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Department of the Treasury
Instructions for Internal Revenue Service

Form W-8BEN-E
(Rev. July 2017)
Certificate of Status of Beneficial Owner for
United States Tax Withholding and Reporting (Entities)

Section references are to the Internal Revenue Code
unless otherwise noted. General Instructions
For definitions of terms used throughout these
Future Developments instructions, see Definitions, later.
For the latest information about developments related to
Purpose of Form
Form W-8BEN-E and its instructions, such as legislation
enacted after they were published, go to IRS.gov/ This form is used by foreign entities to document their
FormW8BENE. statuses for purposes of chapter 3 and chapter 4, as well
as for certain other Code provisions as described later in
these instructions.
What's New
Foreign persons are subject to U.S. tax at a 30% rate
Limited FFIs and limited branches. Limited FFI and on income they receive from U.S. sources that consists of:
limited branch statuses expired on December 31, 2016, Interest (including certain original issue discount (OID));
and have been removed from this form and the Dividends;
instructions. Rents;
Sponsored FFIs and sponsored direct reporting Royalties;
NFFEs. As of January 1, 2017, sponsored FFIs that are Premiums;
registered deemed-compliant FFIs and sponsored direct Annuities;
reporting NFFEs are required to obtain their own GIINs to Compensation for, or in expectation of, services
be provided on this form and can no longer provide the performed;
sponsoring entity’s GIIN. This form has been updated to Substitute payments in a securities lending transaction;
reflect this requirement. or
Other fixed or determinable annual or periodical gains,
Nonreporting IGA FFIs. This form and these
profits, or income.
instructions have been updated to reflect the
requirements for withholding agents to document This tax is imposed on the gross amount paid and is
nonreporting IGA FFIs in the Treasury regulations. These generally collected by withholding under section 1441 or
instructions also clarify that nonreporting IGA FFIs that are 1442 on that amount. A payment is considered to have
sponsored entities should provide their own GIIN (if been made whether it is made directly to the beneficial
required) and should not provide the GIIN of the owner or to another person, such as an intermediary,
sponsoring entity. See the instructions to Part XII. In agent, or partnership, for the benefit of the beneficial
addition, these instructions provide that a trustee of a owner.
trustee-documented trust that is a foreign person should
provide the GIIN it received when it registered as a In addition, section 1446 requires a partnership
participating FFI (including a reporting Model 2 FFI) or conducting a trade or business in the United States to
reporting Model 1 FFI. withhold tax on a foreign partner’s distributive share of the
partnership’s effectively connected taxable income.
Foreign taxpayer identification numbers (TINs). Generally, a foreign person that is a partner in a
These instructions have been updated to require a foreign partnership that submits a Form W-8 for purposes of
TIN (except in certain cases) to be provided on this form section 1441 or 1442 will satisfy the documentation
for certain foreign account holders of a financial account requirements under section 1446 as well. However, in
maintained at a U.S. office or branch of a financial some cases the documentation requirements of sections
institution. See the instructions to line 9b for exceptions to 1441 and 1442 do not match the documentation
this requirement. requirements of section 1446. See Regulations sections
1.1446-1 through 1.1446-6.
Reminder A withholding agent or payer of the income may rely on
Note. If you are a resident in a FATCA partner jurisdiction a properly completed Form W-8BEN-E to treat a payment
(that is, a Model 1 IGA jurisdiction with reciprocity), certain associated with the Form W-8BEN-E as a payment to a
tax account information may be provided to your foreign person who beneficially owns the amounts paid. If
jurisdiction of residence. applicable, the withholding agent may rely on the Form
W-8BEN-E to apply a reduced rate of, or exemption from,
withholding. If you receive certain types of income, you
must provide Form W-8BEN-E to:

Jul 19, 2017 Cat. No. 59691Z

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Claim that you are the beneficial owner of the income payment from a withholding agent, receiving a payment
for which Form W-8BEN-E is being provided or a partner subject to chapter 3 withholding, or if you are an entity
in a partnership subject to section 1446; and maintaining an account with an FFI requesting this form.
If applicable, claim a reduced rate of, or exemption
from, withholding as a resident of a foreign country with Do not use Form W-8BEN-E if:
which the United States has an income tax treaty. You are a U.S. person (including U.S. citizens, resident
aliens, and entities treated as U.S. persons, such as a
You may also use Form W-8BEN-E to identify income corporation organized under the law of a state). Instead,
from a notional principal contract that is not effectively use Form W-9, Request for Taxpayer Identification
connected with the conduct of a trade or business in the Number and Certification.
United States to establish the exception to reporting such You are a foreign insurance company that has made an
income on Form 1042-S. See Regulations section election under section 953(d) to be treated as a U.S.
1.1461-1(c)(2)(ii)(F). person. Instead, provide a withholding agent with Form
Form W-8BEN-E may also be used to claim exemption W-9 to certify to your U.S. status even if you are
from withholding for portfolio interest pursuant to section considered an FFI for purposes of chapter 4.
881(c). The portfolio interest exemption does not apply to You are a nonresident alien individual. Instead, use
payments of interest for which the recipient is a 10 percent Form W-8BEN, Certificate of Foreign Status of Beneficial
shareholder of the payer or to payments of interest Owner for United States Tax Withholding and Reporting
received by a controlled foreign corporation from a related (Individuals), or Form 8233, Exemption From Withholding
person. See sections 881(c)(3) and 881(c)(5). A future on Compensation for Independent (and Certain
version of this form may require that persons receiving Dependent) Personal Services of a Nonresident Alien
interest payments to which this form relates identify any Individual, as applicable.
obligation with respect to which they have one of these You are a disregarded entity, branch, or flow-through
prohibited relationships. entity for U.S. tax purposes. However, you may use this
You may also be required to submit Form W-8BEN-E to form if you are a disregarded entity or flow-through entity
claim an exception from domestic information reporting on using this form either solely to document your chapter 4
Form 1099 and backup withholding (at the backup status (because you hold an account with an FFI) or, if you
withholding rate under section 3406) for certain types of are a disregarded entity or a partnership, to claim treaty
income. Such income includes: benefits because you are a hybrid entity liable to tax as a
Broker proceeds. resident for treaty purposes. See Special Instructions for
Short-term (183 days or less) original issue discount Hybrid Entities, later. A flow-through entity may also use
(short-term OID). this form for purposes of documenting itself as a
Bank deposit interest. participating payee for purposes of section 6050W. If you
Foreign source interest, dividends, rents, or royalties. are a disregarded entity with a single owner or branch of
an FFI, the single owner, if such owner is a foreign person,
Provide Form W-8BEN-E to the withholding agent or should provide Form W-8BEN or Form W-8BEN-E (as
payer before income is paid or credited to you. Failure to appropriate). If the single owner is a U.S. person, a Form
provide a Form W-8BEN-E when requested may lead to W-9 should be provided. If you are a partnership, you
withholding at a 30% rate or the backup withholding rate should provide a Form W-8IMY, Certificate of Foreign
in certain cases when you receive a payment to which Intermediary, Foreign Flow-Through Entity, or Certain
backup withholding applies. U.S. Branches for United States Tax Withholding and
In addition to the requirements of chapter 3, chapter 4 Reporting.
requires withholding agents to identify the chapter 4 status You are acting as an intermediary (that is, acting not for
of entities that are payees receiving withholdable your own account, but for the account of others as an
payments. A withholding agent may request this Form agent, nominee, or custodian), a qualified intermediary
W-8BEN-E to establish your chapter 4 status and avoid (including a qualified intermediary acting as a qualified
withholding at a 30% rate on such payments. derivatives dealer), or a qualified securities lender (QSL).
Instead, provide Form W-8IMY.
Chapter 4 also requires participating FFIs and certain
You are receiving income that is effectively connected
registered deemed-compliant FFIs to document their
with the conduct of a trade or business in the United
entity account holders in order to determine their
States, unless it is allocable to you through a partnership.
chapter 4 statuses regardless of whether withholding
Instead, provide Form W-8ECI, Certificate of Foreign
applies to any payments made to the entities. If you are an
Person’s Claim That Income Is Effectively Connected
entity maintaining an account with an FFI, the FFI may
With the Conduct of a Trade or Business in the United
request that you provide this Form W-8BEN-E in order to
States. If any of the income for which you have provided a
document your chapter 4 status.
Form W-8BEN-E becomes effectively connected, this is a
Additional information. For additional information and change in circumstances and the Form W-8BEN-E is no
instructions for the withholding agent, see the Instructions longer valid.
for the Requester of Forms W-8BEN, W-8BEN-E, You are filing for a foreign government, international
W-8ECI, W-8EXP, and W-8IMY. organization, foreign central bank of issue, foreign
tax-exempt organization, foreign private foundation, or
Who Must Provide Form W-8BEN-E government of a U.S. possession claiming the
You must give Form W-8BEN-E to the withholding agent applicability of section 115(2), 501(c), 892, 895, or
or payer if you are a foreign entity receiving a withholdable 1443(b). Instead, provide Form W-8EXP, Certificate of

