BACKUP WITHHOLDING FOR MISSING AND INCORRECT NAME/TIN(S) (Including instructions for reading tape cartridges and CD/DVD Formats) Publication 1281 (Rev. 5-2021) Catalog Number 63327A Department of the Treasury Internal Revenue Service www.irs.gov
| BACKUP WITHHOLDING FOR MISSING AND INCORRECT NAME/TIN(S) (Including instructions for reading tape cartridges and CD/DVD Formats) Publication 1281 (Rev. 5-2021) Catalog Number 63327A Department of the Treasury Internal Revenue Service www.irs.gov |
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| BACKUP WITHHOLDING FOR MISSING AND INCORRECT NAME/TIN(S) (Including instructions for reading tape cartridges and CD/DVD Formats) |
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TABLE OF CONTENTS PAGE
Part 1 Introduction
• Backup Withholding Rate 3
Part 2 Frequently Asked Questions 4
Part 3 Where to Call for Help 10
Part 4 Actions for Missing TINs and Incorrect Name/TIN Combinations 10
• CP2100 Notice 10
• Missing TIN(s) 10
• Incorrect Name/TIN Combinations 10
• First “B” Notice 11
• Second “B” Notice 12
• Third and Subsequent Notices 12
Part 5 The IRS Matching Process/ Name Controls 13
Part 6 Flow Charts 19
• First “B” Notice Copy 19
• Second “B” Notice Copy 20
Part 7 Name Compression Specifications for “B” Notice Tape Cartridges 21
Part 8 Instructions for Reading Tape Cartridges 22
Part 9 Instructions for Reading CD/DVD media 25
Part 10 Other Forms 29
• Instructions for the Requester of Form W-9
• Form W-9
• Form W-8 Series and Instructions
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PART 1. INTRODUCTION
This publication contains information about the backup withholding (BWH-B) requirements that apply to the
information returns that you filed. The law provides that you may be required to withhold a specified percentage
(see BWH-B Rate) of certain reportable payments made to recipients (payees) for whom you filed an
information return that had a missing or an incorrect Taxpayer Identification Number (TIN). If you are a new filer
of information returns or want an answer to a specific question, you may find it helpful to begin by reading Part
2, Frequently Asked Questions. More detailed information begins in Part 4. We have included copies of the
First and Second “B” Notices, Form W-9, Forms and W-8 series, and SSA (see Part 10) for your convenience.
E- Services provide various electronic and interactive applications. See the IRS web site at, https://la.www4.irs.
gov/e-services/Registration/index.htm to review the on-line tutorial. Payers of income reported on Forms 1099
B, DIV, INT, K, MISC, NEC, OID, G and/or PATR may be eligible to participate in the TIN Matching program.
You can download the TIN Matching Publication, 2108A, at www.IRS.gov.
Backup Withholding (BWH-B) Rate
Rate/Percentage is 24%, effective for all subject payments after December 31, 2017.
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PART 2. FREQUENTLY ASKED QUESTIONS
1. Q… What is backup withholding?
A… Persons (payers) making certain payments to payees must withhold and pay to the IRS a specified
percentage (see “BWH Rate” on page 3) of those payments under certain conditions. Payments
that may be subject to backup withholding include interest, dividends, rents, royalties, commissions,
non-employee compensation, and other payments including broker proceeds and barter exchange
transactions, reportable gross proceeds paid to attorneys, and certain payments made by fishing
boat operators. Payments that are excluded from backup withholding are real estate transactions,
foreclosures and abandonments, cancelled debts, distributions from Archer Medical Savings
Accounts (MSAs), long-term care benefits, distributions from any retirement account, distributions
from an employee stock ownership plan (ESOP), fish purchases for cash, unemployment
compensation, state or local income tax refunds, and qualified tuition program earnings.
2. Q… What is a Taxpayer Identification Number (TIN)?
A… A TIN is a Social Security Number (SSN) issued by the Social Security Administration (SSA) or an
Employer Identification Number (EIN) issued by the IRS. A TIN can have only nine (9) numbers. It
cannot have more or less than nine numbers nor can it have letters. See Question #3 for information
on ITINs and ATINs.
3. Q… What is an Individual Taxpayer Identification Number (ITIN)/Adoption Taxpayer Identification
Number (ATIN)?
A… An ITIN is an individual Taxpayer Identification Number (ITIN) issued by the IRS and may be used
as a TIN to meet federal tax obligations only. Resident aliens and nonresident aliens, who are not
eligible for SSNs, use ITINs. An ITIN has nine numbers in the same format as an SSN and always
begins with the number 9. The fourth and fifth digits are always within the range of 70 through 88. An
ATIN is an Adoption Taxpayer Identification Number issued by the IRS and can be used as a TIN. An
ATIN is only a temporary taxpayer identification number issued for a child born, and adopted, in the
United States. An ATIN contains nine numbers in the same format as an SSN. An ATIN should be
requested when an SSN cannot be obtained in time to file your tax return. Once the adoptive parent
obtains an SSN for the adopted child, the ATIN becomes obsolete.
4. Q… What payments are subject to backup withholding?
a) Rents and commissions, non-employee compensation for services, royalties, reportable gross
proceeds paid to attorneys and other fixed or determinable gains, profits, or income payments
reportable on Form 1099-MISC, Miscellaneous Income.
b) Commissions, fees, or other payments for work performed as an independent contractor on Form
1099-NEC, Nonemployee Compensation.
c) Interest reportable on Form 1099-INT, Interest Income.
d) Dividends reportable on Form 1099-DIV, Dividends and Distributions.
e) Patronage dividends paid in money or qualified check reportable on Form 1099-PATR, Taxable
Distributions Received From Cooperatives.
f) Original issue discount reportable on Form 1099-OID, Original Issue Discount, if the payment is in cash.
g) Gross proceeds reportable on Form 1099-B, Proceeds From Broker and Barter Exchange
Transactions.
h) Gambling winnings reportable on Form W-2G, Certain Gambling Winnings, unless subject to
regular gambling withholding. If not subject to regular gambling withholding, backup withholding
only applies if, and only if, the payee does not furnish a taxpayer identification number to the
payor.
i) Gross payments reportable on Form 1099-K, Payment Card and Third Party Network
Transactions.
j) Form 1099-G payments that are subject to backup withholding under IRC 6041 and 3406(b)(3)(A)
which include taxable grants and agricultural payments (1099-G Box 6 or 7)
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5. Q… Can a payee claim he or she is exempt from backup withholding?
A… Yes. Payees who may be exempt are listed in the “Instructions for the Requester of Form W-9”. They
include tax-exempt organizations, government agencies, corporations (For certain payments), and
other listed entities.
6. Q… Is a payee an exempt corporation if it uses the term “Company” or “Co.” in its name?
A… A payer cannot treat a payee as an exempt organization merely because the business name
contains the word “Company” or “Co.” A payer may treat a payee as exempt if:
• the name contains the term insurance company, indemnity company, reinsurance company or
assurance company. Requirement one is also met if the entities name indicates that it is an entity
listed as a corporation under IRS Regulations, section 301.7701-2(b)(8)(i),
• the payer has on file a corporate resolution or similar document clearly indicating corporate
status,
• the payer receives a Form W-9 which includes an EIN and a statement from the payee that it is a
domestic corporation or,
• the payer receives a withholding certificate described in Section 1.1441-1(e) (2)(i), that includes a
certification that the person whose name is on the certificate is a foreign corporation.
7. Q… When is a TIN considered missing or incorrect?
A… Missing TIN - We consider a TIN to be missing if it is not provided, has more or less than nine
numbers, or it has an alpha character as one of the nine positions.
Example: Missing SSN: 123-45-678
Example: Missing SSN: 123-45-67899
Example: Missing EIN: 12- 345678P
Incorrect TIN - We consider a TIN incorrect if it is in the proper format but the Name/TIN combination
does not match or cannot be found on IRS or SSA files.
Examples of Proper Format:
Correct SSN:123-45-6789
Correct EIN: 12-3456789
8. Q… What files do the IRS use in the matching process?
A… The DM-1 File -- A file containing all SSNs ever issued by the SSA
The EIN-Name Control File -- A file containing all the IRS-assigned EINs
The ITIN File -- A file containing all the IRS-assigned ITINs (On DM-1)
The ATIN File -- A file containing all the IRS-assigned ATINs (On DM-1)
9. Q… What should I do if a payee refuses or neglects to provide a TIN?
A… Begin backup withholding immediately on any reportable payments. Do the required annual
solicitation (request) for the TIN. Question 19 has information about the solicitation requirements for
missing and incorrect TINs. Backup withhold until you receive a TIN.
10. Q… How do I know if a TIN on my account is incorrect?
A… After the submission of Form 1099 information returns, the IRS will send you a CP2100 or a
CP2100A Notice and a listing of incorrect Name/TIN(s) reported on those forms.
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11. Q… What is a CP2100 or CP2100A Notice?
A… It is a notice that tells a payer that he or she may be responsible for backup withholding. It is
accompanied by a listing of missing, incorrect, and/or not currently issued payee TINs. Large volume
filers will receive a CD or DVD data file CP2100, mid-size filers receive a paper CP2100, and small
filers receive a paper CP2100A.
Large Filer …………. 250 or more error documents;
Mid Size Filer ……… Between 50 and 249 documents.
Small Filer …............ Less than 50 error documents.
12. Q… What should I do if I receive a CP2100 or CP2100A Notice?
A… Compare the listing(s) with your records. For missing TINs: If you have not started backup
withholding, begin to do so immediately and continue until you receive a TIN. You must make up to
three solicitations for the TIN (initial, first annual, second annual), as described in Question 19, to
avoid a penalty for failing to include a TIN on the information return.
For incorrect TINs: Compare the accounts on the listing with your business records. See Question
19 for the solicitation requirements in order to avoid a penalty for failure to include the correct TIN
on an Information Return. If they agree, send the appropriate “B” Notice to the payee. If an account
does not agree, this could be the result of a recent update to SSA records, an error in the information
you submitted, or an IRS processing error. If this type of error occurred, the only thing you should do
is correct or update your records, if necessary.
Remember: You do not have to call or write to the IRS to say that you made the correction or update
to your records.
13. Q… What should I do if I receive a CP2100, CP2100A, or 972CG and do not recognize a TCC
provided on the notice?
A… The TCC belongs to the business who transmitted the information returns listed on the notice. The
TCC may belong to the payer; however, the TCC may belong to a third-party hired to transmit the
information returns for the payer. Contact any third-parties you used to transmit your information
returns on your behalf. For example, an accountant, payroll provider, etc.
14. Q… What is a “B” Notice?
A… A “B” Notice is a backup withholding notice. There are two “B” Notices -- the First “B” Notice and the
Second “B” Notice. You must send the First “B” Notice and a Form W-9 to a payee after you receive
the first CP2100 or CP2100A Notice with respect to this account for soliciting a correct Name/TIN
combination. You must send the second “B” Notice to a payee after you receive a second CP2100 or
CP2100A Notice within a 3 calendar year period. The text of the Second “B” Notice is different from
that of the First “B” Notice. The Second “B” Notice tells the payee to contact IRS or SSA to obtain
the correct Name/TIN combination. The mailing of the second notice should not include a Form
W-9. The payor must receive validation of the payee’s Name/TIN combination from SSA or IRS after
sending the second “B” Notice. Payees should be instructed regarding how to request validation
of their name/TIN combinations in accordance with the procedures described in Part 4. Generally,
you do not have to send a “B” Notice more than two times within three calendar years to the same
account.
15. Q… When do I send a “B” Notice to a payee?
A… You have 15 business days from the date of the CP2100A or CP2100 Notice, or the date you
received it (whichever is later), to send a “B” Notice to a payee. For incorrect TINS you only have to
send a “B” Notice to a payee whose Name/TIN combination and account number on your records
agrees with the combination that IRS identified as incorrect.
16. Q… How do I know which “B” Notice to send?
A… If this is the first CP2100 or CP2100A Notice you have received with respect to this account, you
must provide the payee with (1) the First “B” Notice and (2) a copy of Form W-9 (or acceptable
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substitute). You may also provide an optional reply envelope. Your outside mailing envelope must
be clearly marked “IMPORTANT TAX INFORMATION ENCLOSED” or “IMPORTANT TAX RETURN
DOCUMENT ENCLOSED.”
If this is the second CP2100 or CP2100A Notice you have received within three calendar years with
respect to this account, you must provide the payee with the Second “B” Notice. Do not include a
Form W-9. You may also provide an optional reply envelope. Your outside mailing envelope must
be clearly marked “IMPORTANT TAX INFORMATION ENCLOSED” or “IMPORTANT TAX RETURN
DOCUMENT ENCLOSED.”
