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This form is for nonresident aliens. It contains the follow- ing four additional items that don’t appear on Form SSA-1099. Box 6—Rate of Tax This is the rate at which tax was withheld from 85% of your benefits. If tax was withheld at more than one rate during the year, the percentage shown will be the tax rate in December 2022. The tax rate for most nonresident ali- ens is 30%. If you are a resident of Switzerland, your total benefit amount will be taxed at a 15% rate. The figure “0” will appear in this box if you were not taxed in December or if you were exempt under a tax treaty. Benefits received by residents of Canada, Egypt, Germany, Ireland, Israel, Italy, Japan, Romania, and the United Kingdom are ex- empt from U.S. tax. Under a treaty with India, benefits paid to individuals who are both residents and nationals of India are exempt from U.S. tax if the benefits are for services performed for the United States, its subdivisions, or local government authorities. See Pub. 519 for more information on nonresi- dent aliens. Box 7—Amount of Tax Withheld This is the amount of tax taken out of your social security checks. Tax is withheld for any month in which you were a nonresident alien (unless you were exempt under a tax treaty). Box 8—Amount of Tax Refunded An amount in this box shows any tax the SSA refunded to you. When the SSA withholds tax from your checks by mistake, they try to return it to you during the same calen- dar year. If the SSA is unable to send the refund to you before the year ends, you must file a federal income tax return to get a refund of this tax. Box 9—Net Tax Withheld During 2022 (Box 7 minus Box 8) The figure in this box is the result of subtracting the figure in box 8 from the figure in box 7. This is the net amount of tax withheld from your benefits. SAMPLE Form SSA-1042S-SM (1-2023) FORM SSA-1042S – SOCIAL SECURITY BENEFIT STATEMENT • THIS FORM IS FOR USE IN FILING A UNITED STATES FEDERAL INCOME TAX RETURN. • DO NOT RETURN IT TO SOCIAL SECURITY. • READ THE INFORMATION ON THE REVERSE. Box 1. Name Box 2. Beneficiary’s Social Security Number Box 6. Rate of Tax Box 8. Amount of Tax Refunded 4 X O B N I T N U O M A F O N O I T P I R C S E D 3 X O B N I T N U O M A F O N O I T P I R C S E D Box 7. Amount of Tax Withheld Box 9. Net Tax Withheld During 2022 (Box 7 minus Box 8) Box 4. Benefits Repaid to SSA in 2022 2022 022 2 r o f stif e n e B t e N . 5 x o B 2 2 0 2 ni dia P stif e n e B . 3 x o B (Box 3 minus Box 4) Box 10. Address Box 11. Claim Number (Use this number if you need to contact SSA.) Publication 915 (2022) Page 23