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Foreign Government or Other Foreign Organization for the account holders is a specified U.S. person or a
United States Tax Withholding and Reporting, to certify to U.S.-owned foreign entity (unless the account is otherwise
your exemption and identify your chapter 4 status. excepted from U.S. account status for chapter 4
However, you should provide Form W-8BEN-E if you are purposes).
claiming treaty benefits, and you may provide this form if
Change in circumstances. If a change in
you are only claiming you are a foreign person exempt
circumstances makes any information on the Form
from backup withholding or documenting your chapter 4
W-8BEN-E you have submitted incorrect for purposes of
status. For example, a foreign tax-exempt organization
either chapter 3 or chapter 4, you must notify the
under section 501(c) receiving royalty income that is not
withholding agent or financial institution maintaining your
exempt because it is taxable as unrelated business
account within 30 days of the change in circumstances by
income but that is eligible for a reduced rate of withholding
providing the documentation required in Regulations
under a royalty article of a tax treaty should provide Form
section 1.1471-3(c)(6)(ii)(E)(2). See Regulations sections
W-8BEN-E. You should use Form W-8ECI if you are
1.1441-1(e)(4)(ii)(D) for the definition of change in
receiving effectively connected income (for example,
circumstances for purposes of chapter 3, and 1.1471-3(c)
income from commercial activities that is not exempt
(6)(ii)(E) for purposes of chapter 4.
under an applicable section of the Code).
You are a foreign reverse hybrid entity transmitting With respect to an FFI claiming a chapter 4 status
documentation provided by your interest holders to claim ! under an applicable IGA, a change in
treaty benefits on their behalf. Instead, provide Form CAUTION circumstances includes when the jurisdiction
W-8IMY. A foreign reverse hybrid entity also may not use where the FFI is organized or resident (or the jurisdiction
this form to attempt to claim treaty benefits on its own identified in Part II of the form) was included on the list of
behalf. See Foreign Reverse Hybrid Entities, later. jurisdictions treated as having an intergovernmental
You are a withholding foreign partnership or a agreement in effect and is removed from that list or when
withholding foreign trust within the meaning of sections the FATCA status of the jurisdiction changes (for
1441 and 1442 and the accompanying regulations. example, from Model 2 to Model 1). The list of
Instead, provide Form W-8IMY. agreements is maintained at www.treasury.gov/resource-
You are a foreign partnership or foreign grantor trust center/tax-policy/treaties/Pages/FATCA-Archive.aspx.
providing documentation for purposes of section 1446.
Instead, provide Form W-8IMY and accompanying Expiration of Form W-8BEN-E. Generally, a Form
documentation. W-8BEN-E will remain valid for purposes of both chapters
You are a foreign branch of a U.S. financial institution 3 and 4 for a period starting on the date the form is signed
that is an FFI (other than a qualified intermediary branch) and ending on the last day of the third succeeding
under an applicable Model 1 IGA. For purposes of calendar year, unless a change in circumstances makes
identifying yourself to withholding agents, you may submit any information on the form incorrect. For example, a
Form W-9 to certify to your U.S. status. Form W-8BEN signed on September 30, 2014, remains
valid through December 31, 2017.
Giving Form W-8BEN-E to the withholding agent. Do
not send Form W-8BEN-E to the IRS. Instead, give it to However, under certain conditions a Form W-8BEN-E
the person who is requesting it from you. Generally, this will remain in effect indefinitely absent a change of
will be the person from whom you receive the payment, circumstances. See Regulations sections 1.1441-1(e)(4)
who credits your account, or a partnership that allocates (ii) and 1.1471-3(c)(6)(ii) for the period of validity for
income to you. An FFI may also request this form from you chapters 3 and 4 purposes, respectively.

to document the status of your account. Definitions
When to provide Form W-8BEN-E to the withholding
Account holder. An account holder is generally the
agent. Give Form W-8BEN-E to the person requesting it
person listed or identified as the holder or owner of a
before the payment is made to you, credited to your
financial account. For example, if a partnership is listed as
account, or allocated. If you do not provide this form, the
the holder or owner of a financial account, then the
withholding agent may have to withhold at the 30% rate
partnership is the account holder, rather than the partners
(as applicable under chapters 3 or 4), backup withholding
of the partnership. However, an account that is held by a
rate, or the rate applicable under section 1446. If you
disregarded entity (other than a disregarded entity treated
receive more than one type of income from a single
as an FFI for chapter 4 purposes) is treated as held by the
withholding agent for which you claim different benefits,
entity's single owner.
the withholding agent may, at its option, require you to
submit a Form W-8BEN-E for each type of income. Amounts subject to chapter 3 withholding. Generally,
Generally, a separate Form W-8BEN-E must be given to an amount subject to chapter 3 withholding is an amount
each withholding agent. from sources within the United States that is fixed or
Note. If you own the income with one or more other determinable annual or periodical (FDAP) income. FDAP
persons, the income will be treated by the withholding income is all income included in gross income, including
agent as owned by a foreign person that is a beneficial interest (as well as OID), dividends, rents, royalties, and
owner of a payment only if Form W-8BEN or W-8BEN-E compensation. Amounts subject to chapter 3 withholding
(or other applicable document) is provided by each of the do not include amounts that are not FDAP, such as most
owners. An account will be treated as a U.S. account for gains from the sale of property (including market discount
chapter 4 purposes by an FFI requesting this form if any of and option premiums), as well as other specific items of

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income described in Regulations section 1.1441-2 (such Chapter 4 status. The term chapter 4 status means a
as interest on bank deposits and short-term OID). person’s status as a U.S. person, specified U.S. person,
For purposes of section 1446, the amount subject to foreign individual, participating FFI, deemed-compliant
withholding is the foreign partner’s share of the FFI, restricted distributor, exempt beneficial owner,
partnership’s effectively connected taxable income. nonparticipating FFI, territory financial institution,
excepted NFFE, or passive NFFE.
Beneficial owner. For payments other than those for
which a reduced rate of, or exemption from, withholding is Deemed-compliant FFI. Under section 1471(b)(2),
claimed under an income tax treaty, the beneficial owner certain FFIs are deemed to comply with the regulations
of income is generally the person who is required under under chapter 4 without the need to enter into an FFI
U.S. tax principles to include the payment in gross income agreement with the IRS. However, certain
on a tax return. A person is not a beneficial owner of deemed-compliant FFIs are required to register with the
income, however, to the extent that person is receiving the IRS and obtain a GIIN. These FFIs are referred to as
income as a nominee, agent, or custodian, or to the extent registered deemed-compliant FFIs. See Regulations
the person is a conduit whose participation in a section 1.1471-5(f)(1).
transaction is disregarded. In the case of amounts paid
Disregarded entity. A business entity that has a single
that do not constitute income, beneficial ownership is owner and is not a corporation under Regulations section
determined as if the payment were income. 301.7701-2(b) is disregarded as an entity separate from
Foreign partnerships, foreign simple trusts, and foreign its owner. Generally, a disregarded entity does not submit
grantor trusts are not the beneficial owners of income paid this Form W-8BEN-E to a withholding agent. Instead, the
to the partnership or trust. The beneficial owners of owner of such entity provides the appropriate
income paid to a foreign partnership are generally the documentation (for example, a Form W-8BEN-E if the
partners in the partnership, provided that the partner is not owner is a foreign entity). However, if a disregarded entity
itself a partnership, foreign simple or grantor trust, receiving a withholdable payment is an FFI outside the
nominee or other agent. The beneficial owners of income single owner’s country of organization or has its own GIIN,
paid to a foreign simple trust (that is, a foreign trust that is its foreign owner will be required to complete Part II of
described in section 651(a)) are generally the Form W-8BEN-E to document the chapter 4 status of the
beneficiaries of the trust, if the beneficiary is not a foreign disregarded entity receiving the payment.
partnership, foreign simple or grantor trust, nominee, or
Certain entities that are disregarded for U.S. tax
other agent. The beneficial owners of income paid to a
purposes may be treated as treaty residents for purposes
foreign grantor trust (that is, a foreign trust to the extent
of claiming treaty benefits under an applicable tax treaty
that all or a portion of the income of the trust is treated as
or may be recognized as FFIs under an applicable IGA. A
owned by the grantor or another person under sections
hybrid entity claiming treaty benefits on its own behalf is
671 through 679) are the persons treated as the owners of
required to complete Form W-8BEN-E. See Hybrid
the trust. The beneficial owners of income paid to a
Entities under Special Instructions, later.
foreign complex trust (that is, a foreign trust that is not a
foreign simple trust or foreign grantor trust) is the trust A disregarded entity with a U.S. owner or a disregarded
itself. entity with a foreign owner that is not otherwise able to fill
out Part II (that is, because it is in the same country as its
For purposes of section 1446, the same beneficial
single owner and does not have a GIIN) may provide this
owner rules apply, except that under section 1446 a
form to an FFI solely for purposes of documenting itself for
foreign simple trust rather than the beneficiary provides
chapter 4 purposes. In such a case, the disregarded entity
the form to the partnership.
should complete Part I as if it were a beneficial owner and
The beneficial owner of income paid to a foreign estate should not complete line 3.
is the estate itself.
Financial account. A financial account includes:
Note. A payment to a U.S. partnership, U.S. trust, or
A depository account maintained by an FFI;
U.S. estate is treated as a payment to a U.S. payee that is
A custodial account maintained by an FFI;
not subject to 30% withholding for purposes of chapters 3
Equity or debt interests (other than interests regularly
and 4. A U.S. partnership, trust, or estate should provide
traded on an established securities market) in investment
the withholding agent with a Form W-9. For purposes of
entities and certain holding companies, treasury centers,
section 1446, a U.S. grantor trust or disregarded entity
or financial institutions as defined in Regulations section
shall not provide the withholding agent a Form W-9 in its
1.1471-5(e);
own right. Rather, the grantor or other owner shall provide
Certain cash value insurance contracts; and
the withholding agent the appropriate form.
Annuity contracts.
Chapter 3. Chapter 3 means chapter 3 of the Internal For purposes of chapter 4, exceptions are provided for
Revenue Code (Withholding of Tax on Nonresident Aliens accounts such as certain tax-favored savings accounts,
and Foreign Corporations). Chapter 3 contains sections term life insurance contracts, accounts held by estates,
1441 through 1464. escrow accounts, and certain annuity contracts. These
Chapter 4. Chapter 4 means chapter 4 of the Internal exceptions are subject to certain conditions. See
Revenue Code (Taxes to Enforce Reporting on Certain Regulations section 1.1471-5(b)(2). Accounts may also
Foreign Accounts). Chapter 4 contains sections 1471 be excluded from the definition of financial account under
through 1474. an applicable IGA.

