Instruction page only. Do not mail with your tax return.

HEUNG YAN CHAN

655 KELTON AVE, 203
LOS ANGELES, CA 90024

Dear HEUNG YAN

Enclosed please find two copies of your 2022 federal income tax return, which you prepared through Sprintax tax
software.
File one copy with the Internal Revenue Service and retain the second copy for your records.

Tax Summary
Filing Status Other single nonresident alien
Gross Income $19841
Federal Adjusted Gross Income $19841
Federal Taxable Income $19841
Refund Amount $522
* We have attached instructions detailing how to file your tax return with the IRS.

How much is my refund?

Your federal tax refund is $ 522. This will be deposited directly into your checking account.

How do I file my tax return?

Your tax return must be received by April 18th. If you want to use approved Private Delivery
However, we recommend you mail your Service, please mail it to:
federal return as soon as possible using the
United States Post Office certified mail service to:

Department of the Treasury Austin - Internal Revenue

Internal Revenue Service Submission Processing Center
Austin, TX 73301-0215, USA 3651 S IH35,
Austin, TX 78741, USA

1
 Instruction page only. Do not mail with your tax return.

When will I receive my refund?

The IRS will take between 4-6 weeks to process your return, however exact timelines are determined by the IRS.

You can check the status of your federal tax refund at any time by using “Where’s My Refund?”, an interactive
tool available on www.IRS.gov. You can also call the IRS TeleTax System at 800-829-4477 or the IRS Refund
Hotline at 800-829-1954.

When you call the IRS or visit the website, you’ll need the following:
• The first SSN/ITIN shown on your federal tax return. If you recently applied for an ITIN, you will
need to wait for your ITIN notice in order to check your refund status online or you can just call
with a copy of your tax return in front of you.
• Your filing status (as indicated at the top of your 1040-NR, Filing status section)
• The exact amount of the refund shown on your federal return ($amount of the refund)

2
 Instruction page only. Do not mail with your tax return.

Federal Tax Return

checklist
1. Review and sign the following form(s) where indicated with a pen mark.

Form Action
1040-NR Sign on page 2
W8BEN Sign on page 1 (if present)
8843 No need to sign when attached to 1040-NR

2. Attach copies of all your income and tax withholding statements showing the US income sources you used to
prepare your tax return:

Income Document Quantity

W-2 form(s), Copy B * 2

* - If there is a difference between copies B and C, please attach Copy C to your Federal tax return.

3. Confirm that the SSN on all your W2(s) is correct.

3.1. If you don’t have your W2(s) or your SSN on your payment document(s) is incorrect, then you’ll need
to obtain an updated W2 from your employer(s).

4. We recommend you mail your federal return If you want to use approved Private Delivery
with all necessary supporting documents and Service, please mail it to:
attachments as soon as possible using the
United States Post Office certified mail service to:

Department of the Treasury Austin - Internal Revenue

Internal Revenue Service Submission Processing Center
Austin, TX 73301-0215, USA 3651 S IH35,
Austin, TX 78741, USA

3
 Instruction page only. Do not mail with your tax return.

Federal Tax Return

Frequently Asked Questions
How long will it take to process my US tax return?
The IRS will take between 4-6 weeks to process your return, however exact timelines are determined by the IRS.

What is the April 18th deadline?

The April 18th tax deadline is the date by which all tax returns must be filed for the previous year.
If you owe the IRS money and you don’t file your tax return by April 18th, the US tax authorities will impose late
filing penalties and interest on the amount you owe, so the sooner you submit your tax return, the better.

How do I know what’s happening with my tax return?

You can check the status of your federal tax return at any time by using “Where’s My Refund?”, an interactive tool
available at www.IRS.gov. You can also call the IRS TeleTax System at 800-829-4477 or the IRS Refund Hotline at
800-829-1954.
When you call the IRS or visit the website, you’ll need the following:
• The first SSN/ITIN shown on your federal tax return. If you recently applied for an ITIN, you will
need to wait for your ITIN notice in order to check your refund status online or you can just call
with a copy of your tax return in front of you.
• Your filing status (as indicated at the top of your 1040-NR, Filing status section)
• The exact amount of the refund shown on your federal return ($amount of the refund)

What if I don’t have a Social Security Number

If you never received a Social Security Number you’ll need to organize a temporary number. This is called an
Individual Taxpayer Identification Number (ITIN). If you did not apply for an ITIN within Sprintax, you can still apply
for it at www.taxback.com/usa-ITIN-numbers.asp.

What is a W2 form?
The W2 form shows the amount of money you earned from that employer and the amount of tax you paid on
that income. The W2 form is the official government form you receive from your employer(s) in January after the
tax year ends. To claim your US tax refund, the IRS will need copies of your W2 form(s) or final payslips.
If you’ve misplaced your W2(s) / final payslips or never received it, you’ll need to request a new one from your
employer.

