI- Other Information (see instructions)
Answer all questions
A Of what country or countries were you a citizen or national during the tax year?
B In what country did you claim residence for tax purposes during the tax year?
C Have you ever applied to be a green card holder (lawful permanent resident) of the United States? . . . . Yes No
D Were you ever:
1. A U.S. citizen? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
2. A green card holder (lawful permanent resident) of the United States? . . . . . . . . . . . Yes No
If you answer Yes to (1) or (2), see Pub. 519, chapter 4, for expatriation rules that may apply to you.
E If you had a visa on the last day of the tax year, enter your visa type. If you did not have a visa, enter your U.S. immigration
status on the last day of the tax year.
F Have you ever changed your visa type (nonimmigrant status) or U.S. immigration status? . . . . . . . Yes No
If you answered Yes, indicate the date and nature of the change.

G List all dates you entered and left the United States during 2013 (see instructions).
Note. If you are a resident of Canada or Mexico AND commute to work in the United States at frequent
intervals, check the box for Canada or Mexico and skip to item H . . . . . . . . . . . .
Canada Mexico
Date entered United States
mm/dd/yy
Date departed United States
mm/dd/yy
Date entered United States
mm/dd/yy
Date departed United States
mm/dd/yy
H Give number of days (including vacation, nonworkdays, and partial days) you were present in the United States during:
2011 , 2012 , and 2013 .
I Did you file a U.S. income tax return for any prior year? . . . . . . . . . . . . . . . . . . Yes No
If Yes, give the latest year and form number you filed

J

Income Exempt from TaxIf you are claiming exemption from income tax under a U.S. income tax treaty with a foreign country,
complete (1) and (2) below. See Pub. 901 for more information on tax treaties.
1. Enter the name of the country, the applicable tax treaty article, the number of months in prior years you claimed the
treaty benefit, and the amount of exempt income in the columns below. Attach Form 8833 if required (see instructions).
(a) Country
(b) Tax treaty
article
(c) Number of months
claimed in prior tax years
(d) Amount of exempt
income in current tax year
(e) Total. Enter this amount on Form 1040NR-EZ, line 6. Do not enter it on line 3 or line 5 . . . . . .
2. Were you subject to tax in a foreign country on any of the income shown in 1(d) above? . . . . . Yes No
Form 1040NR-EZ (2013)
839717891
00 0
033020141942
Han G Trinh
Vietnam
Vietnam

F1 Student

14 8 2013 2013 12 24
133 0 0

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Form 8843
Department of the Treasury
Internal Revenue Service
Statement for Exempt Individuals and Individuals
With a Medical Condition
For use by alien individuals only.

Information about Form 8843 and its instructions is at www.irs.gov/form8843.

For the year January 1December 31, 2013, or other tax year
beginning , 2013, and ending , 20 .
OMB No. 1545-0074
2013
Attachment
Sequence No. 102
Your first name and initial Last name Your U.S. taxpayer identification number, if any
Fill in your
addresses only if
you are filing this
form by itself and
not with your tax
return
Address in country of residence Address in the United States
Part I General Information
1a Type of U.S. visa (for example, F, J, M, Q, etc.) and date you entered the United States

b Current nonimmigrant status and date of change (see instructions)

2 Of what country were you a citizen during the tax year?

3a What country issued you a passport?
b Enter your passport number

4a Enter the actual number of days you were present in the United States during:
2013 2012 2011
b Enter the number of days in 2013 you claim you can exclude for purposes of the substantial presence test

Part II Teachers and Trainees

5 For teachers, enter the name, address, and telephone number of the academic institution where you taught in 2013

6 For trainees, enter the name, address, and telephone number of the director of the academic or other specialized program
you participated in during 2013

7 Enter the type of U.S. visa (J or Q) you held during:

2007 2008
2009 2010 2011 2012 . If the type of visa you held during any
of these years changed, attach a statement showing the new visa type and the date it was acquired.
8 Were you present in the United States as a teacher, trainee, or student for any part of 2 of the 6 prior
calendar years (2007 through 2012)? . . . . . . . . . . . . . . . . . . . . . . . . Yes No
If you checked the Yes box on line 8, you cannot exclude days of presence as a teacher or trainee unless
you meet the Exception explained in the instructions.
Part III Students
9 Enter the name, address, and telephone number of the academic institution you attended during 2013

10 Enter the name, address, and telephone number of the director of the academic or other specialized program you participated
in during 2013

11 Enter the type of U.S. visa (F, J, M, or Q) you held during:

2007 2008
2009 2010 2011 2012 . If the type of visa you held during any
of these years changed, attach a statement showing the new visa type and the date it was acquired.
12 Were you present in the United States as a teacher, trainee, or student for any part of more than 5 calendar
years? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
If you checked the Yes box on line 12, you must provide sufficient facts on an attached statement to
establish that you do not intend to reside permanently in the United States.
13 During 2013, did you apply for, or take other affirmative steps to apply for, lawful permanent resident status
in the United States or have an application pending to change your status to that of a lawful permanent
resident of the United States? . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
14 If you checked the Yes box on line 13, explain

For Paperwork Reduction Act Notice, see page 4. Cat. No. 17227H Form 8843 (2013)
Han G Trinh 839717891
F1 08/14/2013
F1 Student
Vietnam
Vietnam
B6787213
133 0 0
133
Karen K. Edwards
Grinnell College 1115 8th Avenue Grinnell, IA 50112
Grinnell College 1115 8th Avenue Grinnell, IA 50112
641-269-3703
641-269-3703

Form 8843 (2013) Page 2

Part IV Professional Athletes
15 Enter the name of the charitable sports event(s) in the United States in which you competed during 2013 and the dates of
competition

16 Enter the name(s) and employer identification number(s) of the charitable organization(s) that benefited from the sports
event(s)

Note. You must attach a statement to verify that all of the net proceeds of the sports event(s) were contributed to the charitable
organization(s) listed on line 16.
Part V Individuals With a Medical Condition or Medical Problem
17a Describe the medical condition or medical problem that prevented you from leaving the United States

b
Enter the date you intended to leave the United States prior to the onset of the medical condition or medical problem described
on line 17a

c Enter the date you actually left the United States

18 Physicians Statement:
I certify that
Name of taxpayer
was unable to leave the United States on the date shown on line 17b because of the medical condition or medical problem
described on line 17a and there was no indication that his or her condition or problem was preexisting.
Name of physician or other medical official
Physicians or other medical officials address and telephone number
Physicians or other medical officials signature Date
Sign here
only if you
are filing
this form by
itself and
not with
your tax
return
Under penalties of perjury, I declare that I have examined this form and the accompanying attachments, and, to the best of my knowledge and belief,
they are true, correct, and complete.

Your signature

Date
Form 8843 (2013)