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Financial institution. A financial institution generally or a Model 2 IGA. For a list of jurisdictions treated as
means an entity that is a depository institution, custodial having in effect a Model 1 or Model 2 IGA, see
institution, investment entity, or an insurance company (or www.treasury.gov/resource-center/tax-policy/treaties/
holding company of an insurance company) that issues Pages/FATCA-Archive.aspx.
cash value insurance or annuity contracts. See A Model 1 IGA means an agreement between the
Regulations section 1.1471-5(e). United States or the Treasury Department and a foreign
An investment entity organized in a territory that is not government or one or more agencies to implement
also a depository institution, custodial institution, or FATCA through reporting by FFIs to such foreign
specified insurance company is not treated as a financial government or agency, followed by automatic exchange
institution. Instead, it is a territory NFFE. If such an entity of the reported information with the IRS. An FFI in a Model
cannot qualify as an excepted NFFE as described in 1 IGA jurisdiction that performs account reporting to the
Regulations section 1.1472-1(c)(1) (including an excepted jurisdiction’s government is referred to as a reporting
territory NFFE), it must disclose its substantial U.S. Model 1 FFI.
owners using this definition (applying the 10 percent A Model 2 IGA means an agreement or arrangement
threshold) under Regulations section 1.1473-1(b)(1). between the United States or the Treasury Department
and a foreign government or one or more agencies to
Foreign financial institution (FFI). A foreign financial
implement FATCA through reporting by FFIs directly to
institution (FFI) means a foreign entity that is a financial
the IRS in accordance with the requirements of an FFI
institution.
agreement, supplemented by the exchange of information
Fiscally transparent entity. An entity is treated as between such foreign government or agency and the IRS.
fiscally transparent with respect to an item of income for An FFI in a Model 2 IGA jurisdiction that has entered into
which treaty benefits are claimed to the extent that the an FFI agreement with respect to a branch is a
interest holders in the entity must, on a current basis, take participating FFI but may be referred to as a reporting
into account separately their shares of an item of income Model 2 FFI.
paid to the entity, whether or not distributed, and must The term reporting IGA FFI refers to both reporting
determine the character of the items of income as if they Model 1 FFIs and reporting Model 2 FFIs.
were realized directly from the sources from which
realized by the entity. For example, partnerships, common Nonparticipating FFI. A nonparticipating FFI means an
trust funds, and simple trusts or grantor trusts are FFI that is not a participating FFI, deemed-compliant FFI,
generally considered to be fiscally transparent with or exempt beneficial owner.
respect to items of income received by them. Nonreporting IGA FFI. A nonreporting IGA FFI is an FFI
Flow-through entity. A flow-through entity is a foreign that is a resident of, or located or established in, a Model
partnership (other than a withholding foreign partnership), 1 or Model 2 IGA jurisdiction that meets the requirements
a foreign simple or foreign grantor trust (other than a of:
withholding foreign trust), or, for payments for which a A nonreporting financial institution described in a
reduced rate of, or exemption from, withholding is claimed specific category in Annex II of the Model 1 or Model 2
under an income tax treaty, any entity to the extent the IGA;
entity is considered to be fiscally transparent with respect A registered deemed-compliant FFI described in
to the payment by an interest holder’s jurisdiction. Regulations section 1.1471-5(f)(1)(i)(A) through (F);
A certified deemed-compliant FFI described in
Foreign person. A foreign person includes a foreign Regulations section 1.1471-5(f)(2)(i) through (v); or
corporation, a foreign partnership, a foreign trust, a foreign An exempt beneficial owner described in Regulations
estate, and any other person that is not a U.S. person. It section 1.1471-6.
also includes a foreign branch or office of a U.S. financial
institution or U.S. clearing organization if the foreign Participating FFI. A participating FFI is an FFI that has
branch is a qualified intermediary. Generally, a payment to agreed to comply with the terms of an FFI agreement with
a U.S. branch of a foreign person is a payment to a foreign respect to all branches of the FFI, other than a branch that
person. is a reporting Model 1 FFI or a U.S. branch. The term
participating FFI also includes a reporting Model 2 FFI and
GIIN. The term GIIN means a global intermediary a QI branch of a U.S. financial institution unless such
identification number. A GIIN is the identification number branch is a reporting Model 1 FFI.
assigned to an entity that has registered with the IRS for
chapter 4 purposes. Participating payee. A participating payee means any
person that accepts a payment card as payment or
Hybrid entity. A hybrid entity is any person (other than accepts payment from a third party settlement
an individual) that is treated as fiscally transparent for organization in settlement of a third party network
purposes of its status under the Code but is not treated as transaction for purposes of section 6050W.
fiscally transparent by a country with which the United
States has an income tax treaty. Hybrid entity status is Payee. A payee is generally a person to whom a
relevant for claiming treaty benefits. A hybrid entity is payment is made regardless of whether such person is
required to provide its chapter 4 status if it is receiving a the beneficial owner. For a payment made to a financial
withholdable payment. account, the payee is generally the holder of the financial
account. See Regulations sections 1.1441-1(b)(2) and
Intergovernmental agreement (IGA). An 1.1471-3(a)(3).
intergovernmental agreement (IGA) means a Model 1 IGA

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Payment settlement entity (PSE). A payment use Form W-9 to certify its status as a U.S. person for
settlement entity is a merchant acquiring entity or third chapter 3 and chapter 4 purposes.
party settlement organization. Under section 6050W, a
PSE is generally required to report payments made in Withholdable payment. A withholdable payment is
settlement of payment card transactions or third party defined in Regulations section 1.1473-1(a). For
network transactions. However, a PSE is not required to exceptions applicable to the definition of a withholdable
report payments made to a beneficial owner that is payment, see Regulations section 1.1473-1(a)(4) (for
documented as foreign with an applicable Form W-8. example, certain nonfinancial payments).
Qualified intermediary (QI). A qualified intermediary Withholding agent. Any person, U.S. or foreign, that has
(QI) is a person that is a party to an agreement with the control, receipt, custody, disposal, or payment of U.S.
IRS that is described in Regulations section 1.1441-1(e) source FDAP income subject to chapter 3 or 4 withholding
(5)(iii). A qualified derivatives dealer (QDD) is a QI that is a withholding agent. The withholding agent may be an
has agreed to certain reporting and withholding individual, corporation, partnership, trust, association, or
requirements pursuant to Regulations section 1.1441-1(e) any other entity, including (but not limited to) any foreign
(6). intermediary, foreign partnership, and U.S. branches of
Recalcitrant account holder. A recalcitrant account certain foreign banks and insurance companies.
holder includes an entity (other than an entity required to For purposes of section 1446, the withholding agent is
be treated as a nonparticipating FFI) that fails to comply the partnership conducting the trade or business in the
with a request by an FFI maintaining the account for United States. For a publicly traded partnership, the
documentation and information for determining whether withholding agent may be the partnership, a nominee
the account is a U.S. account. See Regulations section holding an interest on behalf of a foreign person, or both.
1.1471-5(g). See Regulations sections 1.1446-1 through 1.1446-6.
Reverse hybrid entity. A reverse hybrid entity is any
person (other than an individual) that is not fiscally Specific Instructions
transparent under U.S. tax law principles but that is
fiscally transparent under the laws of a jurisdiction with Part I – Identification
which the United States has an income tax treaty. See
of Beneficial Owner
Form W-8IMY and the accompanying instructions for
information on a reverse hybrid entity making a claim of Line 1. Enter your name. If you are a disregarded entity
treaty benefits on behalf of its owners. or branch, do not enter your business name. Instead,
Specified U.S. person. A specified U.S. person is any enter the legal name of your owner (or, if you are a
U.S. person other than a person identified in Regulations branch, the entity that you form a part of) (looking through
section 1.1473-1(c). multiple disregarded entities if applicable). If you are a
disregarded entity that is a hybrid entity filing a treaty
Substantial U.S. owner. A substantial U.S. owner (as claim, however, see Hybrid entities under Special
defined in Regulations section 1.1473-1(b)) means any Instructions, later.
specified U.S. person that:
Owns, directly or indirectly, more than 10 percent (by If you are an account holder providing this form to
vote or value) of the stock of any foreign corporation; TIP an FFI solely for purposes of documenting
Owns, directly or indirectly, more than 10 percent of the yourself as an account holder and you are not
profits or capital interests in a foreign partnership; receiving a withholdable payment or reportable amount
Is treated as an owner of any portion of a foreign trust (as defined in Regulations section 1.1441-1(e)(3)(vi)), you
under sections 671 through 679; or should complete Part I by substituting the references to
Holds, directly or indirectly, more than a 10 percent “beneficial owner” with “account holder.”
beneficial interest in a trust.
The named holder on the account is not
U.S. person. A U.S. person is defined in section 7701(a) ! necessarily the account holder for purposes of
(30) and includes domestic partnerships, corporations, CAUTION chapter 4. See Definitions, earlier, or, for an
and trusts. account maintained by an FFI covered by a Model 1 or
Certain foreign insurance companies issuing Model 2 IGA with respect to the account, the definition of
account holder in an applicable IGA to determine if you
! annuities or cash value insurance contracts that are the account holder. If you hold an account with an FFI
CAUTION elect to be treated as a U.S. person for federal tax
purposes but are not licensed to do business in the United and are unsure whether the definition of “account holder”
States are treated as FFIs for purposes of chapter 4. For under an IGA is applicable to your account, consult with
purposes of providing a withholding agent with the FFI requesting this form.
documentation for both chapter 3 and chapter 4 purposes,
Line 2. If you are a corporation, enter your country of
however, such an insurance company is permitted to use
incorporation. If you are another type of entity, enter the
Form W-9 to certify its status as a U.S. person. Likewise,
country under whose laws you are created, organized, or
a foreign branch of a U.S. financial institution (other than a
governed.
branch that operates as a qualified intermediary) that is
treated as an FFI under an applicable IGA is permitted to Line 3. If you are a disregarded entity receiving a
withholdable payment, enter your name on line 3 if you: 1)