What is a 1042-S form?

If you’ve worked as a trainee, student, teacher or researcher in the US on a J or F visa, you might have received a
1042-S form instead of a W2 form.
It outlines income such as scholarships, fellowships, self-employment or grants and any income exempt from
tax because of a tax treaty. We can use either the W2 or 1042-S to apply for your tax refund.
You should receive the 1042-S by mid-March of the year following the tax year.

4
 Instruction page only. Do not mail with your tax return.

Federal Tax Return

Frequently Asked Questions
What tax returns can I prepare through Sprintax?
With Sprintax, you can prepare your Federal and State tax returns, FICA tax claim and other required tax forms.
Once your taxes are prepared, you will need to mail them to the IRS. Sprintax cannot e-file them for you or mail
them to the IRS for you.

Can I use an international tax treaty?

Depending on your nationality and other conditions you may be able to claim a tax refund under international
“tax treaties”, which are agreements between the US and other countries that allow you to claim back tax you
paid while working abroad.
Sprintax always checks if you’re eligible for an international tax treaty when we prepare your US tax return. Your
eligibility depends on factors like your nationality, length of stay, purpose of stay, type of income, your visa and
other.

Could I owe money to the US tax authorities?

Depending on how your employer taxed you and what the actual tax liability under the tax law is, you may
owe tax or be due a tax refund. If you have a tax liability or if other particular factors apply, then you have an
obligation to file a tax return. Sprintax takes into consideration all of these factors.
Remember, if you owe money and don’t file your return before the April 18th deadline, you’ll get penalties and
fines added to the amount you owe.

5
 Instruction page only. Do not mail with your tax return.

Federal Tax Return

for
HEUNG YAN CHAN
2022

FEDERAL FILING COPY

SIGN AND MAIL TO THE INTERNAL REVENUE SERVICE

Sprintax Inc t 1-866-601-5695

333 N. Michigan Ave, Suite 915, e [email protected]
Chicago, IL, 60601, USA sprintax.com
6
 1040-NR U.S. Nonresident Alien Income Tax Return 2022
Form Department of the Treasury—Internal Revenue Service
IRS Use Only—Do not write
OMB No. 1545-0074 or staple in this space.
See separate
For the year Jan. 1–Dec. 31, 2022, or other tax year beginning , 2022, ending , 20 instructions.
Filing X Single Married filing separately (MFS) Qualifying surviving spouse (QSS) Estate Trust
Status
If you checked the QSS box, enter the child’s name if the qualifying person is a child but not your dependent:
Check only
one box.
Your first name and middle initial Last name Your identifying number
(see instructions)
HEUNG YAN CHAN 194 88 7857
Home address (number and street). If you have a P.O. box, see instructions. Apt. no.
655 KELTON AVE 203
City, town, or post office. If you have a foreign address, also complete spaces below. State ZIP code
LOS ANGELES CA 90024
Foreign country name Foreign province/state/county Foreign postal code

Digital Assets At any time during 2022, did you: (a) receive (as a reward, award, or payment for property or services); or (b) sell, exchange, gift, or
otherwise dispose of a digital asset (or a financial interest in a digital asset)? (See instructions.) . . . . . . Yes X No
Dependents (4) Check the box if qualifies for (see inst.):
(2) Dependent’s Credit for other
(see instructions): Child tax credit
(1) First name Last name identifying number (3) Relationship to you dependents