17. Q… Do I have to mail a Second “B” Notice if I receive the second CP2100 or CP2100A Notice in
the same calendar year as the first notice?
A… No. You may disregard the second CP2100 or CP2100A notice, even if it relates to a different tax
year than the first notice. You also have no obligation to mail a second ‘B’ Notice if you receive the
second CP2100 or CP2100A Notice in a different calendar year than the first, but both of the CP
notices relate to the same payee’s account for the same calendar year.
18. Q… What should I do if a “B” Notice is returned as “undeliverable”?
A… You must begin backup withholding. However, try to get the correct address for the payee and re-
mail the notice. If you cannot find the correct address, keep the undelivered notice with your records
for a period of three years, in order to track the “two-in-three-year” rule (see Question 13) or, until
you have obtained a valid address.
19. Q… After I receive a CP2100 or CP2100A Notice, when do I start and stop backup withholding?
A… You must begin backup withholding on all reportable payments to the payee no later than 30
business days after you have received the CP2100 or CP2100A Notice. You must stop backup
withholding on payments within 30 calendar days after you have received the required certification
(Form W-9) from the payee or TIN validation from the SSA or the IRS, if it was a second notification.
At your option, you may start and stop backup withholding at any time during these 30-day periods.
20. Q… What are the first and second annual solicitation requirements?
A… A solicitation is a request for a payee’s correct TIN. You must make the request to satisfy the backup
withholding requirements and to avoid a penalty for filing another information return with a missing
or an incorrect TIN. The payee must furnish a certified TIN (initial solicitation) on Form W-9 with
respect to payments of interest, dividends, and amounts subject to broker reporting. For other
payments, the payee may furnish/provide the TIN in any manner.
For missing TINs: For all payees you must make the initial solicitation when the payee opens the
account or when the transaction occurs. If the payee does not provide a TIN when you initially
ask for it, you must begin backup withholding. In addition, to avoid a penalty for filing an incorrect
information return, you must make a first annual solicitation by December 31 of the year in which
the account is opened (for accounts opened before December) or January 31 of the following year
(for accounts opened during the preceding December). If the payee does not provide a TIN after the
first annual solicitation, you must make the second annual solicitation by December 31 of the year
following the calendar year in which the account was opened.
For incorrect TINs: You must make up to two annual solicitations in response to the CP2100 or
CP2100A Notice. You must send a B Notice within 15 business days after you receive a CP2100 or
CP2100A Notice. If you receive a Proposed Penalty Notice (972CG) but not a CP2100 or CP2100A
Notice, your annual solicitation must be made by December 31st of the year you received the
Proposed Penalty Notice (972CG).
However, if you already sent a B Notice in the calendar year in response to a CP2100 or CP2100A
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Notice, you do not have to send another solicitation in response to the proposed penalty notice. If
the IRS notifies you in the next calendar year that a TIN is still incorrect, you must make a second
annual solicitation within 15 business days after you receive the second CP2100 or CP2100A Notice.
21. Q… Does a CP2100 or CP2100A Notice indicate whether it is the first or second notification of an
incorrect TIN for a specific account?
A… No. The backup withholding regulations require that payers be responsible for tracking the status of
the notices they receive.
22. Q… What is the relationship between the requirements to make an annual solicitation for a
payee’s TIN and the requirements to send a “B” Notice?
A… Sending a “B” Notice to a payee in response to a CP2100A or CP2100 Notice satisfies the annual
solicitation requirement in order to avoid a penalty for filing an information return with an incorrect
TIN.
23. Q… Why are accounts I corrected still on the listing of missing or incorrect TIN(s)?
A… Due to processing cut-off points, a listing may or may not reflect your latest corrections. If you know
that an account was corrected, do not send a “B” Notice to the payee.
24. Q… What should I do if a TIN was actually on file but was omitted from the Form 1099 or reported
incorrectly?
A… Make any required change to your records and use the correct information on future filings. Do not
send a “B” Notice to the payee.
25. Q… What should I do if this is the first notification and the Form W-9 is returned with the same
incorrect information?
A… Keep the Form W-9 on file to show that the payee certified the Name/TIN combination. Do not
backup withhold.
26. Q… If I don’t do business anymore with a payee, or if it was only a one-time transaction, what
should I do with the “B” Notice?
A… Send it and try to get the correct TIN. Also, note your records to track the notice for the “two-in-three
year” rule. You will need this information if you should renew business with the payee. We require
that you track these accounts for three years after the date of the first CP2100A or CP2100 Notice.
Note: A “B” Notice is not required if no payments have been made to an account and no return is
required for the account for one year.
27. Q… Can a sole proprietor have an SSN or does he or she need an EIN?
A… A sole proprietor may have an SSN or an EIN. However, he or she must always furnish his or her
individual name (on Name Line 1), regardless of whether he or she uses a SSN or an EIN. A sole
proprietor may also provide a business name or Doing Business As (DBA) (on Name Line 2), but he
or she must list his or her individual name first on the account with you.
28. Q… Should I backup withhold on a payee who is a nonresident alien?
A… Yes. A nonresident alien is subject to backup withholding unless you have a signed Form W-8BEN,
Certificate of Foreign Status of Beneficial Owner for United States Tax Withholding, on file for him or
her.
29. Q… Can a Form W-9 for one account be used to correct all accounts?
A… Yes, if the payer required a payee to file only one Form W-9 for all accounts or instruments of the
payee.
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30. Q… Can a payee be subject to backup withholding for more than one reason?
A… Yes. However, backup withhold for only one reason at a time.
31. Q… How do I get an EIN?
A… Complete Form SS-4, Application for Employer Identification Number. Follow “How to Apply” in the
instructions for Form SS-4 to obtain an EIN by mail, telephone, or facsimile (fax).
32. Q… What form do I use to report backup withholding?
A… Report backup withholding on Form 945, Annual Return of Withheld Federal Income Tax. For more
information, including the deposit requirements for Form 945, see the instructions for Form 945, or
Pub. 15, (Circular E), Employer’s Tax Guide.
33. Q… How is a Name/TIN mismatch identified?
A… A Name/TIN combination is incorrect if it does not match, or cannot be found, on IRS or SSA files.
For example, a Name/TIN mismatch occurs when an individual name is submitted with a TIN not
associated with the individual name provided. A TIN is not interchangeable with different names.
A business EIN must be used for a partnership, corporation, or non-disregarded Limited Liability
Company (LLC). An SSN must be used with an individual name (In first name line). A Sole Proprietor
must always provide his/her individual name. A Sole Proprietor may provide his/her Doing Business
As (DBA) name (in second name line) in addition to the required individual name together with the
matching SSN.
34. Q… What amount is subject to backup withholding with respect to security sales made through
margin accounts?
A… The amount subject to backup withholding in the case of a security sale made through a margin
account is limited to the amount of cash available for withdrawal by the customer immediately after
the settlement of the sale. The amount available for withdrawal by the customer does not include
amounts required to satisfy margin account maintenance. If a margin call forces a customer into a
sell - off, such proceeds are not subject to backup withholding.
35. Q… In what manner should a payer treat erroneously withheld tax?
A… If a payer withholds from a payee in error or withholds more than the correct amount of tax, the
payer may refund the amount improperly withheld. The refund must be made prior to the end of the
calendar year and prior to the time the payer issues a Form 1099. If the payer has not deposited
the amount of the tax prior to the time that the refund is made to the payee, the payer should not
deposit the improperly withheld tax. If the improperly withheld tax has been deposited prior to the
time the refund is made to the payee, the payer may adjust any subsequent deposit of tax collected,
which the payer is required to make, by the amount of the tax which has been refunded to the
payee. Payers may use refund alternatives only when backup withholding is the result of an error
by the payer. The timely submission of requested TIN information including any verifications and/or
certifications by the payee does not establish an error by the payer.
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PART 3. WHERE TO CALL FOR HELP
If you have any questions about backup withholding, information reporting, Forms 1099, or the CP2100 or
CP2100A Notice(s) and listing(s), you may call:
Technical Services Operation Customer Service Section
Telephone (866) 455-7438 (TOLL FREE) / (304) 263-8700 (not toll free)
Hours 8:30 am to 4:30 pm Monday through Friday, ET
Access this publication on-line at www.irs.gov/pub/irs-pdf/p1281.pdf.
PART 4. ACTIONS FOR MISSING TIN(S) AND INCORRECT NAME/TIN
COMBINATIONS
The CP2100 or CP2100A Notice includes a listing(s) of the information returns you filed that had missing,
incorrect, and/or not currently issued TIN(s). You should compare the listing(s) to your records to determine
which of the following required actions you must take.
Missing TIN(s)
We consider a TIN to be missing if it is not provided or if it is obviously incorrect. Examples are a TIN with more
or less than nine digits, or with a mixture of digits and letters. For accounts with missing TIN(s), make sure
backup withholding has begun and continue backup withholding until you receive a TIN. If you have not begun
backup withholding, generally you must:
1. Begin backup withholding on any reportable payment you make and continue backup withholding
until you receive a TIN. Remember that in some cases, the TIN must be certified.
2. Do not send a first or second “B” Notice in response to the CP2100 or CP2100A Notice. However,
in order to avoid a penalty for filing an information return that omitted the payee’s TIN, you
must make a first annual solicitation for the TIN (generally by December 31 of the year in which
the account is opened) and if a TIN is still not received make a second annual solicitation by
December 31 of the following year. No annual solicitations are required in the years in which no
reported payments are made.
3. Report amounts withheld on Form 945, Annual Return of Withheld Federal Income Tax, and make
the required deposits.
Note: Generally, you must obtain a TIN from a payee even for a “one-time” transaction. If you do
not, the law allows us to charge a penalty. Publication 1586, Reasonable Cause Regulations and
Requirements for Missing and Incorrect Name/TIN(s), has information on removing or reducing
penalties due to reasonable cause.
Note: If you inadvertently did not include the TIN on the information return, do not contact the payee.
Include the TIN on any future information returns filed.
Incorrect Name/TIN Combinations (including not currently issued TINs)
A Name/TIN combination is incorrect if it does not match or cannot be found on IRS or SSA files. You must
follow different procedures depending on whether information on the listing(s) agrees or disagrees with your
business records. Compare the listing(s) with your records and take the following actions:
For account information that does not agree, check to see if you put the incorrect information on the return, if
the information changed after you filed the return, or if the IRS misprinted the information when processing the
return. In these situations, do not write to the IRS. However:
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1. If you reported the incorrect information on the return, correct your records and include that
information on any future information returns you file. Do not send a “B” Notice to the payee. Do
not send the correction to the IRS.
2. If the information changed after you filed the return, include that information on any future
information returns you file. Do not send a “B” Notice to the payee. Do not send the correction to
the IRS.
3. If the IRS misprinted your information, make a note of it in your records and do not take any action.
Do not send the correction to the IRS.
For account information that agrees with your records, determine whether this is the first or second time, within
three calendar years, that we have notified you about an incorrect Name/TIN combination. Your first notification
of an incorrect Name/TIN combination occurs when the payee TIN appears for the first time on the listing we
send you. The second notification of an incorrect Name/TIN combination is when the same payee TIN appears
for the second time within three calendar years on the listing.
Note: The 60-day exemption from backup withholding on presentation of an awaiting - TIN certificate
applies only to interest and dividend payments, and certain payments made with respect to readily tradable
instruments. Any other reportable payment, such as non-employee compensation, is subject to backup
withholding immediately, even if the payee has applied for and is awaiting a TIN. Upon presentation of an
awaiting TIN certificate, the payee must certify under penalties of perjury that he/she is not currently subject to
backup withholding.
First “B” Notice
1. Send the First “B” Notice, Form W-9, and an optional reply envelope to the payee within 15
business days from the date of the CP2100/CP2100A Notice or the date you received it (whichever
is later). Date the “B” Notice no later than 30 business days after the date of the CP2100/CP2100A
Notice or the date you received it (whichever is later). The outer mailing envelope must be clearly
marked “IMPORTANT TAX INFORMATION ENCLOSED” or “IMPORTANT TAX RETURN
DOCUMENT ENCLOSED.”
2. Make sure that necessary information such as the date, account number, and BWH rate are on the
“B” Notice before mailing it to the payee. If you do not include the optional reply envelope be sure
to provide return address information in your mailing.
3. Update your records with the corrected information you receive from the payee and include it on
any future information returns you file. Do not send the signed Form W-9 to the IRS.