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have registered with the IRS and been assigned a GIIN checking a box on this line, you are representing that you
associated with the legal name of the disregarded entity; qualify for this classification in your country of residence.
2) are a reporting Model 1 FFI or reporting Model 2 FFI;
For most of the chapter 4 statuses, you are
and 3) are not a hybrid entity using this form to claim
TIP required to complete an additional part of this form
treaty benefits.
certifying that you meet the conditions of the
If you are not required to provide the legal name of status indicated on line 5. Complete the required portion
! the disregarded entity, you may want to notify the of this form before signing and providing it to the
CAUTION withholding agent that you are a disregarded withholding agent. See Entities Providing Certifications
entity receiving a payment or maintaining an account by Under an Applicable IGA under Special Instructions, later.
indicating the name of the disregarded entity on line 10. If
you wish to report the name of a disregarded entity FFIs Covered by an IGA and Related Entities
holding an account with the withholding agent requesting
A reporting IGA FFI resident in, or established under the
this form for only information purposes (that is, the
laws of, a jurisdiction covered by a Model 1 IGA should
disregarded entity is not reported on line 1 or in Part II of
check “Reporting Model 1 FFI.” A reporting FFI resident
this form), you may enter the disregarded entity's name on
in, or established under the laws of, a jurisdiction covered
line 3.
by a Model 2 IGA should check “Reporting Model 2 FFI.” If
Line 4. Check the one box that applies. By checking a you are treated as a registered deemed-compliant FFI
box, you are representing that you qualify for the under an applicable IGA, you should check “Nonreporting
classification indicated. You must check the box that IGA FFI” rather than “registered deemed-compliant FFI”
represents your classification (for example, corporation, and provide your GIIN.
partnership, trust, estate, etc.) under U.S. tax principles In general, if you are treated as a nonreporting IGA FFI
(not under the law of a treaty country). If you are providing under an applicable IGA, you should check “Nonreporting
Form W-8BEN-E to an FFI solely for purposes of IGA FFI” even if you meet the qualifications for
documenting yourself for chapter 4 purposes as an deemed-compliant status or are an exempt beneficial
account holder of an account maintained by an FFI, you owner under the chapter 4 regulations. In such a case,
do not need to complete line 4. you should not also check your applicable status under
If you are a partnership, disregarded entity, simple the regulations but should provide your GIIN on line 9, if
trust, or grantor trust receiving a payment for which treaty applicable. If you are an owner-documented FFI that is
benefits are being claimed by such entity, you must check treated as a nonreporting IGA FFI under an applicable
the “Partnership,” “Disregarded entity,” “Simple trust,” or IGA you must check “Owner-documented FFI” and
“Grantor trust” box. For such a case, you must also check complete Part X.
the “yes” box to indicate that you are a hybrid entity An FFI that is related to a reporting IGA FFI and that is
making a treaty claim. You may only check the “no” box if treated as a nonparticipating FFI in its country of
(1) you are a disregarded entity, partnership, simple trust, residence should check “Nonparticipating FFI” in line 5.
or grantor trust and are using the form solely for purposes
of documenting yourself as an account holder of an FFI If you are an FFI in a jurisdiction treated as having an
and the form is not associated with a withholdable IGA in effect, you should not check “Participating FFI” but
payment or a reportable amount or (2) you are using this rather should check “Reporting Model 1 FFI” or “Reporting
form solely for purposes of documenting your status as a Model 2 FFI” as applicable. See www.treasury.gov/
participating payee for purposes of section 6050W. In resource-center/tax-policy/treaties/Pages/FATCA-
such cases, you are not required to complete line 4, but Archive.aspx for a list of jurisdictions treated as having an
you may check the “no” box if you choose to complete IGA in effect.
line 4. You may also use Form W-8IMY to document
Non-Profit Organizations Covered by an IGA
yourself as an account holder of an FFI.
If you are a non-profit entity that is established and
Only entities that are tax-exempt under section maintained in a jurisdiction treated as having an IGA in
! 501(c) should check the “Tax-exempt effect and you meet the definition of “active NFFE”under
CAUTION organization” box for purposes of line 4. Such
Annex I of the applicable IGA, you should not check a box
organizations should use Form W-8BEN-E only if they are on line 5 if you are providing this form to an FFI for
claiming a reduced rate of withholding under an income purposes of documenting yourself as an account holder.
tax treaty or a Code exception other than section 501(c) or Instead, you should provide a certification of your status
if they are using this form solely for purposes of under the IGA. See Entities Providing Certifications Under
documenting themselves as an account holder with an an Applicable IGA under Special Instructions, later.
FFI. However, if you are a private foundation you should
check “Private Foundation” instead of “Tax-exempt Account That Is Not a Financial Account
organization.” If you are providing this form to document an account you
hold with a foreign financial institution that is not a
Line 5. Check the one box that applies to your chapter 4
financial account under Regulations section 1.1471-5(b)
status. You are only required to provide a chapter 4 status
(2), check the “Account that is not a financial account” box
on this form if you are the payee of a withholdable
on line 5.
payment or are documenting the status of a financial
account you hold with an FFI requesting this form. By Line 6. Enter the permanent residence address of the
entity identified in line 1. Your permanent residence

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address is the address in the country where you claim to received when you registered as a participating FFI or
be a resident for purposes of that country’s income tax. If reporting Model 1 FFI. If your branch is receiving the
you are giving Form W-8BEN-E to claim a reduced rate of, payment and is required to be identified in Part II, you are
or exemption from, withholding under an income tax not required to provide a GIIN on line 9a. Instead, provide
treaty, you must determine residency in the manner the GIIN of your branch (if applicable) on line 13.
required by the treaty. Do not show the address of a You must provide your GIIN on line 9 if you are a
financial institution (unless you are a financial institution nonreporting IGA FFI that is (1) treated as registered
providing your own address), a post office box, or an deemed-compliant under Annex II to an applicable Model
address used solely for mailing purposes unless it is the 2 IGA or (2) a registered deemed-compliant FFI under
only address you use and it appears in your organizational Regulations section 1.1471-5(f)(1).
documents (that is, your registered address). If you do not
have a tax residence in any country, the permanent If you are in the process of registering with the IRS
residence address is where you maintain your principal TIP as a participating FFI, registered
office. deemed-compliant FFI (including a sponsored
FFI), reporting Model 1 FFI, reporting Model 2 FFI, direct
Line 7. Enter your mailing address only if it is different reporting NFFE, sponsored direct reporting NFFE, or
from the address on line 6. nonreporting IGA FFI but have not received a GIIN, you
Line 8. Enter your U.S. employer identification number may complete this line by writing “applied for.” However,
(EIN). An EIN is a U.S. taxpayer identification number the person requesting this form from you must receive and
(TIN) for entities. If you do not have a U.S. EIN, apply for verify your GIIN within 90 days.
one on Form SS-4, Application for Employer Identification
Number, if you are required to obtain a U.S. TIN. Line 9b. If you are providing this Form W-8BEN-E to
document yourself as an account holder with respect to a
A partner in a partnership conducting a trade or
financial account (as defined in Regulations section
business in the United States will likely be allocated
1.1471-5(b)) that you hold at a U.S. office of a financial
effectively connected taxable income. The partner is
institution (including a U.S. branch of an FFI) and you
required to file a U.S. federal income tax return and must receive U.S. source income reportable on Form 1042-S
have a TIN.
associated with this form, you must provide the TIN
You must provide a U.S. TIN if you are: issued to you by the jurisdiction in which you are a tax
Claiming an exemption from withholding under section resident identified on line 6 unless:
871(f) for certain annuities received under qualified plans, You have not been issued a TIN (including if the
or jurisdiction does not issue TINs) , or
Claiming benefits under an income tax treaty and have You properly identified yourself as a government,
not provided a foreign TIN on line 9b. central bank of issue, or international organization on
However, a TIN is not required to be shown in order to line 4, or you are a resident of a U.S. possession.
claim treaty benefits on the following items of income: If you are providing this form to document a financial
Dividends and interest from stocks and debt obligations account described above but you do not enter a TIN on
that are actively traded; line 9b, and you are not a government, central bank of
Dividends from any redeemable security issued by an issue, international organization, or resident of a U.S.
investment company registered under the Investment possession, you must provide the withholding agent with
Company Act of 1940 (mutual fund); an explanation of why you have not been issued a TIN.
Dividends, interest, or royalties from units of beneficial For this purpose, an explanation is a statement that you
interest in a unit investment trust that are (or were upon are not legally required to obtain a TIN in your jurisdiction
issuance) publicly offered and are registered with the SEC of tax residence. The explanation may be written on
under the Securities Act of 1933; and line 9b, in the margins of the form, or on a separate
Income related to loans of any of the above securities. attached statement associated with the form. If you are
See Regulations section 1.1441-1(e)(4)(vii) for other writing the explanation on line 9b, you may shorten it to
circumstances when you are required to provide a U.S. “not legally required.” Do not write “not applicable.”
TIN. In addition, if you are not using this form to document a
If you need an EIN, you are encouraged to apply financial account described above, you may provide the
TIP for one online instead of submitting a paper Form TIN issued to you by your jurisdiction of tax residence on
SS-4. For more information, visit IRS.gov/EIN. line 9b for purposes of claiming treaty benefits (rather than
providing a U.S. TIN on line 6b, if required).
Line 9a. If you are a participating FFI, registered Lines 9a and 9b should accommodate the GIIN or
deemed-compliant FFI (including a sponsored FFI TIP foreign TIN, as appropriate. You may need to use
described in the Treasury regulations), reporting Model 1 a smaller font when completing the form. If the
FFI, reporting Model 2 FFI, direct reporting NFFE, trustee GIIN or foreign TIN does not fit in the space provided, you
of a trustee-documented trust that is a foreign person may provide a GIIN or foreign TIN that is indicated and
providing this form for the trust, or sponsored direct clearly identified somewhere else on the form, or on a
reporting NFFE, you are required to enter your GIIN (with separate attached sheet, as long as the GIIN or foreign
regard to your country of residence) on line 9a. If you are TIN is clearly identified as being furnished with respect to
a trustee of a trustee-documented trust and you are a line 9a or 9b, respectively. For example, a handwritten
foreign person, you should provide the GIIN that you GIIN located just outside of line 9a with a corresponding