If more than four

dependents, see
instructions and
check here

Income 1a Total amount from Form(s) W-2, box 1 (see instructions) . . . . . . . . . . . . . 1a 19841
Effectively b Household employee wages not reported on Form(s) W-2 . . . . . . . . . . . . . 1b
Connected c Tip income not reported on line 1a (see instructions) . . . . . . . . . . . . . . 1c
With U.S. d Medicaid waiver payments not reported on Form(s) W-2 (see instructions) . . . . . . . . 1d
Trade or e Taxable dependent care benefits from Form 2441, line 26 . . . . . . . . . . . . . 1e
Business f Employer-provided adoption benefits from Form 8839, line 29 . . . . . . . . . . . 1f
g Wages from Form 8919, line 6 . . . . . . . . . . . . . . . . . . . . . 1g
Attach
h Other earned income (see instructions) . . . . . . . . . . . . . . . . . . 1h
Form(s) W-2,
1042-S, i Reserved for future use . . . . . . . . . . . . . . . 1i
SSA-1042-S, j Reserved for future use . . . . . . . . . . . . . . . . . . . . . . . 1j
RRB-1042-S,
and 8288-A k Total income exempt by a treaty from Schedule OI (Form 1040-NR), item L,
here. Also line 1(e) . . . . . . . . . . . . . . . . . . . 1k 0
attach z Add lines 1a through 1h . . . . . . . . . . . . . . . . . . . . . . . 1z 19841
Form(s)
2a Tax-exempt interest . . . 2a b Taxable interest . . . . . . 2b
1099-R if
tax was 3a Qualified dividends . . . 3a b Ordinary dividends . . . . . 3b
withheld. 4a IRA distributions . . . . 4a 0 b Taxable amount . . . . . . 4b 0
If you did not 5a Pensions and annuities . . 5a 0 b Taxable amount . . . . . . 5b 0
get a Form 6 Reserved for future use . . . . . . . . . . . . . . . . . . . . . . . 6
W-2, see
instructions. 7 Capital gain or (loss). Attach Schedule D (Form 1040) if required. If not required, check here . . 7 0
8 Other income from Schedule 1 (Form 1040), line 10 . . . . . . . . . . . . . . . 8 0
9 Add lines 1z, 2b, 3b, 4b, 5b, 7, and 8. This is your total effectively connected income . . . . 9 19841
10 Adjustments to income:
a From Schedule 1 (Form 1040), line 26 . . . . . . . . . . . 10a 0
b Reserved for future use . . . . . . . . . . . . . . . 10b
c Reserved for future use . . . . . . . . . . . . . . . 10c
d Enter the amount from line 10a. These are your total adjustments to income . . . . . . . 10d 0
11 Subtract line 10d from line 9. This is your adjusted gross income . . . . . . . . . . 11 19841
12 Itemized deductions (from Schedule A (Form 1040-NR)) or, for certain residents of India, standard
deduction (see instructions) . . . . . . . . . . . . . . . . . . . . . . 12 0
13a Qualified business income deduction from Form 8995 or Form 8995-A . 13a
b Exemptions for estates and trusts only (see instructions) . . . . . 13b
c Add lines 13a and 13b . . . . . . . . . . . . . . . . . . . . . . . 13c
14 Add lines 12 and 13c . . . . . . . . . . . . . . . . . . . . . . . 14 0
15 Subtract line 14 from line 11. If zero or less, enter -0-. This is your taxable income . . . . . 15 19841
For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. Cat. No. 11364D Form 1040-NR (2022)
Form 1040-NR (2022) Page 2

Tax and 16 Tax (see instructions). Check if any from Form(s): 1 8814 2 4972 3 16 2174
Credits 17 Amount from Schedule 2 (Form 1040), line 3 . . . . . . . . . . . . . . . . . 17 0
18 Add lines 16 and 17 . . . . . . . . . . . . . . . . . . . . . . . . 18 2174
19 Child tax credit or credit for other dependents from Schedule 8812 (Form 1040) . . . . . . 19 0
20 Amount from Schedule 3 (Form 1040), line 8 . . . . . . . . . . . . . . . . . 20 0
21 Add lines 19 and 20 . . . . . . . . . . . . . . . . . . . . . . . . 21 0
22 Subtract line 21 from line 18. If zero or less, enter -0- . . . . . . . . . . . . . . 22 2174
23a Tax on income not effectively connected with a U.S. trade or business from
Schedule NEC (Form 1040-NR), line 15 . . . . . . . . . . 23a 0
b Other taxes, including self-employment tax, from Schedule 2 (Form 1040),
line 21 . . . . . . . . . . . . . . . . . . . . 23b 0
c Transportation tax (see instructions) . . . . . . . . . . . 23c 0
d Add lines 23a through 23c . . . . . . . . . . . . . . . . . . . . . . 23d 0
24 Add lines 22 and 23d. This is your total tax . . . . . . . . . . . . . . . . . 24 2174
Payments 25 Federal income tax withheld from:
a Form(s) W-2 . . . . . . . . . . . . . . . . . . 25a 2696
b Form(s) 1099 . . . . . . . . . . . . . . . . . . 25b 0
c Other forms (see instructions) . . . . . . . . . . . . . 25c 0
d Add lines 25a through 25c . . . . . . . . . . . . . . . . . . . . . . 25d 2696
e Form(s) 8805 . . . . . . . . . . . . . . . . . . . . . . . . . . 25e 0
f Form(s) 8288-A . . . . . . . . . . . . . . . . . . . . . . . . . 25f 0
g Form(s) 1042-S . . . . . . . . . . . . . . . . . . . . . . . . . 25g 0
26 2022 estimated tax payments and amount applied from 2021 return . . . . . . . . . . 26 0
27 Reserved for future use . . . . . . . . . . . . . . . 27
28 Additional child tax credit from Schedule 8812 (Form 1040) . . . . 28 0
29 Credit for amount paid with Form 1040-C . . . . . . . . . 29 0
30 Reserved for future use . . . . . . . . . . . . . . . 30
31 Amount from Schedule 3 (Form 1040), line 15 . . . . . . . . 31 0
32 Add lines 28, 29, and 31. These are your total other payments and refundable credits . . . . 32 0
33 Add lines 25d, 25e, 25f, 25g, 26, and 32. These are your total payments . . . . . . . . 33 2696
Refund 34 If line 33 is more than line 24, subtract line 24 from line 33. This is the amount you overpaid . . 34 522
35a Amount of line 34 you want refunded to you. If Form 8888 is attached, check here . . . . 35a 522
Direct deposit? b Routing number 0 2 2 0 0 0 0 2 0 c Type: X Checking Savings
See instructions.
d Account number 8 2 7 0 0 2 8 5 8
e If you want your refund check mailed to an address outside the United States not shown on page 1,
enter it here.
36 Amount of line 34 you want applied to your 2023 estimated tax . . 36 0
Amount 37 Subtract line 33 from line 24. This is the amount you owe.
You Owe For details on how to pay, go to www.irs.gov/Payments or see instructions . . . . . . . . 37 0
38 Estimated tax penalty (see instructions) . . . . . . . . . . 38
Third Do you want to allow another person to discuss this return with the IRS? See instructions. Yes. Complete below. No
Party Designee’s Phone Personal identification
Designee name no. number (PIN)
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 complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
Sign Your signature Date Your occupation If the IRS sent you an Identity
Here Protection PIN, enter it here
02/08/2023 STUDENT (see inst.)
Phone no. Email address
Preparer’s name Preparer’s signature Date PTIN Check if:
Paid
Self-employed
Preparer
Firm’s name Phone no.
Use Only Firm’s address Firm’s EIN
Go to www.irs.gov/Form1040NR for instructions and the latest information. Form 1040-NR (2022)
SCHEDULE OI Other Information OMB No. 1545-0074