4. Begin backup withholding on payments made to payees who do not return a signed Form W-9
in response to the First “B” Notice, no later than 30 business days after the date of the CP2100/
CP2100A Notice or the date you received it (whichever is later). However, you may begin backup
withholding the day after the date you receive the CP2100 Notice. Stop backup withholding no
later than 30 calendar days after you receive the signed Form W-9 from the payee. You may stop
backup withholding any time within that 30 calendar day period.
Note: Do not file a corrected Information Return unless you are also making a change to the dollar
amount reported on a Form 1099.
Note: It is your responsibility to send the appropriate “B” Notice to the payee, when required, to obtain
the correct Name/TIN. This information may not be solicited by telephone. You need a TIN that the
payee certifies as correct on Form W-9 in order to stop current backup withholding or prevent backup
withholding from starting.
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Second “B” Notice
1. Send the Second “B” Notice and an optional reply envelope to the payee within 15 business days
after the date of the CP2100/CP2100A Notice or the date you received it (whichever is later). Date
the “B” notice no later than 30 business days after the date of the CP2100/CP2100A Notice or the
date you received it (whichever is later). Do not send a Form W-9. The outer mailing envelope
must be clearly marked “IMPORTANT TAX INFORMATION ENCLOSED” or “IMPORTANT TAX
RETURN DOCUMENT ENCLOSED.”
2. An individual payee must provide the payor with a copy of a Social Security card with his or her
correct name and SSN. Payors may rely upon a Social Security card as being correct only if the
name and SSN combination appearing on the card differ from the name and SSN combination
appearing on the second B notice, or if there is a date appearing on the Social Security card that is
no earlier than six months prior to the date of the second B notice. If the TIN is an EIN, the payee
must contact the IRS to get his or her employer identification number validated on the IRS Letter
147C. A “Letter 685C” is requested from the IRS by the payee to validate an ITIN. The payee then
sends a copy of the “Letter 685C” received from the IRS to the Payer. A “Letter 096C” is requested
by the payee from the IRS to validate an ATIN. The payee then sends a copy of the “Letter 096C”
received from the IRS to the payer.
3. Allow 30 business days after the date of the Second “B” Notice to receive a copy of a Social
Security card described in paragraph 2 or Letter 147C from the payee. Begin backup withholding
on payments made to the payee if you do not receive a copy of a Social Security card or Letter
147C by the 30th business day. You may, at your option, begin backup withholding anytime during
the 30 business day period. You must continue to backup withhold until you receive the validation.
Stop backup withholding no later than 30 days after you receive the required validation. You may
stop backup withholding anytime within the 30 calendar day period after receiving validation.
Note: You are not required to file a corrected Information Return unless you are also making a change
to the dollar amount reported on Form 1099.
Note: It is your responsibility to send the appropriate “B” notice to the payee, when required, to solicit
the correct Name/TIN. This information may not be solicited by telephone. You need a TIN validation
(IRS Letter 147C or a copy of a Social Security cardas appropriate) in order to stop current backup
withholding or prevent backup withholding from starting.
Third and Subsequent Notices
Generally, you may ignore a third or subsequent notice of missing or incorrect TIN(s) if you completed the
actions for the First and Second “B” Notices and the incorrect payee name and TIN combination and account
number remain the same. However, if the CP2100/CP2100A Notice and listing(s) relate to the same payee, but
with a different Name/TIN combination than on the “first” and “second” notice, you must treat the notice as a
“first” notice.
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PART 5. THE IRS MATCHING PROCESS
This section provides an overview of the IRS matching process and the development of name controls.
The information returns you file must include a correct Name/TIN combination to allow us to match the
information reported against the income included on the payee’s income tax return. We check whether a
Name/TIN combination is correct by matching it against a file containing all social security numbers (SSNs)
issued by SSA or against a file containing all employer identification numbers (EINs) issued by IRS. Then we
compare the name control on the payee document (if provided) to the name control on file. If a name control
is not provided, we develop it from the name(s) provided on the first two name lines (up to 40 characters for
each name line including spaces) of the information return. If we can match a provided name or a developed
name control to the name control in our records, we consider it correct. If no match is found using this process,
we consider the Name/TIN combination to be incorrect. The chart on the back of Form W-9 has information for
payees about “What Name and Number to Give the Requester” of Form W-9.
Name Controls
A name control consists of up to four characters. To help ensure that the Name/TIN combination for an account
matches the Name/TIN combination on IRS and SSA files, use the following information when you open an
account for a payee.
Individuals
We develop a name control for an individual from the last name on the information return. For example:
Ralph Teak; Dorothy Willow; Joe McCedar
If an individual has a hyphenated last name, we develop the name control from the first of the two last names.
For example:
Joan Cedar-Hawthorn; Victoria Windsor-Maple
For joint accounts, regardless of whether the payees use the same or different last names, we develop the
name control from the primary payee’s last name. For example:
Joseph Ash & Linda Birch; Edward & Joan Maple
Reminder: If a payee has changed his or her last name, for instance, due to marriage, he or she needs
to inform the Social Security Administration (SSA) of the name change.
Hint: On name line one of the Form 1099, a payer should enter the payee’s first name and new last
name (if the change has been made with SSA), or the payee’s first name, former last name, and new
last name (if the change has not been made with SSA).
Sole Proprietors
We generally develop the name control (first name line) from the last name on the information return. For
example:
Mark Hemlock; The Sunshine Cafe; Karen Birch; Ace Computer Co.
Hint: Payers may enter a sole proprietor’s business, trade, or “doing business as” name on the second
name line of the information return. However, the individual name must be provided on the first name
line. When individual name is provided on the first name line as shown above, the Sole Proprietor can
provide either SSN or EIN (TIN) information.
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Estates
We develop the name control for a decedent’s estate from the decedent’s name on the first name line on the
information return. The decedent’s name may be followed by the word “Estate.” (The TIN should be the one
that was assigned to the estate.) For example:
Frank White Estate
Alan Greene, Exec
Estate of Frank White
John Black, Exec
Trusts and Fiduciaries
We generally develop the name control for a trust or fiduciary account from the name of the person in whose
name the trust or fiduciary account was established. For example:
Jonathan Periwinkle Irrevocable Trust
FBO Patrick Redwood
Chestnut Bank, Trustee
Memory Church Endowment Trust
John Waxbean, Trustee
Partnerships
We develop the name control for a partnership from the trade or business name of the partnership; if there is
not any, we develop the name control from the last name of the first partner listed on the original Form SS-4
(which was used to apply for the EIN). For example:
(The) Oak Tree A.S. Greene, K.L. Black & O.H. Brown, Ptrs.
Bob Orange & Carol Black, et al Ptrs. d.b.a.
The Merry Go Round
E.F. Brown, M.S. White & T.J. Green, Ptrs.
The Brown & White Company
Other Organizations
We develop the name control for other organizations from the entity’s name on the original Form SS-4 (which
was used to apply for the EIN).
St Bernard’s Methodist Church Building
Fund for St. Bernard’s Church
ABC Company
Main Street Store
NOTE: Extraneous words, titles, and special characters (i.e., Mr., Mrs., Dr., and apostrophes, etc.),
may be dropped during the development of name controls. For example, we dropped the period in St.
Bernard’s Methodist Church.
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First B Notice
IMPORTANT TAX NOTICE ACTION IS REQUIRED
Backup Withholding Warning!
WE NEED A FORM W-9 FROM YOU BEFORE: _______________________. Otherwise; backup withholding
will begin on
Account Number
Current Name on Account
Current TIN on Account
The Internal Revenue Service (IRS) has notified us that the taxpayer identification number (TIN) on your
account with us does not match its records. The IRS considers a TIN as incorrect if either the name or number
shown on an account does not match a name and number combination in their files or the files of the Social
Security Administration (SSA). If you do not take appropriate action to help us correct this problem before the
date shown above, the law requires us to backup withhold on interest, dividends, and certain other payments
that we make to your account. The backup withholding rate is: __ [set forth rates/dates] In addition to
backup withholding, you may be subject to a $50 penalty by the IRS for failing to give us your correct Name/
TIN combination. This notice tells you how to help us make your account records accurate and how to avoid
backup withholding and the penalty.
Why Your TIN May Be Considered As Incorrect.
An individual’s TIN is his or her social security number (SSN). Often a TIN does not match IRS records
because a name has changed through marriage, divorce, adoption, etc., and the change has not been
reported to SSA, so it has not been recorded in SSA’s files. Sometimes an account or transaction may not
contain the correct SSN of the actual owner. For example, an account in a child’s name may reflect a parent’s
SSN. (An account should be in the name and SSN of the actual owner.)
What You Need To Do for Individuals
If you have never been assigned a social security number (or if you lost your social security card and do not
know your SSN), call your local SSA office and find out how to obtain an original (or a replacement) social
security card. Then apply for it. If you already have a social security number: Compare the name and SSN
on your account with us (shown at the beginning of this notice) with the name and SSN shown on your social
security card. Then use the chart on the next page to decide what action to take.
IF Then
1. The last name and SSN on your account 1. Contact your local SSA office to ascertain
agree with the last name and SSN on whether the information on SSA’s
your social security card records is different from that on your
social security card, and to resolve any
problem. Also, put your name and SSN
on the enclosed Form W-9 following the
instructions on the form. Sign the Form
W-9 and send it to us.
2. The SSN on your account is different 2. Put your name and SSN, as shown on
from the SSN on your social security your social security card, on the enclosed
card, but the last name is the same Form W-9, following the instructions on
the form, sign it, and send it to us. You do
not need to contact SSA.
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3. The last name on your account is 3. Take one of the following steps (but
different from the last name on your not both): (a) If the last name on your
social security card, but the SSN is the account is correct, contact SSA to correct
same on both the name on your social security card.
Put your SSN and name shown on your
account on the enclosed Form W-9
following the instructions on the form,
sign it, and send it to us. However, if
you are not able to contact SSA at this
time, you can provide us with both last
names. Put your SSN and the name
shown on your social security card plus
the last name shown on your account (in
that order) on the enclosed Form W-9
following the instructions on the form,
sign it, and return it to us. For example,
if your social security card lists your
maiden name, give us your SSN and
your name in the following order: First/
maiden/married name. Please note,
however, that you should contact SSA as
soon as possible so they can correct their
records.
(b) If the last name on your social
security card is correct, put that name
and your SSN on the enclosed Form W-9
following the instructions on the form.
Sign it, and return it to us. You do not
need to contact SSA.
4. Both the last name and SSN on your 4. (a) If the last name and SSN on your
account are different from the last name social security card are correct, put that
and SSN on your social security card name and SSN on the enclosed Form
W-9 following the instructions on the
form. Sign it, and send it to us. You do
not need to contact SSA.
(b) If the last name on your account and
the SSN on your social security card are
correct, follow the procedure in section
3(a) above. Be sure to put the name
shown on your account and the name
on your social security card on the Form
W-9.
Once you have resolved what your correct name and TIN combination is, you must provide this information
to us (and all your other payors) for all of your accounts to avoid a problem in the future. If you are required
to visit an SSA office, take this notice, your social security card, and any other related documents with
you. Information regarding what documentation is needed to update information with the Social Security
Administration is available at ssa.gov.
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Instructions for Non-individuals and Certain Sole Proprietors
For most non-individuals (such as trusts, estates, partnerships, and similar entities), the TIN is the employer
identification number (EIN). The EIN on your account may be incorrect because it does not contain the number
of the actual owner of the account. For example, an account of an investment club or bowling league should
reflect the organization’s own EIN and name, rather than the SSN of a member. Please put the name and EIN
on the enclosed Form W-9, sign it, and send it to us.
A sole proprietor must furnish his or her individual name and either his or her SSN or the EIN for his or her
sole proprietorship. In addition to his or her individual name, the sole proprietor may also furnish the business
name for the sole proprietorship, provided his or her individual name is listed before the business name. A sole
proprietor must not furnish only the business name. Please put the individual name and SSN or EIN on the
enclosed Form W-9, sign it, and send it to us.
Important Reminder!
You must send us a signed IRS Form W-9 before the due date of this notice even if the name and number
(SSN or EIN) on your account with us match the name and number (SSN or EIN) on your social security card
or the document issuing you an EIN. If we do not receive your Form W-9, and any other documents that we
need to change the name or TIN (or both) on your account before the date of this notice, we are required by
law to backup withhold on any reportable payment that we pay to your account until we receive the necessary
documents. A Form W-9 is enclosed for your convenience, as well as any additional documents allowing us to
change the Name/TIN combination on your account.
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Second B Notice
IMPORTANT TAX NOTICE ACTION IS REQUIRED
Second Backup Withholding Warning!