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                                                                 requirements of an applicable IGA or the regulations 
arrow pointing to line 9a is a properly provided GIIN for 
                                                                 under chapter 4 (a related entity), you must check "Branch 
this purpose.
                                                                 treated as nonparticipating FFI."
Line 10. This line may be used by you or by the                  Line 12. Enter the address of the branch or disregarded 
withholding agent or FFI to include any referencing              entity.
information that is useful to the withholding agent to 
                                                                 Line 13. If you are a reporting Model 1 FFI, reporting 
document the beneficial owner. For example, withholding 
                                                                 Model 2 FFI, or participating FFI, you must enter the GIIN 
agents who are required to associate the Form 
                                                                 on line 13 of your branch that receives the payment. If you 
W-8BEN-E with a particular Form W-8IMY may want to 
                                                                 are a disregarded entity that completed Part I, line 3 of this 
use line 10 for a referencing number or code that will 
                                                                 form and are receiving payments associated with this 
make the association clear. You may also want to use 
                                                                 form, enter your GIIN. Do not enter your GIIN on line 9. If 
line 10 to include the number of the account for which you 
                                                                 you are a U.S. branch, enter a GIIN applicable to any 
are providing the form. If you are a single owner of a 
                                                                 other branch of the FFI (including in its residence country).
disregarded entity you may use line 10 to inform the 
withholding agent that the account to which a payment is                If you are in the process of registering your branch 
made or credited is held in the name of the disregarded          TIP    with the IRS but have not received a GIIN, you 
entity (unless the name of the disregarded entity is                    may complete this line by writing “applied for.” 
required to be provided on line 3).                              However, the person requesting this form from you must 
You may also use line 10 to identify income from a               receive and verify your GIIN within 90 days.
notional principal contract that is not effectively connected 
with the conduct of a trade or business in the United            Part III – Claim of Tax Treaty Benefits
States.
                                                                 Line 14a. If you are claiming a reduced rate of, or 
Part II – Disregarded Entity                                     exemption from, withholding under an income tax treaty 
                                                                 you must enter the country where you are a resident for 
or Branch Receiving Payment                                      income tax treaty purposes and check the box to certify 
Complete Part II for a disregarded entity that has its own       that you are a resident of that country.
GIIN and is receiving a withholdable payment, or for a 
                                                                 Line 14b. If you are claiming a reduced rate of, or 
branch (including a branch that is a disregarded entity that 
                                                                 exemption from, withholding under an income tax treaty 
does not have a GIIN) operating in a jurisdiction other than 
                                                                 you must check the box to certify that you:
the country of residence identified in line 2. For example, 
                                                                 Derive the item of income for which the treaty benefit is 
assume ABC Co., which is a participating FFI resident in 
                                                                 claimed, and
Country A, operates through a branch in Country B (which 
                                                                 Meet the limitation on benefits provision contained in 
is a Model 1 IGA jurisdiction) and the branch is treated as 
                                                                 the treaty, if any.
a reporting Model 1 FFI under the terms of the Country B 
Model 1 IGA. ABC Co. should not enter its GIIN on line 9,        An item of income may be derived by either the entity 
and the Country B branch should complete this Part II by         receiving the item of income or by the interest holders in 
identifying itself as a reporting Model 1 IGA FFI and            the entity or, in certain circumstances, both. An item of 
providing its GIIN on line 13. If the Country B branch           income paid to an entity is considered to be derived by the 
receiving the payment is a disregarded entity you may be         entity only if the entity is not fiscally transparent under the 
required to provide its legal name on line 3.                    laws of the entity’s jurisdiction with respect to the item of 
                                                                 income. An item of income paid to an entity shall be 
       If the disregarded entity receiving a withholdable        considered to be derived by the interest holder in the 
TIP    payment has its own GIIN, Part II should be               entity only if:
       completed regardless of whether it is in the same         The interest holder is not fiscally transparent in its 
country as the single owner identified in Part I.                jurisdiction with respect to the item of income, and
                                                                 The entity is considered to be fiscally transparent under 
If you have multiple branches/disregarded entities               the laws of the interest holder’s jurisdiction with respect to 
receiving payments from the same withholding agent and           the item of income. An item of income paid directly to a 
the information in Part I is the same for each branch/           type of entity specifically identified in a treaty as a resident 
disregarded entity that will receive payments, a                 of a treaty jurisdiction is treated as derived by a resident of 
withholding agent may accept a single Form W-8BEN-E              that treaty jurisdiction.
from you with a schedule attached that includes all of the 
                                                                 Limitation on benefits treaty provisions.   If you are a 
Part II information for each branch/disregarded entity 
                                                                 resident of a foreign country that has entered into an 
rather than separate Forms W-8BEN-E to identify each 
                                                                 income tax treaty with the United States that contains a 
branch/disregarded entity receiving payments associated 
                                                                 limitation on benefits (LOB) article, you must complete 
with the form and an allocation of the payment to each 
                                                                 one of the checkboxes in line 14b. You may only check a 
branch/disregarded entity.
                                                                 box if the limitation on benefits article in that treaty 
Line 11. Check the one box that applies. If no box               includes a provision that corresponds to the checkbox on 
applies to the disregarded entity, you do not need to            which you are relying to claim treaty benefits. A particular 
complete this part. If you check reporting Model 1 FFI,          treaty might not include every type of test for which a 
reporting Model 2 FFI, or participating FFI, you must            checkbox is provided. For example, “Company that meets 
complete line 13 (see below). If your branch is a branch of      the derivative benefits test” is generally not available to a 
a reporting IGA FFI that cannot comply with the 