2022
(Form 1040-NR) Go to www.irs.gov/Form1040NR for instructions and the latest information.
Department of the Treasury Attach to Form 1040-NR.
Attachment
Internal Revenue Service Answer all questions. Sequence No. 7C
Name shown on Form 1040-NR Your identifying number
HEUNG YAN CHAN 194-88-7857
A Of what country or countries were you a citizen or national during the tax year? HONG KONG S.A.R.
B In what country did you claim residence for tax purposes during the tax year? HONG KONG S.A.R.
C Have you ever applied to be a green card holder (lawful permanent resident) of the United States? . . . . . Yes X No
D Were you ever:
1. A U.S. citizen? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes X No
2. A green card holder (lawful permanent resident) of the United States? . . . . . . . . . . . . . . Yes X No
If you answer “Yes” to (1) or (2), see Pub. 519, chapter 4, for expatriation rules that apply to you.
E If you had a visa on the last day of the tax year, enter your visa type. If you didn’t have a visa, enter your U.S.
immigration status on the last day of the tax year. F1
F Have you ever changed your visa type (nonimmigrant status) or U.S. immigration status? . . . . . . . . Yes X 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 2022. See instructions.
Note: If you’re 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 Date departed United States Date entered United States Date departed United States
mm/dd/yy mm/dd/yy mm/dd/yy mm/dd/yy
01/01/2022 08/20/2022
09/21/2022 12/10/2022

H Give number of days (including vacation, nonworkdays, and partial days) you were present in the United States during:
2020 69 , 2021 121 , and 2022 313 .
I Did you file a U.S. income tax return for any prior year? . . . . . . . . . . . . . . . . . . . Yes X No
If “Yes,” give the latest year and form number you filed:
J Are you filing a return for a trust? . . . . . . . . . . . . . . . . . . . . . . . . . . Yes X No
If “Yes,” did the trust have a U.S. or foreign owner under the grantor trust rules, make a distribution or loan to a
U.S. person, or receive a contribution from a U.S. person? . . . . . . . . . . . . . . . . . . Yes No
K Did you receive total compensation of $250,000 or more during the tax year? . . . . . . . . . . . . Yes X No
If “Yes,” did you use an alternative method to determine the source of this compensation? . . . . . . . Yes No
L Income Exempt From Tax—If you are claiming exemption from income tax under a U.S. income tax treaty with a foreign country,
complete (1) through (3) 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 (d) Amount of exempt
claimed in prior tax years income in current tax year

(e) Total. Enter this amount on Form 1040-NR, line 1k. Do not enter it anywhere else on line 1 . .
2. Were you subject to tax in a foreign country on any of the income shown in 1(d) above? . . . . . . . . Yes No
3. Are you claiming treaty benefits pursuant to a Competent Authority determination? . . . . . . . . . . Yes X No
If “Yes,” attach a copy of the Competent Authority determination letter to your return.
M Check the applicable box if:
1. This is the first year you are making an election to treat income from real property located in the United States as effectively connected
with a U.S. trade or business under section 871(d). See instructions . . . . . . . . . . . . . . . . . . . .
2. You have made an election in a previous year that has not been revoked, to treat income from real property located in the United
States as effectively connected with a U.S. trade or business under section 871(d). See instructions . . . . . . . . . .
For Paperwork Reduction Act Notice, see the Instructions for Form 1040-NR. Cat. No. 72756T Schedule OI (Form 1040-NR) 2022
Form 8843 Statement for Exempt Individuals and Individuals
With a Medical Condition
OMB No. 1545-0074

For use by alien individuals only.