YOU MUST HAVE THE IRS OR SSA VALIDATE YOUR TAXPAYER IDENTIFICATION NUMBER AND
RETURN IT TO US BY: ________________________________. Otherwise, backup withholding will begin.
Account Number
Current Name on Account
Current TIN on Account
We have received notice from the Internal Revenue Service (IRS) twice within 3 years stating that the
combination of the name and taxpayer identification number (Name/TIN combination) on your account with us
is incorrect. (Your account number, current name on the account, and current taxpayer identification number
(TIN) on the account are shown above.) A Name/TIN combination is incorrect if it does not match a Name/TIN
combination shown on the records of the Social Security Administration (SSA) or the IRS.
You should follow the instructions below to correct this problem and send the corrected information to us
before the date shown above. If we do not have the correct information before that date, the law requires us to
backup withhold on interest, dividends, and certain other payments that we make to your account. The backup
withholding rate is: __ [set forth rates/dates]
Section 3406 of the Internal Revenue Code requires that we withhold a predetermined percent in tax, called
backup withholding, when you do not give us your correct Name/TIN combination. Because of the notices we
received from the IRS, we are now required to disregard any future Name/TIN combinations you furnish us for
your account (whether or not you certify your TIN under penalties of perjury) unless SSA (or, in the case of an
incorrect employer identification number, the IRS) validates your Name/TIN combination. Also, the IRS may
charge you a $50 penalty for failing to provide us with your correct Name/TIN combination.
What You Need To Do
Follow the instructions below to correct your account record to avoid backup withholding on your account (or to
stop it once it has begun) and to avoid the penalty.
Individuals
Instructions for Incorrect Social Security Numbers
If the incorrect TIN you furnished us is a social security number, you must:
1. Provide us with a copy of your Social Security card. The social security card must show your
correct name/SSN combination that differs from the name and SSN combination appearing on this
notice or it must show a date of issuance that is no earlier than six months prior to the date on this
notice. Send the copy directly to us with a copy of this notice attached.
2. If you do not have a card meeting the requirement in item 1, you must apply for a Social Security
card by submitting SSA Form SS-5 to the SSA in person or by mail. That form and further
information regarding application for a Social Security card is available at ssa.gov.
3. In addition to the required identifying information for obtaining a Social Security card, give a copy
of this notice to the SSA.
4. Allow 7-10 business days for receipt of your Social Security card.
5. Once you receive your Social Security card, make a copy of the card and send the copy directly to
us with a copy of this notice attached.
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Non- individuals or Certain Sole Proprietors
Instructions for Incorrect Employer Identification Numbers
If the incorrect TIN you furnished is an employer identification number, you must:
1. Write the Internal Revenue Service Center where you file your income tax return, and ask the IRS
to send you a Letter 147C;
2. Enclose a copy of this notice in your letter to the Internal Revenue Service Center; and
3. When the IRS sends you the Letter 147C, send it to us with a copy of this notice attached.
Note: Internal Revenue Service Center address information can be found at www.irs.gov.
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PART 6. FLOW CHART Part 6. FLOWCHARTS
FLOWCHARTING FOR INCORRECT NAMES/TINs
FLOWCHARTING for INCORRECT NAME/TINs
Does the This is the
Name/TIN and the second
Incorrect account number on YES Is this the rst NO noti cation
Name/TIN the notice match noti cation? within a three
your records? year period.
NO
YES
Send the rst Send the
Is the mismatch due YES No action B-Notice with second
to IRS processing? required. Form W-9 to B-Notice to
the payee. the payee.
NO
Mismatch due
to record Did the
update. Did the payee payee return
Is the mismatch return a certi ed a copy of his or her
NO Social Security card
due to an error in W-9 within 30 OR a 147C within 30
your submission? No action business days? business
required. days?
YES NO YES NO
YES
Correct your
records if
necessary.
Update your Begin backup Begin backup
records with withholdiing Update your withholdiing
the certi ed within/by 30 records within/by 30
Name/TIN. business days. business days.
Stop backup
withholding if
already begun.
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FLOWCHARTING for MISSING TINs
FLOWCHARTING FOR MISSING TINs
Continue to
Is the missing TIN Are you backup backup
NO YES
Missing TIN due to an error in withholding on the withhold until
your submission? account? a TIN is
received.
YES NO
Correct your
records if Begin backup
necessary. withholding.
Annual
solicitation Remit backup
request for TIN, withholding on
remit backup Form 945.
withholding on NO Have you YES Did you receive a NO Continue to
Form 945. requested a TIN? response? backup
Continue to withhold until
backup withhold a TIN is
until a TIN is received.
received.
YES
Make annual
Update your solicitations
records and for TIN as
STOP backup required to
withholding. avoid penalty.
Note -The EIN of the filer of forms W-2G, 1099-B, 1099-DIV, 1099-G, 1099-INT, 1099-K, 1099-MISC,
1099-NEC, 1099-OID, or 1099-PATR must match the EIN of the filer of Form 945, Annual Return of
Withheld Federal Income Tax.
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PART 7. NAME COMPRESSION SPECIFICATIONS FOR “B” NOTICE TAPE
CARTRIDGES
Use the following information to standardize the entity information on your computer program/system so that it
is the same as the entity information on the “B” Notice cartridges we send to you:
Payee Name Line 1
• Blank out or eliminate all special characters on this line except ampersands (&), dashes (-) and
commas (,).
• For each position on this line, if a character is not an alpha, numeric, blank, ampersand, dash, or
comma, change it to a blank. Exception: apostrophes (‘) should be eliminated (instead of being
changed to a blank) i.e. O’Hanlon should be OHanlon
Payee Name Line 2
• Blank out or eliminate all special characters on this line except ampersands, dashes, and
percentage symbols (%).
• For each position on this line, if a character is not an alpha, numeric, blank, ampersand, dash, or
percentage symbol, change it to a blank. Exception: apostrophes should be eliminated (instead of
being changed to a blank).
Street Address
• Blank out all special characters on this line except ampersands, dashes, and percentage symbols.
• For each position on this line, if a character is not an alpha, numeric, blank, ampersand, dash, or
percentage symbol, change it to a blank.
City
• Blank out all special characters on this line except ampersands and dashes.
• For each position on this line, if a character is not an alpha, numeric, blank, ampersand or dash,
change it to a blank.
Squeeze-and-Left Justify
We use this command to search for groups of leading blanks and intervening blanks in each payee entity line
(payee name lines 1, 2, street address, and city) and remove them. It also left-justifies each line. Therefore,
For each entity line:
1) eliminate all leading blanks, 2) if two or more blanks in a row are followed by significant data, eliminate all
but one blank and 3) blank fill trailing positions left on the line.
Foreign Addresses Forms 1099 filed on tape cartridge, or electronically, undergo the following processing. If
the FOREIGN-COUNTRY-INDICATOR is equal to “1” THEN:
• set the STATE CODE to “.” (Note: this code has two positions, the first is a period and the second
is a blank) and
• set the ZIP code to “00000”.
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PART 8. INSTRUCTIONS FOR READING TAPE CARTRIDGES
General
A tape cartridge file will have the following characteristics:
A. 18 channel Standard Label/EBCDIC with: (a) odd parity and (b) a density of 1600 BPI.
B. Tape cartridges will be ½ -inch tape contained in plastic cartridges which are approximately
4-inches by 5 -inches by 1 -inch in dimension. Magnetic tape will be chromium dioxide particle
based ½ -inch tape.
C. Tape cartridges are 3480 compatible (a) Contain 37,871 CPI
D. Tape thickness - 1.0 or 1.5 mils
Record Length
A tape will be blocked in groups of 20 records, subject to the following:
A. a record will be 208 tape positions,
B. all records except the Header and Trailer Labels will be blocked,
C. a block will be 4,160 tape positions, and
D. in the event of a short block (less than 20 records), all remaining positions will be filled in with 9s.
Tape Marking Conventions
Header Label:
1. 1. Standard headers will be used. They will be marked VOL1, HDR1, HDR2. 2. The HDR1 record
will contain the Data Set Name “O4061211.” 3. This record will be 80 positions long.
Trailer Label:
1. Standard trailer labels will be used. They will begin with EOR1, EOR2, EOF1 or EOF2.
2. This label will be 80 positions long.
Tape Marks:
1. Tape marks are used to signify the physical end of the recording on the tape.
2. They follow the header label, and precede and follow the trailer label.
External Label:
A label marked with the Data Set Name “O4061211” will be put on the cartridge(s).
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PAYER “A” RECORD
TAPE POSITION FIELD TITLE LENGTH DESCRIPTION AND REMARKS
1 RECORD TYPE 1 AN “A” WILL BE ENTERED
2-16 ACCESS KEY 15 NUMBER USED BY THE IRS TO GROUP
A PAYER’S INFORMATION RETURN
TRANSMITTALS.
17-18 SERVICE CENTER 2 TWO DIGIT SERVICE CENTER CODES:
BROOKHAVEN 19
CINCINNATI 17
MEMPHIS 49
OGDEN 29
PHILADELPHIA 28
19-27 PAYER’S EIN 9 THE NINE DIGIT NUMBER ASSIGNED BY THE
IRS.
28-67 PAYER’S NAME 40 SELF-EXPLANATORY.
68-75 NUMBER OF 8 THE NUMBER OF INFORMATION RETURNS
DOCUMENTS WITH MISSING AND INCORRECT TINS
ASSOCIATED WITH THIS PAYER. IT WILL BE
RIGHT JUSTIFIED AND ZERO FILLED.
76-83 BWH TIN STATUS 1 8 THE NUMBER OF DOCUMENTS SENT TO THE
CNT PAYER WITH A BWH-TIN-STATUS-INDEQUAL
TO “1” (SEE PAYER “B” RECORD). IT WILL BE
RIGHT JUSTIFIED AND ZERO FILLED.
84-91 BWH TIN STATUS 2 8 THE NUMBER OF DOCUMENTS SENT TO THE
CNT PAYER WITH A BWH-TIN-STATUS-IND EQUAL
TO “2” (SEE PAYER “B” RECORD). IT WILL BE
RIGHT JUSTIFIED AND ZERO FILLED.
92-99 BWH TIN STATUS 3 8 THE NUMBER OF DOCUMENTS SENT TO THE
CNT PAYER WITH A BWH-TIN-STATUS-IND EQUAL
TO “3” (SEE PAYER “B” RECORD). IT WILL BE
RIGHT JUSTIFIED AND ZERO FILLED.
100 FILLER 1 BLANK FILLED
101-104 TAX YEAR 4 TAX YEAR DOCUMENTS WERE SUBMITTED
105-208 FILLER 104 BLANK FILLED
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PAYER “B” RECORD
TAPE POSITION FIELD TITLE LENGTH DESCRIPTION AND REMARKS
1 RECORD TYPE 1 A “B” WILL BE ENTERED.
2-10 TIN 9 THE PAYEE’S TIN.
11 BWH TIN STATUS 1 “1” MISSING TIN “2” NOT CURRENTLY ISSUED
TIN “3” INCORRECT NAME/TIN
12-16 TCC 5 TRANSMITTER CONTROL CODE
17-18 DOC TYPE 2 “10” = Form 1099-K “79” = Form 1099-B “91” =
Form 1099-G “86” = Form 1099-DIV “92” = Form
1099-INT “95” = Form 1099-MISC “96” = Form
1099-OID “97” = Form 1099-PATR
“71” = Form 1099-NEC
19-38 ACCOUNT NUMBER 20 PAYEE’S ACCOUNT NUMBER FROM PAYER
39-78 NAME LINE 1 40 PAYEE’S NAME LINE 1
79-118 NAME LINE 2 40 PAYEE’S NAME LINE 2
119-158 STREET ADDRESS 40 PAYEE’S STREET ADDRESS
159-188 CITY 30 PAYEE’S CITY
189-190 STATE CODE 2 PAYEE’S STATE CODE
191-195 ZIP CODE 5 PAYEE’S ZIP CODE
196 TIN INDICATOR 1 “1” = payer indicated EIN
“2” = payer indicated SSN
“0” = no TIN indicated
197-200 PAYER OFFICE CODE 4 ALPHANUMERIC
201-208 SEQUENCE NUMBER 8 SEQUENCE NUMBER WITHIN PAYER
PAYER “C” RECORD
TAPE POSITION FIELD TITLE LENGTH DESCRIPTION AND REMARKS
1 RECORD TYPE 1 A “C” WILL BE ENTERED
2-33 RECORD COUNTS 32 COUNTS AS DESCRIBED IN POSITIONS 68-99
OF THE PAYER “A” RECORD
34-208 FILLER 175 BLANK FILLED
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PART 9
CD/DVD Information
If you have 250 to 100,000 incorrect payee “B” records, your data will be on a CD. If you have over 100,000
payee “B” records then your data will be delivered on a DVD. Please make sure you have the correct type of
reader. Many older readers only read CDs.