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company resident in a treaty country that is not a member vote and value of the company's shares be owned,
of the EU, EEA, or NAFTA. In addition, each treaty LOB directly or indirectly, by seven or fewer equivalent
article that contains a specific test listed below may have beneficiaries (ultimate owners who are resident in an EU,
particular requirements that must be met that differ from EEA, or NAFTA country and are entitled to identical
the requirements in another treaty with regard to the same benefits under their own treaty with the United States
test. Accordingly, you must check the relevant treaty LOB under one of the ownership tests included within the LOB
article for the particular requirements associated with article (other than the stock ownership and base erosion
each test. In general, only one LOB checkbox is required test)). In addition, this test requires that less than 50% of
to claim a treaty exemption even if more than one the company's gross income be paid or accrued, directly
checkbox would suffice to claim the benefits of the treaty or indirectly, to persons who would not be equivalent
for that item of income. beneficiaries.
Each of the tests is summarized below for your general Company with an item of income that meets the active
convenience but may not be relied upon for making a final trade or business test—this test generally requires that the
determination that you meet an LOB test. Rather you must company be engaged in an active trade or business in its
check the text of the LOB article itself to determine which country of residence, that its activities in that country be
tests are available under that treaty and the particular substantial in relation to its U.S. activities, if the payer is a
requirements of those tests. See Table 4, Limitation on related party, and the income be derived in connection to
Benefits, at IRS.gov/Individuals/International-Taxpayers/ or incidental to that trade or business.
Tax-Treaty-Tables, for a summary of the major tests Favorable discretionary determination received—this
within the Limitation on Benefits article that are relevant test requires that the company obtain a favorable
for documenting any entity's claim for treaty benefits. determination granting benefits from the U.S. competent
Government—this test is met if the entity is the authority that, despite the company's failure to meet a
Contracting State, political subdivision, or local authority. specific objective LOB test in the applicable treaty, it may
Tax-exempt pension trust or pension fund—this test nonetheless claim the requested benefits. Unless a treaty
generally requires that more than half the beneficiaries or or technical explanation specifically provides otherwise,
participants in the trust or fund be residents of the country you may not claim discretionary benefits while your claim
of residence of the trust or fund itself. for discretionary benefits is pending.
Other tax-exempt organization—this test generally Other—for other LOB tests that are not listed above (for
requires that more than half the beneficiaries, members, example, a headquarters test). Identify the other test
or participants of religious, charitable, scientific, artistic, relied upon, or enter N/A if the treaty has no LOB article.
cultural, or educational organizations be residents of the For example, if you meet the headquarters test under the
country of residence of the organization. United States-Netherlands income tax treaty, you should
Publicly-traded corporation—this test generally requires write “Headquarters test, Article 26(5)” in the space
the corporation's principal class of shares to be primarily provided.
and regularly traded on a recognized stock exchange in If an entity is claiming treaty benefits on its own behalf,
its country of residence, while other treaties may permit it should complete Form W-8BEN-E. If an interest holder
trading in either the United States or the treaty country, or in an entity that is considered fiscally transparent in the
in certain third countries if the primary place of interest holder’s jurisdiction is claiming a treaty benefit,
management is the country of residence. the interest holder should complete Form W-8BEN (if an
Subsidiary of publicly-traded corporation—this test individual) or Form W-8BEN-E (if an entity) on its own
generally requires that more than 50% of the vote and behalf as the appropriate treaty resident, and the fiscally
value of the company's shares be owned, directly or transparent entity should associate the interest holder’s
indirectly, by five or fewer companies that are Form W-8BEN or Form W-8BEN-E with a Form W-8IMY
publicly-traded corporations and that themselves meet the completed by the fiscally transparent entity (see Hybrid
publicly-traded corporation test, as long as all companies entities under Special Instructions, later).
in the chain of ownership are resident in either the United An income tax treaty may not apply to reduce the
States or the same country of residence as the subsidiary. ! amount of any tax on an item of income received
Company that meets the ownership and base erosion CAUTION by an entity that is treated as a domestic
test—this test generally requires that more than 50% of corporation for U.S. tax purposes. Therefore, neither the
the vote and value of the company's shares be owned, domestic corporation nor its shareholders are entitled to
directly or indirectly, by individuals, governments, the benefits of a reduction of U.S. income tax on an item
tax-exempt entities, and publicly-traded corporations of income received from U.S. sources by the corporation.
resident in the same country as the company, as long as
all companies in the chain of ownership are resident in the If you are an entity that derives the income as a
same country of residence, and less than 50% of the TIP resident of a treaty country, you may check this
company's gross income is accrued or paid, directly or box if the applicable income tax treaty does not
indirectly, to persons who would not be good contain a “limitation on benefits” provision.
shareholders for purposes of the ownership test.
Company that meets the derivative benefits test—this Line 14c. If you are a foreign corporation claiming treaty
test is generally limited to NAFTA, EU, and EEA country benefits under an income tax treaty that entered into force
treaties, and may apply to all benefits or only to certain before January 1, 1987 (and has not been renegotiated)
items of income (interest, dividends, and royalties). It on (1) U.S. source dividends paid to you by another
generally requires that more than 95% of the aggregate foreign corporation or (2) U.S. source interest paid to you

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by a U.S. trade or business of another foreign corporation, the entitlement to the dividend is determined, and that you
you must generally be a “qualified resident” of a treaty satisfy the conditions of Article 28(2)(f)(aa) and (bb) and
country. See section 884 for the definition of interest paid Article 28(4) of the treaty with respect to the dividends.
by a U.S. trade or business of a foreign corporation Persons claiming treaty benefits on royalties if the treaty
(“branch interest”) and other applicable rules. contains different withholding rates for different types of
In general, a foreign corporation is a qualified resident royalties.
of a country if any of the following apply: Persons claiming treaty benefits on interest other than
It meets a 50% ownership and base erosion test. the generally applicable rate. For example, under the
It is primarily and regularly traded on an established United States-Australia treaty, the generally applicable
securities market in its country of residence or the United interest rate is 10% under Article 11(2). However, interest
States. may be exempt from withholding if the specific conditions
It carries on an active trade or business in its country of under Article 11(3) are met.
residence.
Parts IV Through XXVIII –
It gets a ruling from the IRS that it is a qualified resident.
See Regulations section 1.884-5 for the requirements that Certification of Chapter 4 Status
must be met to satisfy each of these tests. You should complete only one part of Parts IV through
If you are claiming treaty benefits under an XXVIII certifying to your chapter 4 status (if required). You
are not required to complete a chapter 4 status
CAUTION December 31, 1986, do not check box 14c.
! income tax treaty entered into force after certification if you are not the payee of withholdable
Instead, check box 14b. payment or you do not hold an account with an FFI
requesting this form. Identify which part (if any) you should
Line 15. Line 15 must be used only if you are claiming complete by reference to the box you checked on line 5.
treaty benefits that require that you meet conditions not An entity that selects nonparticipating FFI, participating
covered by the representations you make in line 14 (or FFI, registered deemed-compliant FFI (other than a
other certifications on the form). This line is generally not sponsored FFI), reporting Model 1 FFI, reporting Model 2
applicable to claiming treaty benefits under an interest or FFI, or direct reporting NFFE (other than a sponsored
dividends (other than dividends subject to a preferential direct reporting NFFE) on line 5 is not required to
rate based on ownership) article of a treaty or other complete any of the certifications in Parts IV through
income article, unless such article requires additional XXVIII.
representations. For example, certain treaties allow for a IGA. In lieu of the certifications contained in Parts IV
zero rate on dividends for certain qualified residents through XXVIII of Form W-8BEN-E, in certain cases you
provided that additional requirements are met, such as may provide an alternate certification to a withholding
ownership percentage, ownership period, and that the agent. See Entities Providing Certifications Under an
resident meet a combination of tests under an applicable Applicable IGA under Special Instructions, later.
LOB article. You should indicate the specific treaty article
and paragraph or subparagraph, as applicable. You
should also use this space to set out the requirements you Part IV – Sponsored FFI
meet under the identified treaty article.
Line 16. If you are a sponsored FFI described in
The following are examples of persons who should Regulations section 1.1471-5(f)(1)(i)(F), enter the name of
complete this line: the sponsoring entity that has agreed to fulfill the due
Exempt organizations claiming treaty benefits under the diligence, reporting, and withholding obligations (as
exempt organization articles of the treaties with Canada, applicable) on behalf of the sponsored FFI identified in
Mexico, Germany, and the Netherlands. line 1. You must provide your GIIN on line 9.
Foreign corporations that are claiming a preferential
rate applicable to dividends based on ownership of a Line 17. You must check the applicable box to certify that
specific percentage of stock in the entity paying the you are either a sponsored investment entity or sponsored
dividend and owning the stock for a specified period of controlled foreign corporation (within the meaning of
time. Such persons should provide the percentage of section 957(a)) and that you satisfy the other relevant
ownership and the period of time they owned the stock. requirements for this status.
For example, under the United States-Italy treaty, to claim
the 5% dividend rate, the Italian corporation must own Part V – Certified Deemed-Compliant
25% of the voting stock for a 12-month period. Nonregistering Local Bank
In addition, for example, if you qualify for and are Line 18. If you are a certified deemed-compliant
claiming a zero rate on dividend payments under Article nonregistering local bank, you must check the box to
10(3) of the United States-Germany income tax treaty, certify that you meet all of the requirements for this
you should fill out line 15 with “Article 10(3),” “0,” and certified deemed-compliant status.
“dividends” in the spaces provided. In the space provided
for an explanation, you may write that you are the Part VI – Certified Deemed-Compliant
beneficial owner of the dividends, you are a resident of
Germany, you have directly owned shares representing FFI With Only Low-Value Accounts
80% or more of the voting power of the company paying Line 19. If you are a certified deemed-compliant FFI with
the dividends for the 12-month period ending on the date only low-value accounts, you must check the box to certify