Go to www.irs.gov/Form8843 for the latest information.
2022
Attachment
Department of the Treasury For the year January 1—December 31, 2022, or other tax year Sequence No. 102
Internal Revenue Service beginning , 2022, and ending , 20 .
Your first name and initial Last name Your U.S. taxpayer identification number, if any
HEUNG YAN CHAN 194-88-7857
Fill in your Address in country of residence Address in the United States
addresses only if 533 SAI SHA ROAD 655 KELTON AVE
you are filing this
NEW TERRITORIES 203
form by itself and
not with your tax HONG KONG LOS ANGELES, CA 90024
return HONG KONG S.A.R. 00000
Part I General Information
1a Type of U.S. visa (for example, F, J, M, Q, etc.) and date you entered the United States: F1 09/09/2018
b Current nonimmigrant status. If your status has changed, also enter date of change and previous status. See instructions.
F1
2 Of what country or countries were you a citizen during the tax year? HONG KONG S.A.R.
3a What country or countries issued you a passport? HONG KONG S.A.R.
b Enter your passport number(s): KJ0624834
4a Enter the actual number of days you were present in the United States during:
2022 313 2021 121 2020 69
b Enter the number of days in 2022 you claim you can exclude for purposes of the substantial presence test: 313
Part II Teachers and Trainees
5 For teachers, enter the name, address, and telephone number of the academic institution where you taught in 2022:

6 For trainees, enter the name, address, and telephone number of the director of the academic or other specialized program you
participated in during 2022:

7 Enter the type of U.S. visa (J or Q) you held during: 2016 2017
2018 2019 2020 2021 . 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 (2016 through 2021)? . . . . . . . . . . . . . . . . . . . . . . . . Yes X 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 2022:
UNIVERSITY OF CALIFORNIA-LOS ANGELES (UCLA), 106 TOM BRADLEY INTERNATIONAL HALL, LOS ANGELES, CA, 90095,
3108254321
10 Enter the name, address, and telephone number of the director of the academic or other specialized program you participated
in during 2022: CLINTON GILLILAND, 417 CHARLES E. YOUNG DRIVE WEST, LOS ANGELES, CA, 90095, 3108254321

11 Enter the type of U.S. visa (F, J, M, or Q) you held during: 2016 2017
2018 F1 2019 F1 2020 F1 2021 F1 . 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 X 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 2022, 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 X No
14 If you checked the “Yes” box on line 13, explain:

For Paperwork Reduction Act Notice, see instructions. Cat. No. 17227H Form 8843 (2022)
Form 8843 (2022) 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 2022 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.
See instructions.

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 Physician’s 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

Physician’s or other medical official’s address and telephone number

Physician’s or other medical official’s signature Date

Sign here 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,
only if you they are true, correct, and complete.
are filing
this form by
itself and 02.08.23
not with
your tax
return Your signature Date

Form 8843 (2022)

 Instruction page only. Do not mail with your tax return.

Federal Tax Return

for
HEUNG YAN CHAN
2022

YOUR COPY
RETAIN FOR YOUR RECORDS

Sprintax Inc t 1-866-601-5695

333 N. Michigan Ave, Suite 915, e [email protected]
Chicago, IL, 60601, USA sprintax.com
7
 1040-NR U.S. Nonresident Alien Income Tax Return 2022
Form Department of the Treasury—Internal Revenue Service
IRS Use Only—Do not write
OMB No. 1545-0074 or staple in this space.
See separate
For the year Jan. 1–Dec. 31, 2022, or other tax year beginning , 2022, ending , 20 instructions.
Filing X Single Married filing separately (MFS) Qualifying surviving spouse (QSS) Estate Trust
Status
If you checked the QSS box, enter the child’s name if the qualifying person is a child but not your dependent:
Check only
one box.
Your first name and middle initial Last name Your identifying number
(see instructions)
HEUNG YAN CHAN 194 88 7857
Home address (number and street). If you have a P.O. box, see instructions. Apt. no.
655 KELTON AVE 203
City, town, or post office. If you have a foreign address, also complete spaces below. State ZIP code
LOS ANGELES CA 90024
Foreign country name Foreign province/state/county Foreign postal code

Digital Assets At any time during 2022, did you: (a) receive (as a reward, award, or payment for property or services); or (b) sell, exchange, gift, or
otherwise dispose of a digital asset (or a financial interest in a digital asset)? (See instructions.) . . . . . . Yes X No
Dependents (4) Check the box if qualifies for (see inst.):
(2) Dependent’s Credit for other
(see instructions): Child tax credit
(1) First name Last name identifying number (3) Relationship to you dependents