The enclosed CD/DVD is encrypted. You should be able to read it by putting it into a CD/DVD reader on your
computer. If you have the “Auto-Run” feature turned on, the system should bring up a pop-up window asking
you to: Please contact the IRS at 1-866-455-7438 to receive your encryption key. International callers may
dial 304-263-8700. Have the following information available when calling: TIN, company name, primary or
secondary contact and self assigned PIN number. This encryption key will be needed to unlock your CD/DVD.
If you do not have “Auto-Run” turned on, you won’t see the pop-up window. Contact the IRS at 1-866-455-
7438 to receive your encryption key. International callers may dial 304-263-8700. Please have the following
information available when calling: TIN, company name, primary or secondary contact and self assigned PIN
number. You should have filled out Form 10301 and returned it to the IRS. This form tells the IRS the self
selected PIN that you would like to use.
When you view the CD/DVD there should be one file named “UDnnnn”**. This file will be an .exe file. When
you double-click on the file a box will open asking for your encryption key. Put in your encryption key, click “OK”
the next screen will ask you to browse the folder tree and select to where you want to extract the files. Click on
“OK” and the files are extracted. Please make sure to keep tax data secure.
On the CD/DVD please find the files described below:
I40642.UAnnnn ** is the Payer A-Record file. 114 Characters.
I40642.UBnnnn ** is all the Incorrect Payee B-Records. Each 222 Characters.
I40642.UCnnnn ** is the Payer C-Record file. 37 Characters.
A Copy of Publication 1281. ** nnnn is the CD/DVD transmittal number.
Each file record layout is described below.
These files are .txt files; So if you read them with Note Pad, word processing software, etc. you will see the
Pipe Codes “|” as separate characters between each field. If you open the file with Excel, you can read it as
a delimited file set the delimiters as pipes “|”. You then will see the file laid out without the Pipe Codes “|”, just
like Cartridges of past years. Be careful to set or convert fields to text so that leading zeros are not truncated or
blanked out.
The IRS hopes this new delivery method meets most of your requests to move away from the tape cartridges.
PAYER “A” RECORD FILE
POSITION FIELD TITLE LENGTH DESCRIPTION AND REMARKS
1 RECORD TYPE 1 AN “A” WILL BE ENTERED
2 Pipe Code 1 “|”
3-17 ACCESS KEY 15 NUMBER USED BY THE IRS TO GROUP A PAYER’S
INFORMATION RETURN TRANSMITTAL
18 Pipe Code 1 “|”
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19-20 SERVICE CAMPUS 2 TWO DIGIT SERVICE CAMPUS CODE
BROOKHAVEN=19
CINCINNATI = 17
MEMPHIS = 49
OGDEN = 29
PHILADELPHIA = 28
21 Pipe Code 1 “|”
22-30 PAYER’S TIN 9 THE NINE DIGIT NUMBER ASSIGNED BY THE IRS
31 Pipe Code 1 “|”
32-71 PAYER’S NAME 40 SELF-EXPLANATORY
72 Pipe Code 1 “|”
73-80 NUMBER OF 8 THE NUMBER OF INFORMATION RETURNS WITH
DOCUMENTS MISSING AND INCORRECT TINS ASSOCIATED WITH
THIS PAYER. IT WILL BE RIGHT JUSTIFIED AND
ZERO FILLED
81 Pipe Code 1 “|”
82-89 BWH TIN STATUS 1 CNT 8 THE NUMBER OF DOCUMENTS SENT TO THE PAYER
WITH A BWH-TIN-STATUS-IND EQUAL TO “1” (SEE
PAYER “B” RECORD). IT WILL BE RIGHT JUSTIFIED
AND ZERO FILLED
90 Pipe Code 1 “|”
91-98 BWH TIN STATUS 2 CNT 8 THE NUMBER OF DOCUMENTS SENT TO THE PAYER
WITH A BWH-TIN-STATUS-IND EQUAL TO “2” (SEE
PAYER “B” RECORD) IT WILL BE RIGHT JUSTIFIED
AND ZERO FILLED.
99 Pipe Code 1 “|”
100-107 BWH TIN STATUS 3 CNT 8 THE NUMBER OF DOCUMENTS SENT TO THE PAYER
WITH A BWH-TIN-STATUS-IND EQUAL TO “3” (SEE
PAYER “B” RECORD) IT WILL BE RIGHT JUSTIFIED
AND ZERO FILLED.
108 Pipe Code 1 “|”
109 FILLER 1 BLANK FILLED
110 Pipe Code 1 “|”
111-114 TAX YEAR 4 TAX YEAR DOCUMENTS WERE SUBMITTED
PAYEE “B” RECORD FILE
POSITION FIELD TITLE LENGTH DESCRIPTION AND REMARKS
1 RECORD TYPE 1 A “B” WILL BE ENTERED
2 Pipe Code 1 “|”
3-11 TIN 9 THE PAYEE’S TIN
12 Pipe Code 1 “|”
13 BWH TIN STATUS 1 “1” MISSING TIN “2” NOT CURRENTLY ISSUED “3” INCORRECT NAME/
TIN
14 Pipe Code 1 “|”
15-19 TCC 5 TRANSMITTER CONTROL CODE
20 Pipe Code 1 “|”
27
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|
21-22 DOC TYPE 2 “02” = Form 1042-S
“10” = Form 1099-K
“21” = Form W-2
“27” = Form 5498S
“28” = Form 5498S
“31” = Form 1099-Q
“32” = Form W2-G
“71” = Form 1099-H (through Tax Year 2019)
“71” = Form 1099-NEC (Tax Year 2020 and later)
“72” = Form 5498-ESA
“73” = Form 1099-CAP
“75” = Form 1099-S
“79” = Form 1099-B
“80” = Form 1099-A
“81” = Form 1098
“83” = Form 1098-T
“84” = Form 1098-E
“85” = Form 1099-C
“86” = Form 1099-G
“91” = Form 1099-DIV
“92” = Form 1099-INT
“93” = Form 1099-LTC
“94” = Form 1099-SA
“95” = Form 1099-MISC
“96” = Form 1099-OID
“97” = Form 1099-PATR
“98” = Form 1099-R
23 Pipe Code 1 “|”
24-43 ACCOUNT NUMBER 20 PAYEE’S ACCOUNT NUMBER FROM PAYER
44 Pipe Code 1 “|”
45-84 NAME LINE 40 PAYEE’S NAME LINE 1
85 Pipe Code 1 “|”
86-125 NAME LINE 40 PAYEE’S NAME LINE 2
126 Pipe Code 1 “|”
127-166 STR. ADDRESS 40 PAYEE’S STREET ADDRESS
167 Pipe Code 1 “|”
168-197 CITY 30 PAYEE’S CITY
198 Pipe Code 1 “|”
199-200 STATE CODE 2 PAYEE’S STATE CODE
201 Pipe Code 1 “|”
202-206 ZIP CODE 5 PAYEE’S ZIP CODE
207 Pipe Code 1 “|”
208 TIN INDICATOR 1 “1” = Payer indicated EIN “2” = Payer indicated SSN “0” = no TIN indicated
209 Pipe Code 1 “|”
210-213 PAYER OFFICE CODE 4 BLANK FILLED
214 Pipe Code 1 “|”
215-222 SEQUENCE 8 NUMBER OF THE RECORD AS IT APPEARED IN YOUR FILE
28
|
|
PAYER “C” RECORD FILE
POSITION RECORD FILE FIELD LENGTH DESCRIPTION AND REMARKS
TITLE
1 RECORD TYPE 1 A “C” WILL BE ENTERED
2 Pipe Code 1 “|”
3-10 NUMBER OF 8 THE NUMBER OF INFORMATION RETURNS WITH
DOCUMENTS MISSING AND INCORRECT TINS ASSOCIATED WITH
THIS PAYER. IT WILL BE RIGHT JUSTIFIED AND
ZERO FILLED
11 Pipe Code 1 “|”
12-19 BWH TIN STATUS 8 THE NUMBER OF DOCUMENTS SENT TO THE PAYER
WITH A BWH-TIN-STATUS-IND EQUAL TO “1” (SEE
PAYER “B” RECORD). IT WILL BE RIGHT JUSTIFIED
AND ZERO FILLED
20 1 CNT 1 “|”
21-28 Pipe Code BWH TIN 8 THE NUMBER OF DOCUMENTS SENT TO THE PAYER
STATUS 2 CNT WITH A BWH-TIN-STATUS-IND EQUAL TO “2” (SEE
PAYER “B” RECORD) IT WILL BE RIGHT JUSTIFIED
AND ZERO FILLED
29 Pipe Code 1 “|”
30-37 BWH TIN STATUS 3 CNT 8 THE NUMBER OF DOCUMENTS SENT TO THE PAYER
WITH A BWH-TIN-STATUS-IND EQUAL TO “3” (SEE
PAYER “B” RECORD) IT WILL BE RIGHT JUSTIFIED
AND ZERO FILLED.
PART 10. OTHER FORMS
Instructions for the Requester of Form W-9
• Form W-9, Request for Taxpayer Identification Number and Certification
• Instructions for the Requester of Forms W-8BEN, W-8BEN-E, W-8ECI, W-8EXP and W-8IMY
• Form W-8BEN, Certificate of Foreign Status of Beneficial Owner for United States Tax Withholding
• Form W-8BEN-E, Certificate of Entities Status of Beneficial Owner for United States Tax Withholding
(Entities)
• Form W-8ECI, Certificate of Foreign Person’s Claim for Exemption From Withholding on Income
Effectively Connected With the Conduct of a Trade or Business in the United States
• Form W-8EXP, Certificate of Foreign Government or Other Foreign Organization for United States
Tax Withholding
• Form W-8IMY, Certificate of Foreign Intermediary, Foreign Flow-Through Entity, or Certain U.S.
Branches for United States Tax Withholding
29
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Department of the Treasury
Internal Revenue Service
Instructions for the
Requester of Form W-9
(Rev. November 2017)
Request for Taxpayer Identification Number
and Certification
Section references are to the Internal Revenue Code unless A participating foreign financial institution (PFFI) should
otherwise noted. request Form W-9 from an account holder that is a U.S. person.
If an account is jointly held, the PFFI should request a Form W-9
from each holder that is a U.S. person.
Future Developments
Advise foreign persons to use the appropriate Form W-8 or
For the latest developments related to Form W-9 and its Form 8233, Exemption From Withholding on Compensation for
instructions, such as legislation enacted after they were Independent (and Certain Dependent) Personal Services of a
published, go to IRS.gov/FormW9. Nonresident Alien Individual. See Pub. 515, Withholding of Tax
on Nonresident Aliens and Foreign Entities, for more information
and a list of the W-8 forms.
Reminders
FATCA and backup withholding exemptions. FATCA Electronic Submission of Forms W-9
requires a participating foreign financial institution to report all Requesters may establish a system for payees and payees'
U.S. account holders that are specified U.S. persons. Form W-9 agents to submit Forms W-9 electronically, including by fax. A
has an Exemptions box on the front of the form that includes requester is anyone required to file an information return. A
entry for the Exempt payee code (if any) and Exemption from payee is anyone required to provide a taxpayer identification
FATCA Reporting Code (if any). The references for the number (TIN) to the requester.
appropriate codes are in the Exemptions section of Form W-9,
and in the Payees Exempt From Backup Withholding and Payee's agent. A payee's agent can be an investment advisor
Payees and Account Holders Exempt From FATCA Reporting (corporation, partnership, or individual) or an introducing broker.
sections of these instructions. An investment advisor must be registered with the Securities
and Exchange Commission (SEC) under the Investment
The Certification section in Part II of Form W-9 includes Advisers Act of 1940. The introducing broker is a broker-dealer
certification relating to FATCA reporting. that is regulated by the SEC and the National Association of
Backup withholding rate. The backup withholding rate is 28% Securities Dealers, Inc., and that is not a payer. Except for a
for reportable payments. broker who acts as a payee's agent for “readily tradable
instruments,” the advisor or broker must show in writing to the
Backup withholding liability. If you do not collect backup payer that the payee authorized the advisor or broker to transmit
withholding from affected payees as required, you may become the Form W-9 to the payer.
liable for any uncollected amount.