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that you meet all of the requirements for this certified Line 24d. Check the box if you do not have any
deemed-compliant classification. contingent beneficiaries or designated classes with
unidentified beneficiaries. While this certification is not
Part VII – Certified Deemed-Compliant
required, an owner reporting statement provided by an
Sponsored, Closely owner-documented FFI will remain valid indefinitely for
chapter 4 purposes absent a change in circumstances
Held Investment Vehicle with respect to offshore obligations (as defined in
Line 20. Enter the name of your sponsoring entity that Regulations section 1.6049-5(c)(1)) only if this
has agreed to fulfill the due diligence, reporting, and certification is provided and the account balance of all
withholding obligations of the entity identified in line 1 as if accounts held by the owner-documented FFI with the
the entity in line 1 were a participating FFI. You must also withholding agent does not exceed $1,000,000 on the
enter the GIIN of your sponsoring entity on line 9a. later of June 30, 2014, or the last day of the calendar year
in which the account was opened, and the last day of
Line 21. If you are a sponsored, closely held investment
each subsequent calendar year preceding the payment,
vehicle, you must check the box to certify that you meet all
applying the account aggregation rules of Regulations
of the requirements for this certified deemed-compliant
section 1.1471-5(b)(4)(iii).
status.
Part XI – Restricted Distributor
Part VIII – Certified
Line 25a. If you are a restricted distributor you must
Deemed-Compliant
check the box to certify that you meet all of the
Limited Life Debt requirements for this status.
Investment Company Lines 25b and 25c. Check the appropriate box to certify
your status. Do not check both boxes.
Line 22. If you are a limited life debt investment entity,
you must check the box to certify that you meet all of the A restricted distributor may certify only with
requirements for this certified deemed-compliant status. ! respect to an account it maintains in connection
CAUTION with a distribution agreement with a restricted
Part IX – Certain Investment Entities fund. A restricted distributor that, in connection with such
a distribution agreement, receives a payment subject to
That Do Not Maintain Financial
chapter 3 withholding or a withholdable payment should
Accounts complete Form W-8IMY and not this form except to the
extent it holds interests in connection with such an
Line 23. If you are an FFI that is a financial institution
agreement as a beneficial owner.
solely because you are described in Regulations section
1.1471-5(e)(4)(i)(A) and you do not maintain financial
accounts, you must check the box to certify that you meet Part XII – Nonreporting IGA FFI
all of the requirements for this certified deemed-compliant Line 26. Check the box to indicate that you are treated as
status. a nonreporting IGA FFI. You must identify the IGA by
entering the name of the jurisdiction that has the IGA
Part X – Owner-Documented FFI treated as in effect with the United States, and indicate
Line 24a. If you are an owner-documented FFI, you must whether it is a Model 1 or Model 2 IGA. You must also
check the box to certify that you meet all of the provide the withholding agent with the specific category of
requirements for this status and are providing this form to FFI described in Annex II of the IGA. In providing the
a U.S. financial institution, participating FFI, reporting specific category of FFI described in Annex II, you should
Model 1 FFI, or reporting Model 2 FFI that agrees to act as use the language from Annex II that best and most
a designated withholding agent with respect to you. See specifically describes your status. For example, indicate
Regulations section 1.1471-5(f)(3) for more information “investment entity wholly owned by exempt beneficial
about an owner-documented FFI, including with respect to owners” rather than “exempt beneficial owner.” If you are
a designated withholding agent. a nonreporting IGA FFI claiming a deemed-compliant
status under the regulations, you must instead indicate on
Line 24b. Check the box to certify that you have provided
this line which section of the regulations you qualify under.
or will provide the documentation set forth in the
certifications, including the FFI owner reporting statement If you are a nonreporting financial institution under an
and the valid documentation for each person identified on applicable IGA because you qualify as an
the FFI owner reporting statement described on line 24b. owner-documented FFI under the regulations, do not
check “Nonreporting IGA FFI.” Instead, you must check
Line 24c. Check the box to certify that you have provided “Owner-documented FFI” and complete Part X rather than
or will provide the auditor’s letter (in lieu of the information this Part XII.
required by line 24b) that satisfies the requirements
See instructions for line 9a for when a GIIN is required
reflected on this line.
for a nonreporting IGA FFI (including a trustee of a
Check either line 24b or line 24c. Do not check trustee-documented trust that is a foreign person).
TIP both boxes.

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Part XIII – Foreign Government, Part XVIII – Excepted
Government of a U.S. Possession, or Nonfinancial Group Entity
Foreign Central Bank of Issue Line 32. If you are an excepted nonfinancial group entity
you must check the box to certify that you meet all of the
Line 27. If you are a foreign government or political
requirements for this status.
subdivision of a foreign government (including wholly
owned agencies and instrumentalities thereof), Part XIX – Excepted Nonfinancial
government of a U.S. possession, or foreign central bank
of issue (each as defined in Regulations section 1.1471-6) Start-Up Company
you must check the box and certify that you meet all of the Line 33. If you are an excepted nonfinancial start-up
requirements for this status (including that you do not company you must check the box to certify that you meet
engage in the type of commercial financial activities all of the requirements for this status. You must also
described on this line except to the extent permitted under provide the date you were formed or your board passed a
Regulations section 1.1471-6(h)(2)). resolution (or equivalent measure) approving a new line of
If you are a foreign government or political business (which cannot be that of a financial institution or
TIP subdivision of a foreign government (including passive NFFE).
wholly owned agencies and instrumentalities
thereof), government of a U.S. possession, or foreign Part XX – Excepted Nonfinancial
central bank of issue, you should only complete Form Entity in Liquidation or Bankruptcy
W-8BEN-E for payments for which you are not claiming
the applicability of section(s) 115(2), 892, or 895; Line 34. If you are an excepted nonfinancial group entity
otherwise you should use Form W-8EXP. in liquidation or bankruptcy you must check the box to
certify that you meet all of the requirements for this status.
You must also provide the date that you filed a plan of
Part XIV – International Organization
liquidation, plan of reorganization, or bankruptcy petition.
Line 28a. Check this box to certify that you are an
international organization described in section 7701(a) Part XXI – 501(c) Organization
(18). Line 35. If you are an entity claiming chapter 4 status as
If you are an entity that has been designated as a section 501(c) organization pursuant to Regulations
TIP an international organization by executive order section 1.1471-5(e)(5)(v) you must check the box and
(pursuant to 22 U.S.C. 288 through 288f), check provide the date that the IRS issued you a determination
box 28a. If you are claiming an exemption from letter or provide a copy of an opinion from U.S. counsel
withholding for purposes of chapter 3, however, use Form certifying that you qualify as a section 501(c) organization
W-8EXP. (without regard to whether you are a foreign private
foundation).
Line 28b. If you are an international organization other If you are a section 501(c) organization claiming
than an international organization described in line 28a, TIP an exemption from withholding for purposes of
you must check the box to certify that you satisfy all of the chapter 3, however, use Form W-8EXP.
requirements for this status.
Part XV – Exempt Retirement Plans Part XXII – Nonprofit Organization
Lines 29a, b, c, d, e, and f. If you are an exempt Line 36. If you are a nonprofit organization (other than an
retirement plan you must check the appropriate box to entity claiming chapter 4 status as a section 501(c)
certify that you meet all of the requirements for this status. organization pursuant to Regulations section 1.1471-5(e)
(5)(v)) you must check the box to certify that you meet all
Part XVI – Entity Wholly Owned of the requirements for this status.
by Exempt Beneficial Owners Nonprofit organization under an IGA. If you are an
entity that is established and maintained in a jurisdiction
Line 30. If you are an entity wholly owned by exempt that is treated as having in effect an IGA and you are
beneficial owners you must check the box to certify that described in Annex I as a nonprofit organization that is an
you meet all of the requirements for this status. You must Active NFFE, see Entities Providing Certifications Under
also provide the owner documentation described in this an Applicable IGA under Special Instructions, later.
line establishing that each of your direct owners or debt
holders is an exempt beneficial owner described in Part XXIII – Publicly-Traded
Regulations section 1.1471-6(b).
NFFE or NFFE Affiliate of
Part XVII – Territory a Publicly-Traded Corporation
Financial Institution Line 37a. If you are a publicly-traded NFFE you must
Line 31. If you are a territory financial institution you must check the box to certify that you are not a financial
check the box to certify that you meet all of the institution and provide the name of a securities exchange
requirements for this status. on which your stock is publicly traded.

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Line 37b. If you are an NFFE that is a member of the applicable IGA). The references to “controlling U.S.
same expanded affiliated group as a publicly-traded U.S. persons” in this part and Part XXIX apply only if the form is
or foreign entity you must check this box, provide the being provided to an FFI treated as a reporting Model 1
name of the publicly-traded entity, and identify the FFI or reporting Model 2 FFI.
securities market on which the stock of the publicly-
Part XXVII – Excepted
traded entity is traded. See Regulations section
1.1472-1(c)(1)(i) to determine if the stock of an entity is Inter-Affiliate FFI
regularly traded on an established securities market
(substituting the term “U.S. entity” for “NFFE,” as Line 41. If you are an excepted inter-affiliate FFI you
appropriate, for purposes of testing whether an entity is must check the box to certify that you meet all of the
publicly traded). requirements of this classification. This classification will
only apply for an excepted inter-affiliate FFI that holds
Part XXIV – Excepted Territory NFFE deposit accounts described in the certification for this part
and that is documenting itself to the financial institution
Line 38. If you are an excepted territory NFFE you must that maintains the deposit account. You are not eligible for
check the box to certify that you meet all of the this classification if you receive or make withholdable
requirements for this classification. See Regulations payments to or from any person other than a member of
section 1.1472-1(c)(1)(iii) for the definition of an excepted your expanded affiliated group, other than the depository
territory NFFE. institution described in the previous sentence. See
Regulations section 1.1471-5(e)(5)(iv) for all the
Part XXV – Active NFFE
requirements of this status.
Line 39. If you are an active NFFE you must check the
box to certify that you meet all of the requirements for this Part XXVIII – Sponsored
status, including the assets and passive income test Direct Reporting NFFEs
described in the certification for this part. For purposes of
applying this test, passive income includes dividends, Lines 42 and 43. If you are a sponsored direct reporting
interest, rents, royalties, annuities, and certain other forms NFFE you must enter the name of the sponsoring entity
of passive income. See Regulations section 1.1472-1(c) on line 42 and check the box to certify that you meet all of
(1)(iv)(A) for additional detail for the definition of passive the requirements for this classification. You must also
income. Also see Regulations section 1.1472-1(c)(1)(iv) provide your GIIN in line 9a.
(B) for exceptions from the definition of passive income for
certain types of income. Part XXIX – Substantial U.S.
Owners of Passive NFFE
Part XXVI – Passive NFFE
If you identified yourself as a passive NFFE (including an
Line 40a. If you are a passive NFFE you must check the investment entity that is a territory NFFE but is not an
box to certify that you are not a financial institution and are excepted territory NFFE under Regulations section
not certifying your status as a publicly-traded NFFE, NFFE 1.1472-1(c)) with one or more substantial U.S. owners in
affiliate of a publicly-traded company, excepted territory Part XXVI, you must identify each substantial U.S. owner.
NFFE, active NFFE, direct reporting NFFE, or sponsored Provide the name, address, and TIN of each substantial
direct reporting NFFE. U.S. owner in the relevant column. You may attach this
information on a separate statement, which remains
Note. If you would be a passive NFFE but for the fact that subject to the same perjury statement and other
you are managed by certain types of FFIs (see certifications made in Part XXX. If you are reporting
Regulations section 1.1471-5(e)(4)(i)(B)), you should not controlling U.S. persons (as defined in an applicable IGA)
complete line 40a as you would be considered a financial to a Model 1 FFI or reporting Model 2 FFI with which you
institution and not a passive NFFE. maintain an account that requests such ownership
If you are an NFFE that may qualify as an active information with this form, you may use this space or
TIP NFFE (or other NFFE described in another part of attach a separate statement to report such persons.
this form), you may still check line 40a and
Part XXX – Certification
disclose your substantial U.S. owners or certify that you
have no substantial U.S. owners. Form W-8BEN-E must be signed and dated by an
authorized representative or officer of the beneficial
Line 40b. Check this box to certify that you have no owner, participating payee (for purposes of section
substantial U.S. owners. 6050W), or account holder of an FFI requesting this form.
You must check the box to certify that you have the legal
Line 40c. If you do not check the box and make the capacity to sign for the entity identified on line 1 that is the
certification on line 40b, you must check this box 40c and beneficial owner of the income. If Form W-8BEN-E is
complete Part XXIX to identify and provide the name, completed by an agent acting under a duly authorized
address, and TIN of each of your substantial U.S. owners. power of attorney, the form must be accompanied by the
power of attorney in proper form or a copy thereof
Note. If you are an NFFE that is providing Form
specifically authorizing the agent to represent the principal
W-8BEN-E to an FFI treated as a reporting Model 1 FFI or
in making, executing, and presenting the form. Form
reporting Model 2 FFI, you may also use Part XXIX to
2848, Power of Attorney and Declaration of
report controlling U.S. persons (as defined in an