If more than four

dependents, see
instructions and
check here

Income 1a Total amount from Form(s) W-2, box 1 (see instructions) . . . . . . . . . . . . . 1a 19841
Effectively b Household employee wages not reported on Form(s) W-2 . . . . . . . . . . . . . 1b
Connected c Tip income not reported on line 1a (see instructions) . . . . . . . . . . . . . . 1c
With U.S. d Medicaid waiver payments not reported on Form(s) W-2 (see instructions) . . . . . . . . 1d
Trade or e Taxable dependent care benefits from Form 2441, line 26 . . . . . . . . . . . . . 1e
Business f Employer-provided adoption benefits from Form 8839, line 29 . . . . . . . . . . . 1f
g Wages from Form 8919, line 6 . . . . . . . . . . . . . . . . . . . . . 1g
Attach
h Other earned income (see instructions) . . . . . . . . . . . . . . . . . . 1h
Form(s) W-2,
1042-S, i Reserved for future use . . . . . . . . . . . . . . . 1i
SSA-1042-S, j Reserved for future use . . . . . . . . . . . . . . . . . . . . . . . 1j
RRB-1042-S,
and 8288-A k Total income exempt by a treaty from Schedule OI (Form 1040-NR), item L,
here. Also line 1(e) . . . . . . . . . . . . . . . . . . . 1k 0
attach z Add lines 1a through 1h . . . . . . . . . . . . . . . . . . . . . . . 1z 19841
Form(s)
2a Tax-exempt interest . . . 2a b Taxable interest . . . . . . 2b
1099-R if
tax was 3a Qualified dividends . . . 3a b Ordinary dividends . . . . . 3b
withheld. 4a IRA distributions . . . . 4a 0 b Taxable amount . . . . . . 4b 0
If you did not 5a Pensions and annuities . . 5a 0 b Taxable amount . . . . . . 5b 0
get a Form 6 Reserved for future use . . . . . . . . . . . . . . . . . . . . . . . 6
W-2, see
instructions. 7 Capital gain or (loss). Attach Schedule D (Form 1040) if required. If not required, check here . . 7 0
8 Other income from Schedule 1 (Form 1040), line 10 . . . . . . . . . . . . . . . 8 0
9 Add lines 1z, 2b, 3b, 4b, 5b, 7, and 8. This is your total effectively connected income . . . . 9 19841
10 Adjustments to income:
a From Schedule 1 (Form 1040), line 26 . . . . . . . . . . . 10a 0
b Reserved for future use . . . . . . . . . . . . . . . 10b
c Reserved for future use . . . . . . . . . . . . . . . 10c
d Enter the amount from line 10a. These are your total adjustments to income . . . . . . . 10d 0
11 Subtract line 10d from line 9. This is your adjusted gross income . . . . . . . . . . 11 19841
12 Itemized deductions (from Schedule A (Form 1040-NR)) or, for certain residents of India, standard
deduction (see instructions) . . . . . . . . . . . . . . . . . . . . . . 12 0
13a Qualified business income deduction from Form 8995 or Form 8995-A . 13a
b Exemptions for estates and trusts only (see instructions) . . . . . 13b
c Add lines 13a and 13b . . . . . . . . . . . . . . . . . . . . . . . 13c
14 Add lines 12 and 13c . . . . . . . . . . . . . . . . . . . . . . . 14 0
15 Subtract line 14 from line 11. If zero or less, enter -0-. This is your taxable income . . . . . 15 19841
For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. Cat. No. 11364D Form 1040-NR (2022)
Form 1040-NR (2022) Page 2

