UC Santa Barbara                                Attachment 5150 D
Policies                                              
Issuing Unit:  Administrative Services          Date: September 1, 1982





                                             Date:

Internal Revenue Service


Ladies and Gentlemen:

This is to certify that The University of California at Santa Barbara has

paid to________________________________________________, a citizen of
        (nonresident alien employee's name and address)
                                                             
_______________________________, classified as a nonresident alien,
(country of alien's citizenship)

for services rendered and/or subsistence during the calendar

year 19____ through____________________________, the
                     (final day of employment)

amount of $_____________ from which tax has been withheld in the amount

of $______________.


                              By:___________________________
                                       Payroll Title

For questions or comments regarding the format of the above information, please contact webcontact@ucsbuxa.ucsb.edu.

Last Modified By: HMW, 5/21/97

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