Electronic system. Generally, the electronic system must:
TIN matching e-services. The IRS website offers TIN Ensure the information received is the information sent, and
Matching e-services for certain payers to validate name and TIN document all occasions of user access that result in the
combinations. See Taxpayer Identification Number (TIN) submission;
Matching on page 4. Make reasonably certain that the person accessing the
system and submitting the form is the person identified on Form
How Do I Know When To Use W-9, the investment advisor, or the introducing broker;
Form W-9? Provide the same information as the paper Form W-9;
Be able to supply a hard copy of the electronic Form W-9 if
Use Form W-9 to request the taxpayer identification number the Internal Revenue Service requests it; and
(TIN) of a U.S. person (including a resident alien) and to request Require as the final entry in the submission an electronic
certain certifications and claims for exemption. (See Purpose of signature by the payee whose name is on Form W-9 that
Form on Form W-9.) Withholding agents may require signed authenticates and verifies the submission. The electronic
Forms W-9 from U.S. exempt recipients to overcome a signature must be under penalties of perjury and the perjury
presumption of foreign status. For federal tax purposes, a U.S. statement must contain the language of the paper Form W-9.
person includes but is not limited to:
An individual who is a U.S. citizen or U.S. resident alien; For Forms W-9 that are not required to be signed, the
A partnership, corporation, company, or association created TIP electronic system need not provide for an electronic
or organized in the United States or under the laws of the United signature or a perjury statement.
States;
Any estate (other than a foreign estate); or For more details, see the following.
A domestic trust (as defined in Regulations section Announcement 98-27, which is on page 30 of Internal
301.7701-7). Revenue Bulletin 1998-15 at www.irs.gov/pub/irs-irbs/
irb98-15.pdf.
A partnership may require a signed Form W-9 from its U.S. Announcement 2001-91, which is on page 221 of Internal
partners to overcome a presumption of foreign status and to Revenue Bulletin 2001-36 at www.irs.gov/pub/irs-irbs/
avoid withholding on the partner's allocable share of the irb01-36.pdf.
partnership's effectively connected income. For more
information, see Regulations section 1.1446-1.
Nov 21, 2017 Cat. No. 20479P
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“The Internal Revenue Service does not require your consent
Individual Taxpayer Identification to any provision of this document other than the certifications
Number (ITIN) required to avoid backup withholding.”
Form W-9 (or an acceptable substitute) is used by persons If you use a substitute form, you are required to provide the
required to file information returns with the IRS to get the payee's Form W-9 instructions to the payee only if he or she requests
(or other person's) correct name and TIN. For individuals, the them. However, if the IRS has notified the payee that backup
TIN is generally a social security number (SSN). withholding applies, then you must instruct the payee to strike
However, in some cases, individuals who become U.S. out the language in the certification that relates to
resident aliens for federal tax purposes are not eligible to obtain underreporting. This instruction can be given orally or in writing.
an SSN. This includes certain resident aliens who must receive See item 2 of the Certification on Form W-9. You can replace
information returns but who cannot obtain an SSN. “defined below” with “defined in the instructions” in item 3 of the
Certification on Form W-9 when the instructions will not be
These individuals must apply for an ITIN on Form W-7, provided to the payee except upon request. For more
Application for IRS Individual Taxpayer Identification Number, information, see Rev. Proc. 83-89,1983-2 C.B. 613; amplified by
unless they have an application pending for an SSN. Individuals Rev. Proc. 96-26, which is on page 22 of Internal Revenue
who have an ITIN must provide it on Form W-9. Bulletin 1996-8 at www.irs.gov/pub/irs-irbs/irb96-08.pdf.
Note. ITINs that haven’t been included on a U.S. federal tax TIN Applied For
return at least once in the last three consecutive tax years will For interest and dividend payments and certain payments with
expire. Expired ITINs must be renewed in order to avoid delays respect to readily tradable instruments, the payee may return a
in processing the ITIN holder’s tax return. If the IRS deactivates properly completed, signed Form W-9 to you with “Applied For”
the ITIN because it has expired, the ITIN may still be used on written in Part I. This is an “awaiting-TIN” certificate. The payee
Form W-9. However, the ITIN holder will have to apply to renew has 60 calendar days, from the date you receive this certificate,
the deactivated ITIN if there is a need to file a tax return. For to provide a TIN. If you do not receive the payee's TIN at that
more information, see the Instructions for Form W-7. time, you must begin backup withholding on payments.
Substitute Form W-9 Reserve rule. You must backup withhold on any reportable
You may develop and use your own Form W-9 (a substitute payments made during the 60-day period if a payee withdraws
Form W-9) if its content is substantially similar to the official IRS more than $500 at one time, unless the payee reserves an
Form W-9 and it satisfies certain certification requirements. amount equal to the current year's backup withholding rate on all
reportable payments made to the account.
You may incorporate a substitute Form W-9 into other
business forms you customarily use, such as account signature Alternative rule. You also may elect to backup withhold during
cards. However, the certifications on the substitute Form W-9 this 60-day period, after a 7-day grace period, under one of the
must clearly state (as shown on the official Form W-9) that under two alternative rules discussed below.
penalties of perjury: Option 1. Backup withhold on any reportable payments if the
1. The payee's TIN is correct, payee makes a withdrawal from the account after the close of 7
business days after you receive the awaiting-TIN certificate.
2. The payee is not subject to backup withholding due to Treat as reportable payments all cash withdrawals in an amount
failure to report interest and dividend income, up to the reportable payments made from the day after you
3. The payee is a U.S. person, and receive the awaiting-TIN certificate to the day of withdrawal.
4. The FATCA code entered on this form (if any) indicating Option 2. Backup withhold on any reportable payments
that the payee is exempt from FATCA reporting is correct. made to the payee's account, regardless of whether the payee
makes any withdrawals, beginning no later than 7 business days
You may provide certification instructions on a substitute after you receive the awaiting-TIN certificate.
Form W-9 in a manner similar to the official form. If you are not
collecting a FATCA exemption code by omitting that field from The 60-day exemption from backup withholding does
the substitute Form W-9 (see Payees and Account Holders ! not apply to any payment other than interest, dividends,
Exempt From FATCA Reporting, later), you may notify the payee CAUTION and certain payments relating to readily tradable
that item 4 does not apply. instruments. Any other reportable payment, such as
nonemployee compensation, is subject to backup withholding
You may not: immediately, even if the payee has applied for and is awaiting a
1. Use a substitute Form W-9 that requires the payee, by TIN.
signing, to agree to provisions unrelated to the required
certifications, or Even if the payee gives you an awaiting-TIN certificate, you must
2. Imply that a payee may be subject to backup withholding backup withhold on reportable interest and dividend payments if
unless the payee agrees to provisions on the substitute form that the payee does not certify, under penalties of perjury, that the
are unrelated to the required certifications. payee is not subject to backup withholding.
A substitute Form W-9 that contains a separate signature line If you do not collect backup withholding from affected payees as
just for the certifications satisfies the requirement that the required, you may become liable for any uncollected amount.
certifications be clearly stated.
Payees Exempt From Backup
If a single signature line is used for the required certifications
and other provisions, the certifications must be highlighted, Withholding
boxed, printed in bold-face type, or presented in some other The following payees are exempt from backup withholding with
manner that causes the language to stand out from all other respect to the payments below, and should enter the
information contained on the substitute form. Additionally, the corresponding exempt payee code on Form W-9. You may rely
following statement must be presented to stand out in the same on the payee’s claim of exemption unless you have actual
manner as described above and must appear immediately knowledge that the exempt payee code and/or classification
above the single signature line: selected are not valid, or if they are inconsistent with each other.
-2- Instr. for Req. of Form W-9 (Rev. 11-2017)
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In that case, you may rely on the Form W-9 for purposes of Payments made in settlement of payment card or third par-
obtaining the payee’s TIN, but you must treat the payee as ty network transactions. Only payees listed in items 1 through
non-exempt. If the payee failed to enter an exempt payee code, 4 are exempt.
but the classification selected indicates that the payee is
exempt, you may accept the classification and treat the payee as Payments Exempt From Backup
exempt unless you have actual knowledge that the classification
is not valid. Withholding
If the payee is not exempt, you are required to backup Payments that are not subject to information reporting also are
withhold on reportable payments if the payee does not provide a not subject to backup withholding. For details, see sections
TIN in the manner required or does not sign the certification, if 6041, 6041A, 6042, 6044, 6045, 6049, 6050A, 6050N, and
required. 6050W and their regulations. The following payments generally
are exempt from backup withholding.
1. An organization exempt from tax under
section 501(a), any IRA, or a custodial account under section Dividends and patronage dividends.
403(b)(7) if the account satisfies the requirements of section Payments to nonresident aliens subject to withholding under
401(f)(2); section 1441.
Payments to partnerships not engaged in a trade or business
2. The United States or any of its agencies or in the United States and that have at least one nonresident alien
instrumentalities; partner.
3. A state, the District of Columbia, a U.S. commonwealth or Payments of patronage dividends not paid in money.
possession, or any of their political subdivisions, agencies, or Payments made by certain foreign organizations.
instrumentalities; Section 404(k) distributions made by an ESOP.
4. A foreign government or any of its political subdivisions, Interest payments.
agencies, or instrumentalities; or Payments of interest on obligations issued by individuals.
5. A corporation; However, if you pay $600 or more of interest in the course of
6. A dealer in securities or commodities required to register your trade or business to a payee, you must report the payment.
in the United States, the District of Columbia, or a U.S. Backup withholding applies to the reportable payment if the
commonwealth or possession; payee has not provided a TIN or has provided an incorrect TIN.
Payments described in section 6049(b)(5) to nonresident
7. A futures commission merchant registered with the aliens.
Commodity Futures Trading Commission; Payments on tax-free covenant bonds under
8. A real estate investment trust; section 1451.
9. An entity registered at all times during the tax year under Payments made by certain foreign organizations.
the Investment Company Act of 1940; Mortgage or student loan interest paid to you.
10. A common trust fund operated by a bank under Other types of payment.
section 584(a); Wages.
11. A financial institution; Distributions from a pension, annuity, profit-sharing or stock
bonus plan, any IRA, an owner-employee plan, or other deferred
12. A middleman known in the investment community as a compensation plan.
nominee or custodian; or Distributions from a medical or health savings account and
13. A trust exempt from tax under section 664 or described in long-term care benefits.
section 4947. Certain surrenders of life insurance contracts.
The following types of payments are exempt from backup Distribution from qualified tuition programs or
withholding as indicated for payees listed in 1 through 13, Coverdell ESAs.
above. Gambling winnings if regular gambling winnings withholding is
required under section 3402(q). However, if regular gambling
Interest and dividend payments. All listed payees are exempt winnings withholding is not required under section 3402(q),
except the payee in item 7. backup withholding applies if the payee fails to furnish a TIN.
Broker transactions. All payees listed in items 1 through 4 and Real estate transactions reportable under
6 through 11 are exempt. Also, C corporations are exempt. A section 6045(e).
person registered under the Investment Advisers Act of 1940 Cancelled debts reportable under section 6050P.
who regularly acts as a broker also is exempt. Fish purchases for cash reportable under
section 6050R.
Barter exchange transactions and patronage dividends.
Only payees listed in items 1 through 4 are exempt. Payees and Account Holders Exempt
Payments reportable under sections 6041 and 6041A. From FATCA Reporting
Payees listed in items 1 through 5 generally are exempt. Reporting under chapter 4 (FATCA) with respect to U.S. persons
However, the following payments made to a corporation and generally applies only to foreign financial institutions (FFI)
reportable on Form 1099-MISC, Miscellaneous Income, are not (including a branch of a U.S. financial institution that is treated as
exempt from backup withholding. an FFI under an applicable intergovernmental agreement (IGA)).
Medical and health care payments. Thus, for example, a U.S. financial institution maintaining an
Attorneys' fees (also gross proceeds paid to an attorney, account in the United States does not need to collect an
reportable under section 6045(f)). exemption code for FATCA reporting. If you are providing a
Payments for services paid by a federal executive agency. Form W-9, you may pre-populate the FATCA exemption code
(See Rev. Rul. 2003-66, which is on page 1115 of Internal with "Not Applicable," "N/A," or a similar indication that an
Revenue Bulletin 2003-26 at www.irs.gov/pub/irs-irbs/ exemption from FATCA reporting does not apply. Any payee that
irb03-26.pdf.) provides such a form, however, cannot be treated as exempt
from FATCA reporting. For details on the FATCA reporting
Instr. for Req. of Form W-9 (Rev. 11-2017) -3-
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requirements, including specific information regarding which 2. Any one of the joint payees who has not established
financial institutions are required to report, see sections 1471 to foreign status gives you a TIN.