Tax and 16 Tax (see instructions). Check if any from Form(s): 1 8814 2 4972 3 16 2174
Credits 17 Amount from Schedule 2 (Form 1040), line 3 . . . . . . . . . . . . . . . . . 17 0
18 Add lines 16 and 17 . . . . . . . . . . . . . . . . . . . . . . . . 18 2174
19 Child tax credit or credit for other dependents from Schedule 8812 (Form 1040) . . . . . . 19 0
20 Amount from Schedule 3 (Form 1040), line 8 . . . . . . . . . . . . . . . . . 20 0
21 Add lines 19 and 20 . . . . . . . . . . . . . . . . . . . . . . . . 21 0
22 Subtract line 21 from line 18. If zero or less, enter -0- . . . . . . . . . . . . . . 22 2174
23a Tax on income not effectively connected with a U.S. trade or business from
Schedule NEC (Form 1040-NR), line 15 . . . . . . . . . . 23a 0
b Other taxes, including self-employment tax, from Schedule 2 (Form 1040),
line 21 . . . . . . . . . . . . . . . . . . . . 23b 0
c Transportation tax (see instructions) . . . . . . . . . . . 23c 0
d Add lines 23a through 23c . . . . . . . . . . . . . . . . . . . . . . 23d 0
24 Add lines 22 and 23d. This is your total tax . . . . . . . . . . . . . . . . . 24 2174
Payments 25 Federal income tax withheld from:
a Form(s) W-2 . . . . . . . . . . . . . . . . . . 25a 2696
b Form(s) 1099 . . . . . . . . . . . . . . . . . . 25b 0
c Other forms (see instructions) . . . . . . . . . . . . . 25c 0
d Add lines 25a through 25c . . . . . . . . . . . . . . . . . . . . . . 25d 2696
e Form(s) 8805 . . . . . . . . . . . . . . . . . . . . . . . . . . 25e 0
f Form(s) 8288-A . . . . . . . . . . . . . . . . . . . . . . . . . 25f 0
g Form(s) 1042-S . . . . . . . . . . . . . . . . . . . . . . . . . 25g 0
26 2022 estimated tax payments and amount applied from 2021 return . . . . . . . . . . 26 0
27 Reserved for future use . . . . . . . . . . . . . . . 27
28 Additional child tax credit from Schedule 8812 (Form 1040) . . . . 28 0
29 Credit for amount paid with Form 1040-C . . . . . . . . . 29 0
30 Reserved for future use . . . . . . . . . . . . . . . 30
31 Amount from Schedule 3 (Form 1040), line 15 . . . . . . . . 31 0
32 Add lines 28, 29, and 31. These are your total other payments and refundable credits . . . . 32 0
33 Add lines 25d, 25e, 25f, 25g, 26, and 32. These are your total payments . . . . . . . . 33 2696
Refund 34 If line 33 is more than line 24, subtract line 24 from line 33. This is the amount you overpaid . . 34 522
35a Amount of line 34 you want refunded to you. If Form 8888 is attached, check here . . . . 35a 522
Direct deposit? b Routing number 0 2 2 0 0 0 0 2 0 c Type: X Checking Savings
See instructions.
d Account number 8 2 7 0 0 2 8 5 8
e If you want your refund check mailed to an address outside the United States not shown on page 1,
enter it here.
36 Amount of line 34 you want applied to your 2023 estimated tax . . 36 0
Amount 37 Subtract line 33 from line 24. This is the amount you owe.
You Owe For details on how to pay, go to www.irs.gov/Payments or see instructions . . . . . . . . 37 0
38 Estimated tax penalty (see instructions) . . . . . . . . . . 38
Third Do you want to allow another person to discuss this return with the IRS? See instructions. Yes. Complete below. No
Party Designee’s Phone Personal identification
Designee name no. number (PIN)
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 complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
Sign Your signature Date Your occupation If the IRS sent you an Identity
Here Protection PIN, enter it here
02/08/2023 STUDENT (see inst.)
Phone no. Email address
Preparer’s name Preparer’s signature Date PTIN Check if:
Paid
Self-employed
Preparer
Firm’s name Phone no.
Use Only Firm’s address Firm’s EIN
Go to www.irs.gov/Form1040NR for instructions and the latest information. Form 1040-NR (2022)
SCHEDULE OI Other Information OMB No. 1545-0074

2022
(Form 1040-NR) Go to www.irs.gov/Form1040NR for instructions and the latest information.
Department of the Treasury Attach to Form 1040-NR.
Attachment
Internal Revenue Service Answer all questions. Sequence No. 7C
Name shown on Form 1040-NR Your identifying number
HEUNG YAN CHAN 194-88-7857
A Of what country or countries were you a citizen or national during the tax year? HONG KONG S.A.R.
B In what country did you claim residence for tax purposes during the tax year? HONG KONG S.A.R.
C Have you ever applied to be a green card holder (lawful permanent resident) of the United States? . . . . . Yes X No
D Were you ever:
1. A U.S. citizen? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes X No
2. A green card holder (lawful permanent resident) of the United States? . . . . . . . . . . . . . . Yes X No
If you answer “Yes” to (1) or (2), see Pub. 519, chapter 4, for expatriation rules that apply to you.
E If you had a visa on the last day of the tax year, enter your visa type. If you didn’t have a visa, enter your U.S.
immigration status on the last day of the tax year. F1
F Have you ever changed your visa type (nonimmigrant status) or U.S. immigration status? . . . . . . . . Yes X 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 2022. See instructions.
Note: If you’re 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 Date departed United States Date entered United States Date departed United States
mm/dd/yy mm/dd/yy mm/dd/yy mm/dd/yy
01/01/2022 08/20/2022
09/21/2022 12/10/2022