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Representative, may be used for this purpose. The agent, Line 2. Enter the country under whose laws you are
as well as the beneficial owner, payee, or account holder created, organized, or governed.
(as applicable), may incur liability for the penalties
provided for an erroneous, false, or fraudulent form. By Line 3. Leave this line blank. For purposes of completing
signing Form W-8BEN-E, the authorized representative, this form as a hybrid entity making a treaty claim
officer, or agent of the entity also agrees to provide a new (including a disregarded entity), you are treated as the
form within 30 days following a change in circumstances beneficial owner and should be identified in line 1.
affecting the correctness of the form. Line 4. Check the box that applies among disregarded
A withholding agent may allow you to provide this form entity, partnership, grantor trust, or simple trust. You must
with an electronic signature. The electronic signature must also check the box indicating that you are a hybrid making
indicate that the form was electronically signed by a a treaty claim and complete Part III.
person authorized to do so (for example, with a time and Line 5. Leave this line blank, except in the circumstances
date stamp and statement that the form has been described above.
electronically signed). Simply typing your name into the
Lines 6, 7, and 8. Complete lines 6, 7, and 8 as provided
signature line is not an electronic signature.
in the specific instructions, earlier.
Broker transactions or barter exchanges. Income
Line 9b. If your country of residence for tax purposes has
from transactions with a broker or a barter exchange is
issued you a tax identifying number, enter it here. Do not
subject to reporting rules and backup withholding unless
enter the tax identifying number of your owner(s).
Form W-8BEN-E or a substitute form is filed to notify the
broker or barter exchange that you are an exempt foreign Line 10. This reference line is used to associate this
person. Form W-8BEN-E with another applicable withholding
You are an exempt foreign person for a calendar year certificate or other documentation provided for purposes
in which: of chapter 4. For example, if you are a partnership making
You are a foreign corporation, partnership, estate, or a treaty claim, you may want to provide information for the
trust; and withholding agent to associate this Form W-8BEN-E with
You are neither engaged, nor plan to be engaged the Form W-8IMY and owner documentation you provide
during the year, in a U.S. trade or business that has for purposes of establishing the chapter 4 status of your
effectively connected gains from transactions with a owner(s).
broker or barter exchange. You must complete Parts III and XXX in accordance
with the specific instructions above. Complete Part II if
Special Instructions applicable.

Hybrid Entity Making a Claim of Treaty Benefits Foreign Reverse Hybrid Entities
If you are a hybrid entity making a claim for treaty benefits A foreign reverse hybrid entity should only file a Form
as a resident on your own behalf, you may do so as W-8BEN-E for payments for which it is not claiming treaty
permitted under an applicable tax treaty. You should benefits on behalf of its owners and must provide a
complete this Form W-8BEN-E to claim treaty benefits in chapter 4 status when it is receiving a withholdable
the manner described in the instructions for Part III and payment. A foreign reverse hybrid entity claiming treaty
complete Part I to the extent indicated below. Note that benefits on behalf of its owners should provide the
you should not complete line 5 indicating your chapter 4 withholding agent with Form W-8IMY (including its
status unless you are a disregarded entity that is treated chapter 4 status when receiving a withholdable payment)
as the payee for chapter 4 purposes. along with a withholding statement and Forms W-8BEN or
W-8BEN-E (or documentary evidence to the extent
If you are a flow-through entity claiming treaty benefits permitted) on behalf of each of its owners claiming treaty
on a payment that is a withholdable payment, you should benefits. See Form W-8IMY and accompanying
also provide Form W-8IMY along with a withholding instructions for more information.
statement (if required) establishing the chapter 4 status of
each of your partners or owners. Allocation information is Entities Providing Certifications
not required on this withholding statement unless one or Under an Applicable IGA
more partners or owners are subject to chapter 4
An FFI in an IGA jurisdiction with which you have an
withholding (such as a nonparticipating FFI). If you are a
account may provide you with a chapter 4 status
disregarded entity claiming treaty benefits on a payment
certification other than as shown in Parts IV through XXVIII
that is a withholdable payment, unless you are treated as
in order to satisfy its due diligence requirements under the
the payee for chapter 4 purposes and have your own
applicable IGA. In such a case, you may attach the
GIIN, your single owner should provide Form W-8BEN-E
alternative certification to this Form W-8BEN-E in lieu of
or Form W-8BEN (as applicable) to the withholding agent
completing a certification otherwise required in Parts IV
along with this form. You or the withholding agent may use
through XXVIII provided that you: (1) determine that the
line 10 to inform the withholding agent to associate the
certification accurately reflects your status for chapter 4
two forms.
purposes or under an applicable IGA; and (2) the
Line 1. Enter your legal name (determined by reference withholding agent provides a written statement to you that
to your legal identity in your country of incorporation or it has provided the certification to meet its due diligence
organization). requirements as a participating FFI or registered

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deemed-compliant FFI under an applicable IGA. For certifications appear. If the applicable certifications do not
example, Entity A organized in Country A holds an appear on any Form W-8 (if, for example, new regulations
account with an FFI in Country B. Country B has a Model provide for an additional status and this form has not been
1 IGA in effect. The FFI in Country B may ask Entity A to updated to incorporate the status) then you may provide
provide a chapter 4 status certification based on the terms an attachment certifying that you qualify for the applicable
of the Country B IGA in order to fulfil its due diligence and status described in a particular Regulations section.
documentation requirements under the Country B IGA. Include a citation to the applicable provision in the
You may also provide with this form an applicable IGA Regulations. Any such attached certification becomes an
certification if you are determining your chapter 4 status integral part of this Form W-8BEN-E and is subject to the
under the definitions provided in an applicable IGA and penalty of perjury statement and other certifications made
your certification identifies the jurisdiction that is treated in Part XXX.
as having an IGA in effect and describes your status as an
Paperwork Reduction Act Notice. We ask for the
NFFE or FFI in accordance with the applicable IGA.
information on this form to carry out the Internal Revenue
However, if you determine your status under an applicable
laws of the United States. You are required to provide the
IGA as an NFFE, you must still determine if you are an
information. We need it to ensure that you are complying
excepted NFFE under the Regulations in order to
with these laws and to allow us to figure and collect the
complete this form unless you are provided an alternative
right amount of tax.
certification by an FFI described in the preceding
paragraph that covers your certification as an NFFE (such You are not required to provide the information
as “active NFFE”) as defined in an applicable IGA. requested on a form that is subject to the Paperwork
Additionally, you are required to comply with the Reduction Act unless the form displays a valid OMB
conditions of your status under the law of the IGA control number. Books or records relating to a form or its
jurisdiction to which you are subject if you are determining instructions must be retained as long as their contents
your status under that IGA. If you cannot provide the may become material in the administration of any Internal
certifications in Parts IV through XXVIII, or if you are a Revenue law. Generally, tax returns and return
nonprofit entity that meets the definition of “active NFFE” information are confidential, as required by section 6103.
under the applicable IGA, do not check a box in line 5.
However, if you determine your status under the The time needed to complete and file this form will vary
definitions of the IGA and can certify to a chapter 4 status depending on individual circumstances. The estimated
included on this form, you do not need to provide the average time is:Recordkeeping, 12 hr., 40 min.;
certifications described in this paragraph unless required Learning about the law or the form, 4 hr., 17 min.;
by the FFI to whom you are providing this form. Preparing and sending the form, 8 hr., 16 min.
Any certifications provided under an applicable IGA If you have comments concerning the accuracy of
remain subject to the penalty of perjury statement and these time estimates or suggestions for making this form
other certifications made in Part XXX. simpler, we would be happy to hear from you. You can
send us comments from IRS.gov/FormComments. You
Entities Providing Alternate or Additional can write to the Internal Revenue Service, Tax Forms and
Certifications Under Regulations Publications, 1111 Constitution Ave. NW, IR-6526,
If you qualify for a status that is not shown on this form, Washington, DC 20224. Do not send Form W-8IMY to this
you may attach applicable certifications for such status office. Instead, give it to your withholding agent.
from any other Form W-8 on which the relevant

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