1474 and related regulations. See Regulations section
1.1471-3(d)(2) for when an FFI may rely on documentary If any one of the joint payees who has not established foreign
evidence to treat a U.S. person as other than a specified U.S. status gives you a TIN, use that number for purposes of backup
person and see Regulations section 1.1471-3(f)(3) for when an withholding and information reporting.
FFI may presume a U.S. person as other than a specified U.S. For more information on foreign payees, see the Instructions
person. for the Requester of Forms W-8BEN, W-8ECI, W-8EXP, and
If you receive a Form W-9 with a FATCA exemption code and W-8IMY.
you know or have reason to know the person is a specified U.S.
person, you may not rely on the Form W-9 to treat the person as Names and TINs To Use
exempt from FATCA reporting. However, you may still rely on an for Information Reporting
otherwise completed Form W-9 to treat a person as a specified Show the full name and address as provided on Form W-9 on
U.S. person. An exemption from FATCA reporting (or lack the information return filed with the IRS and on the copy
thereof) does not affect backup withholding as described earlier furnished to the payee. If the payee has marked their address
in these instructions. The following are not specified U.S. “NEW”, you should update your records. If you made payments
persons and are thus exempt from FATCA reporting. to more than one payee or the account is in more than one
A. An organization exempt from tax under section 501(a), or name, enter on the first name line of the information return only
any individual retirement plan as defined in section 7701(a)(37); the name of the payee whose TIN is shown on Form W-9. You
may show the names of any other individual payees in the area
B. The United States or any of its agencies or below the first name line on the information return. Forms W-9
instrumentalities; showing an ITIN must have the name exactly as shown on
C. A state, the District of Columbia, a U.S. commonwealth or line 1a of the Form W-7 application. If you are a PFFI reporting a
possession, or any of their political subdivisions, agencies, or U.S. account on Form 8966, FATCA Report, and the account is
instrumentalities; jointly held by U.S. persons, file a separate Form 8966 for each
holder.
D. A corporation the stock of which is regularly traded on one
or more established securities markets, as described in Reg. For more information on the names and TINs to use for
section 1.1472-1(c)(1)(i); TIP information reporting, see section J of the General
Instructions for Certain Information Returns.
E. A corporation that is a member of the same expanded
affiliated group as a corporation described in Reg. section
1.1472-1(c)(1)(i); Notices From the IRS
The IRS will send you a notice if the payee's name and TIN on
F. A dealer in securities, commodities, or derivative financial the information return you filed do not match the IRS's records.
instruments (including notional principal contracts, futures, (See Taxpayer Identification Number (TIN) Matching.) If you
forwards, and options) that is registered as such under the laws receive a backup withholding notice, you may have to send a “B”
of the United States or any State; notice to the payee to solicit another TIN. Pub. 1281, Backup
G. A real estate investment trust; Withholding for Missing and Incorrect Name/TIN(s), contains
copies of the two types of “B” notices. If you receive a penalty
H. A regulated investment company as defined in section notice, you also may have to send a solicitation to the payee.
851 or an entity registered at all times during the tax year under See Pub. 1586, Reasonable Cause Regulations and
the Investment Company Act of 1940; Requirements for Missing and Incorrect Name/TINs.
I. A common trust fund as defined in section 584(a);
Taxpayer Identification Number (TIN)
J. A bank as defined in section 581;
Matching
K. A broker; TIN Matching allows a payer or authorized agent who is required
L. A trust exempt from tax under section 664 or described in to file Forms 1099-B, DIV, INT, K, MISC, OID, and/or PATR to
section 4947; or match TIN and name combinations with IRS records before
submitting the forms to the IRS. TIN Matching is one of the
M. A tax-exempt trust under a section 403(b) plan or section e-services products that is offered and is accessible through the
457(g) plan. IRS website. Go to IRS.gov and enter “e-services” in the search
box. It is anticipated that payers who validate the TIN and name
Joint Foreign Payees combinations before filing information returns will receive fewer
If the first payee listed on an account gives you a backup withholding (CP2100) notices and penalty notices.
Form W-8 or a similar statement signed under penalties of
perjury, backup withholding applies unless: Additional Information
1. Every joint payee provides the statement regarding For more information on backup withholding, see Pub. 1281.
foreign status, or
-4- Instr. for Req. of Form W-9 (Rev. 11-2017)
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Request for Taxpayer Give Form to the
Form W-9 requester. Do not
(Rev. November 2017) Identification Number and Certification
Department of the Treasury send to the IRS.
Internal Revenue Service a Go to www.irs.gov/FormW9 for instructions and the latest information.
1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank.
2 Business name/disregarded entity name, if different from above
3 Check appropriate box for federal tax classification of the person whose name is entered on line 1. Check only one of the 4 Exemptions (codes apply only to
following seven boxes. certain entities, not individuals; see
instructions on page 3):
on page 3. Individual/sole proprietor or C Corporation S Corporation Partnership Trust/estate
single-member LLC Exempt payee code (if any)
Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=Partnership) a
Note: Check the appropriate box in the line above for the tax classification of the single-member owner. Do not check Exemption from FATCA reporting
LLC if the LLC is classified as a single-member LLC that is disregarded from the owner unless the owner of the LLC is
Print or type. another LLC that is not disregarded from the owner for U.S. federal tax purposes. Otherwise, a single-member LLC that code (if any)
is disregarded from the owner should check the appropriate box for the tax classification of its owner.
Other (see instructions) a (Applies to accounts maintained outside the U.S.)
Specific Instructions 5 Address (number, street, and apt. or suite no.) See instructions. Requester’s name and address (optional)
See
6 City, state, and ZIP code
7 List account number(s) here (optional)
Part I Taxpayer Identification Number (TIN)
Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid Social security number
backup withholding. For individuals, this is generally your social security number (SSN). However, for a
resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other ––
entities, it is your employer identification number (EIN). If you do not have a number, see How to get a
TIN, later. or
Note: If the account is in more than one name, see the instructions for line 1. Also see What Name and Employer identification number
Number To Give the Requester for guidelines on whose number to enter.
–
Part II Certification
Under penalties of perjury, I certify that:
1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and
2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue
Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am
no longer subject to backup withholding; and
3. I am a U.S. citizen or other U.S. person (defined below); and
4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct.
Certification instructions.You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because
you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid,
acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments
other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions for Part II, later.
Sign Signature of
Here U.S. person a Date a
• Form 1099-DIV (dividends, including those from stocks or mutual
General Instructions funds)
Section references are to the Internal Revenue Code unless otherwise • Form 1099-MISC (various types of income, prizes, awards, or gross
noted. proceeds)
Future developments. For the latest information about developments • Form 1099-B (stock or mutual fund sales and certain other
related to Form W-9 and its instructions, such as legislation enacted transactions by brokers)
after they were published, go to www.irs.gov/FormW9.
• Form 1099-S (proceeds from real estate transactions)
Purpose of Form • Form 1099-K (merchant card and third party network transactions)
An individual or entity (Form W-9 requester) who is required to file an • Form 1098 (home mortgage interest), 1098-E (student loan interest),
information return with the IRS must obtain your correct taxpayer 1098-T (tuition)
identification number (TIN) which may be your social security number • Form 1099-C (canceled debt)
(SSN), individual taxpayer identification number (ITIN), adoption • Form 1099-A (acquisition or abandonment of secured property)
taxpayer identification number (ATIN), or employer identification number Use Form W-9 only if you are a U.S. person (including a resident
(EIN), to report on an information return the amount paid to you, or other alien), to provide your correct TIN.
amount reportable on an information return. Examples of information
returns include, but are not limited to, the following. If you do not return Form W-9 to the requester with a TIN, you might
• Form 1099-INT (interest earned or paid) be subject to backup withholding. See What is backup withholding,
later.
Cat. No. 10231X Form W-9 (Rev. 11-2017)
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Form W-9 (Rev. 11-2017) Page 2
By signing the filled-out form, you: Example. Article 20 of the U.S.-China income tax treaty allows an
1. Certify that the TIN you are giving is correct (or you are waiting for a exemption from tax for scholarship income received by a Chinese
number to be issued), student temporarily present in the United States. Under U.S. law, this
student will become a resident alien for tax purposes if his or her stay in
2. Certify that you are not subject to backup withholding, or the United States exceeds 5 calendar years. However, paragraph 2 of
3. Claim exemption from backup withholding if you are a U.S. exempt the first Protocol to the U.S.-China treaty (dated April 30, 1984) allows
the provisions of Article 20 to continue to apply even after the Chinese
payee. If applicable, you are also certifying that as a U.S. person, your student becomes a resident alien of the United States. A Chinese
allocable share of any partnership income from a U.S. trade or business student who qualifies for this exception (under paragraph 2 of the first
is not subject to the withholding tax on foreign partners' share of protocol) and is relying on this exception to claim an exemption from tax
effectively connected income, and on his or her scholarship or fellowship income would attach to Form
4. Certify that FATCA code(s) entered on this form (if any) indicating W-9 a statement that includes the information described above to
support that exemption.
that you are exempt from the FATCA reporting, is correct. See What is If you are a nonresident alien or a foreign entity, give the requester the
FATCA reporting, later, for further information. appropriate completed Form W-8 or Form 8233.
Note: If you are a U.S. person and a requester gives you a form other
than Form W-9 to request your TIN, you must use the requester’s form if Backup Withholding
it is substantially similar to this Form W-9. What is backup withholding?Persons making certain payments to you
Definition of a U.S. person.For federal tax purposes, you are must under certain conditions withhold and pay to the IRS 28% of such
considered a U.S. person if you are: payments. This is called “backup withholding.” Payments that may be
• An individual who is a U.S. citizen or U.S. resident alien; subject to backup withholding include interest, tax-exempt interest,
• A partnership, corporation, company, or association created or dividends, broker and barter exchange transactions, rents, royalties,
organized in the United States or under the laws of the United States; nonemployee pay, payments made in settlement of payment card and
third party network transactions, and certain payments from fishing boat
• An estate (other than a foreign estate); or operators. Real estate transactions are not subject to backup
• A domestic trust (as defined in Regulations section 301.7701-7). withholding.
Special rules for partnerships.Partnerships that conduct a trade or You will not be subject to backup withholding on payments you
business in the United States are generally required to pay a withholding receive if you give the requester your correct TIN, make the proper
tax under section 1446 on any foreign partners’ share of effectively certifications, and report all your taxable interest and dividends on your
connected taxable income from such business. Further, in certain cases tax return.
where a Form W-9 has not been received, the rules under section 1446 Payments you receive will be subject to backup withholding if:
require a partnership to presume that a partner is a foreign person, and 1. You do not furnish your TIN to the requester,
pay the section 1446 withholding tax. Therefore, if you are a U.S. person
that is a partner in a partnership conducting a trade or business in the 2. You do not certify your TIN when required (see the instructions for
United States, provide Form W-9 to the partnership to establish your Part II for details),
U.S. status and avoid section 1446 withholding on your share of 3. The IRS tells the requester that you furnished an incorrect TIN,
partnership income. 4. The IRS tells you that you are subject to backup withholding
In the cases below, the following person must give Form W-9 to the because you did not report all your interest and dividends on your tax
partnership for purposes of establishing its U.S. status and avoiding return (for reportable interest and dividends only), or
withholding on its allocable share of net income from the partnership 5. You do not certify to the requester that you are not subject to
conducting a trade or business in the United States. backup withholding under 4 above (for reportable interest and dividend
• In the case of a disregarded entity with a U.S. owner, the U.S. owner accounts opened after 1983 only).
of the disregarded entity and not the entity; Certain payees and payments are exempt from backup withholding.
• In the case of a grantor trust with a U.S. grantor or other U.S. owner, See Exempt payee code, later, and the separate Instructions for the
generally, the U.S. grantor or other U.S. owner of the grantor trust and Requester of Form W-9 for more information.
not the trust; and Also see Special rules for partnerships, earlier.
• In the case of a U.S. trust (other than a grantor trust), the U.S. trust
(other than a grantor trust) and not the beneficiaries of the trust. What is FATCA Reporting?