H Give number of days (including vacation, nonworkdays, and partial days) you were present in the United States during:
2020 69 , 2021 121 , and 2022 313 .
I Did you file a U.S. income tax return for any prior year? . . . . . . . . . . . . . . . . . . . Yes X No
If “Yes,” give the latest year and form number you filed:
J Are you filing a return for a trust? . . . . . . . . . . . . . . . . . . . . . . . . . . Yes X No
If “Yes,” did the trust have a U.S. or foreign owner under the grantor trust rules, make a distribution or loan to a
U.S. person, or receive a contribution from a U.S. person? . . . . . . . . . . . . . . . . . . Yes No
K Did you receive total compensation of $250,000 or more during the tax year? . . . . . . . . . . . . Yes X No
If “Yes,” did you use an alternative method to determine the source of this compensation? . . . . . . . Yes No
L Income Exempt From Tax—If you are claiming exemption from income tax under a U.S. income tax treaty with a foreign country,
complete (1) through (3) 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 (d) Amount of exempt
claimed in prior tax years income in current tax year

(e) Total. Enter this amount on Form 1040-NR, line 1k. Do not enter it anywhere else on line 1 . .
2. Were you subject to tax in a foreign country on any of the income shown in 1(d) above? . . . . . . . . Yes No
3. Are you claiming treaty benefits pursuant to a Competent Authority determination? . . . . . . . . . . Yes X No
If “Yes,” attach a copy of the Competent Authority determination letter to your return.
M Check the applicable box if:
1. This is the first year you are making an election to treat income from real property located in the United States as effectively connected
with a U.S. trade or business under section 871(d). See instructions . . . . . . . . . . . . . . . . . . . .
2. You have made an election in a previous year that has not been revoked, to treat income from real property located in the United
States as effectively connected with a U.S. trade or business under section 871(d). See instructions . . . . . . . . . .
For Paperwork Reduction Act Notice, see the Instructions for Form 1040-NR. Cat. No. 72756T Schedule OI (Form 1040-NR) 2022
Form 8843 Statement for Exempt Individuals and Individuals
With a Medical Condition
OMB No. 1545-0074

For use by alien individuals only.

Go to www.irs.gov/Form8843 for the latest information.
2022
Attachment
Department of the Treasury For the year January 1—December 31, 2022, or other tax year Sequence No. 102
Internal Revenue Service beginning , 2022, and ending , 20 .
Your first name and initial Last name Your U.S. taxpayer identification number, if any
HEUNG YAN CHAN 194-88-7857
Fill in your Address in country of residence Address in the United States
addresses only if 533 SAI SHA ROAD 655 KELTON AVE
you are filing this
NEW TERRITORIES 203
form by itself and
not with your tax HONG KONG LOS ANGELES, CA 90024
return HONG KONG S.A.R. 00000
Part I General Information
1a Type of U.S. visa (for example, F, J, M, Q, etc.) and date you entered the United States: F1 09/09/2018
b Current nonimmigrant status. If your status has changed, also enter date of change and previous status. See instructions.
F1
2 Of what country or countries were you a citizen during the tax year? HONG KONG S.A.R.
3a What country or countries issued you a passport? HONG KONG S.A.R.
b Enter your passport number(s): KJ0624834
4a Enter the actual number of days you were present in the United States during:
2022 313 2021 121 2020 69
b Enter the number of days in 2022 you claim you can exclude for purposes of the substantial presence test: 313
Part II Teachers and Trainees
5 For teachers, enter the name, address, and telephone number of the academic institution where you taught in 2022:

6 For trainees, enter the name, address, and telephone number of the director of the academic or other specialized program you
participated in during 2022:

7 Enter the type of U.S. visa (J or Q) you held during: 2016 2017
2018 2019 2020 2021 . 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 (2016 through 2021)? . . . . . . . . . . . . . . . . . . . . . . . . Yes X 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 2022:
UNIVERSITY OF CALIFORNIA-LOS ANGELES (UCLA), 106 TOM BRADLEY INTERNATIONAL HALL, LOS ANGELES, CA, 90095,
3108254321
10 Enter the name, address, and telephone number of the director of the academic or other specialized program you participated
in during 2022: CLINTON GILLILAND, 417 CHARLES E. YOUNG DRIVE WEST, LOS ANGELES, CA, 90095, 3108254321

11 Enter the type of U.S. visa (F, J, M, or Q) you held during: 2016 2017
2018 F1 2019 F1 2020 F1 2021 F1 . 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 X 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 2022, 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 X No
14 If you checked the “Yes” box on line 13, explain:

For Paperwork Reduction Act Notice, see instructions. Cat. No. 17227H Form 8843 (2022)
Form 8843 (2022) 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 2022 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.
See instructions.

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 Physician’s 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

Physician’s or other medical official’s address and telephone number

Physician’s or other medical official’s signature Date

Sign here 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,
only if you they are true, correct, and complete.
are filing
this form by
itself and 02.08.23
not with
your tax
return Your signature Date

Form 8843 (2022)

 Instruction page only. Do not mail with your tax return.

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