Foreign person. If you are a foreign person or the U.S. branch of a The Foreign Account Tax Compliance Act (FATCA) requires a
foreign bank that has elected to be treated as a U.S. person, do not use participating foreign financial institution to report all United States
Form W-9. Instead, use the appropriate Form W-8 or Form 8233 (see account holders that are specified United States persons. Certain
Pub. 515, Withholding of Tax on Nonresident Aliens and Foreign payees are exempt from FATCA reporting. See Exemption from FATCA
Entities). reporting code, later, and the Instructions for the Requester of Form
Nonresident alien who becomes a resident alien.Generally, only a W-9 for more information.
nonresident alien individual may use the terms of a tax treaty to reduce
or eliminate U.S. tax on certain types of income. However, most tax Updating Your Information
treaties contain a provision known as a “saving clause.” Exceptions You must provide updated information to any person to whom you
specified in the saving clause may permit an exemption from tax to claimed to be an exempt payee if you are no longer an exempt payee
continue for certain types of income even after the payee has otherwise and anticipate receiving reportable payments in the future from this
become a U.S. resident alien for tax purposes. person. For example, you may need to provide updated information if
If you are a U.S. resident alien who is relying on an exception you are a C corporation that elects to be an S corporation, or if you no
contained in the saving clause of a tax treaty to claim an exemption longer are tax exempt. In addition, you must furnish a new Form W-9 if
from U.S. tax on certain types of income, you must attach a statement the name or TIN changes for the account; for example, if the grantor of a
to Form W-9 that specifies the following five items. grantor trust dies.
1. The treaty country. Generally, this must be the same treaty under
which you claimed exemption from tax as a nonresident alien. Penalties
2. The treaty article addressing the income. Failure to furnish TIN. If you fail to furnish your correct TIN to a
3. The article number (or location) in the tax treaty that contains the requester, you are subject to a penalty of $50 for each such failure
saving clause and its exceptions. unless your failure is due to reasonable cause and not to willful neglect.
4. The type and amount of income that qualifies for the exemption Civil penalty for false information with respect to withholding. If you
from tax. make a false statement with no reasonable basis that results in no
5. Sufficient facts to justify the exemption from tax under the terms of backup withholding, you are subject to a $500 penalty.
the treaty article.
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Form W-9 (Rev. 11-2017) Page 3
Criminal penalty for falsifying information. Willfully falsifying IF the entity/person on line 1 is THEN check the box for . . .
certifications or affirmations may subject you to criminal penalties a(n) . . .
including fines and/or imprisonment.
Misuse of TINs.If the requester discloses or uses TINs in violation of • Corporation Corporation
federal law, the requester may be subject to civil and criminal penalties. • Individual Individual/sole proprietor or single-
• Sole proprietorship, or member LLC
Specific Instructions • Single-member limited liability
company (LLC) owned by an
Line 1 individual and disregarded for U.S.
You must enter one of the following on this line; do not leave this line federal tax purposes.
blank. The name should match the name on your tax return. • LLC treated as a partnership for Limited liability company and enter
If this Form W-9 is for a joint account (other than an account U.S. federal tax purposes, the appropriate tax classification.
maintained by a foreign financial institution (FFI)), list first, and then • LLC that has filed Form 8832 or (P= Partnership; C= C corporation;
circle, the name of the person or entity whose number you entered in 2553 to be taxed as a corporation, or S= S corporation)
Part I of Form W-9. If you are providing Form W-9 to an FFI to document or
a joint account, each holder of the account that is a U.S. person must • LLC that is disregarded as an
provide a Form W-9. entity separate from its owner but
a. Individual. Generally, enter the name shown on your tax return. If the owner is another LLC that is
you have changed your last name without informing the Social Security not disregarded for U.S. federal tax
Administration (SSA) of the name change, enter your first name, the last purposes.
name as shown on your social security card, and your new last name.
Note: ITIN applicant: Enter your individual name as it was entered on • Partnership Partnership
your Form W-7 application, line 1a. This should also be the same as the • Trust/estate Trust/estate
name you entered on the Form 1040/1040A/1040EZ you filed with your
application. Line 4, Exemptions
b. Sole proprietor or single-member LLC. Enter your individual If you are exempt from backup withholding and/or FATCA reporting,
name as shown on your 1040/1040A/1040EZ on line 1. You may enter enter in the appropriate space on line 4 any code(s) that may apply to
your business, trade, or “doing business as” (DBA) name on line 2. you.
Exempt payee code.
c. Partnership, LLC that is not a single-member LLC, C • Generally, individuals (including sole proprietors) are not exempt from
corporation, or S corporation. Enter the entity's name as shown on the backup withholding.
entity's tax return on line 1 and any business, trade, or DBA name on
line 2. • Except as provided below, corporations are exempt from backup
d. Other entities. Enter your name as shown on required U.S. federal withholding for certain payments, including interest and dividends.
tax documents on line 1. This name should match the name shown on the • Corporations are not exempt from backup withholding for payments
charter or other legal document creating the entity. You may enter any made in settlement of payment card or third party network transactions.
business, trade, or DBA name on line 2. • Corporations are not exempt from backup withholding with respect to
e. Disregarded entity. For U.S. federal tax purposes, an entity that is attorneys’ fees or gross proceeds paid to attorneys, and corporations
disregarded as an entity separate from its owner is treated as a that provide medical or health care services are not exempt with respect
“disregarded entity.” See Regulations section 301.7701-2(c)(2)(iii). Enter to payments reportable on Form 1099-MISC.
the owner's name on line 1. The name of the entity entered on line 1 The following codes identify payees that are exempt from backup
should never be a disregarded entity. The name on line 1 should be the withholding. Enter the appropriate code in the space in line 4.
name shown on the income tax return on which the income should be 1—An organization exempt from tax under section 501(a), any IRA, or
reported. For example, if a foreign LLC that is treated as a disregarded a custodial account under section 403(b)(7) if the account satisfies the
entity for U.S. federal tax purposes has a single owner that is a U.S. requirements of section 401(f)(2)
person, the U.S. owner's name is required to be provided on line 1. If
the direct owner of the entity is also a disregarded entity, enter the first 2—The United States or any of its agencies or instrumentalities
owner that is not disregarded for federal tax purposes. Enter the 3—A state, the District of Columbia, a U.S. commonwealth or
disregarded entity's name on line 2, “Business name/disregarded entity possession, or any of their political subdivisions or instrumentalities
name.” If the owner of the disregarded entity is a foreign person, the 4—A foreign government or any of its political subdivisions, agencies,
owner must complete an appropriate Form W-8 instead of a Form W-9. or instrumentalities
This is the case even if the foreign person has a U.S. TIN.
5—A corporation
Line 2 6—A dealer in securities or commodities required to register in the
If you have a business name, trade name, DBA name, or disregarded United States, the District of Columbia, or a U.S. commonwealth or
entity name, you may enter it on line 2. possession
7—A futures commission merchant registered with the Commodity
Line 3 Futures Trading Commission
Check the appropriate box on line 3 for the U.S. federal tax 8—A real estate investment trust
classification of the person whose name is entered on line 1. Check only 9—An entity registered at all times during the tax year under the
one box on line 3. Investment Company Act of 1940
10—A common trust fund operated by a bank under section 584(a)
11—A financial institution
12—A middleman known in the investment community as a nominee or
custodian
13—A trust exempt from tax under section 664 or described in section
4947
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Form W-9 (Rev. 11-2017) Page 4
The following chart shows types of payments that may be exempt M—A tax exempt trust under a section 403(b) plan or section 457(g)
from backup withholding. The chart applies to the exempt payees listed plan
above, 1 through 13. Note: You may wish to consult with the financial institution requesting
IF the payment is for . . . THEN the payment is exempt this form to determine whether the FATCA code and/or exempt payee
for . . . code should be completed.
Interest and dividend payments All exempt payees except Line 5
for 7 Enter your address (number, street, and apartment or suite number).
Broker transactions Exempt payees 1 through 4 and 6 This is where the requester of this Form W-9 will mail your information
through 11 and all C corporations. returns. If this address differs from the one the requester already has on
S corporations must not enter an file, write NEW at the top. If a new address is provided, there is still a
exempt payee code because they chance the old address will be used until the payor changes your
are exempt only for sales of address in their records.
noncovered securities acquired
prior to 2012. Line 6
Barter exchange transactions and Exempt payees 1 through 4 Enter your city, state, and ZIP code.
patronage dividends
Part I. Taxpayer Identification Number (TIN)
Payments over $600 required to be Generally, exempt payees Enter your TIN in the appropriate box.If you are a resident alien and
reported and direct sales over 1 through 52
$5,0001 you do not have and are not eligible to get an SSN, your TIN is your IRS
individual taxpayer identification number (ITIN). Enter it in the social
security number box. If you do not have an ITIN, see How to get a TIN
Payments made in settlement of Exempt payees 1 through 4 below.
payment card or third party network
transactions If you are a sole proprietor and you have an EIN, you may enter either
your SSN or EIN.
1 See Form 1099-MISC, Miscellaneous Income, and its instructions. If you are a single-member LLC that is disregarded as an entity
separate from its owner, enter the owner’s SSN (or EIN, if the owner has
2 However, the following payments made to a corporation and one). Do not enter the disregarded entity’s EIN. If the LLC is classified as
reportable on Form 1099-MISC are not exempt from backup a corporation or partnership, enter the entity’s EIN.
withholding: medical and health care payments, attorneys’ fees, gross
proceeds paid to an attorney reportable under section 6045(f), and Note: See What Name and Number To Give the Requester, later, for
payments for services paid by a federal executive agency. further clarification of name and TIN combinations.
Exemption from FATCA reporting code.The following codes identify How to get a TIN.If you do not have a TIN, apply for one immediately.
payees that are exempt from reporting under FATCA. These codes To apply for an SSN, get Form SS-5, Application for a Social Security
apply to persons submitting this form for accounts maintained outside Card, from your local SSA office or get this form online at
of the United States by certain foreign financial institutions. Therefore, if www.SSA.gov. You may also get this form by calling 1-800-772-1213.
you are only submitting this form for an account you hold in the United Use Form W-7, Application for IRS Individual Taxpayer Identification
States, you may leave this field blank. Consult with the person Number, to apply for an ITIN, or Form SS-4, Application for Employer
requesting this form if you are uncertain if the financial institution is Identification Number, to apply for an EIN. You can apply for an EIN
subject to these requirements. A requester may indicate that a code is online by accessing the IRS website at www.irs.gov/Businesses and
not required by providing you with a Form W-9 with “Not Applicable” (or clicking on Employer Identification Number (EIN) under Starting a
any similar indication) written or printed on the line for a FATCA Business. Go to www.irs.gov/Forms to view, download, or print Form
exemption code. W-7 and/or Form SS-4. Or, you can go to www.irs.gov/OrderForms to
A—An organization exempt from tax under section 501(a) or any place an order and have Form W-7 and/or SS-4 mailed to you within 10
individual retirement plan as defined in section 7701(a)(37) business days.
B—The United States or any of its agencies or instrumentalities If you are asked to complete Form W-9 but do not have a TIN, apply
for a TIN and write “Applied For” in the space for the TIN, sign and date
C—A state, the District of Columbia, a U.S. commonwealth or the form, and give it to the requester. For interest and dividend
possession, or any of their political subdivisions or instrumentalities payments, and certain payments made with respect to readily tradable
D—A corporation the stock of which is regularly traded on one or instruments, generally you will have 60 days to get a TIN and give it to
more established securities markets, as described in Regulations the requester before you are subject to backup withholding on
section 1.1472-1(c)(1)(i) payments. The 60-day rule does not apply to other types of payments.
E—A corporation that is a member of the same expanded affiliated You will be subject to backup withholding on all such payments until
group as a corporation described in Regulations section 1.1472-1(c)(1)(i) you provide your TIN to the requester.
F—A dealer in securities, commodities, or derivative financial Note: Entering “Applied For” means that you have already applied for a
instruments (including notional principal contracts, futures, forwards, TIN or that you intend to apply for one soon.
and options) that is registered as such under the laws of the United Caution: A disregarded U.S. entity that has a foreign owner must use
States or any state the appropriate Form W-8.
G—A real estate investment trust
Part II. Certification
H—A regulated investment company as defined in section 851 or an To establish to the withholding agent that you are a U.S. person, or
entity registered at all times during the tax year under the Investment resident alien, sign Form W-9. You may be requested to sign by the
Company Act of 1940 withholding agent even if item 1, 4, or 5 below indicates otherwise.
I—A common trust fund as defined in section 584(a) For a joint account, only the person whose TIN is shown in Part I
J—A bank as defined in section 581 should sign (when required). In the case of a disregarded entity, the
K—A broker person identified on line 1 must sign. Exempt payees, see Exempt payee
code, earlier.
L—A trust exempt from tax under section 664 or described in section
4947(a)(1) Signature requirements.Complete the certification as indicated in
items 1 through 5 below.
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Form W-9 (Rev. 11-2017) Page 5
1. Interest, dividend, and barter exchange accounts opened For this type of account: Give name and EIN of:
before 1984 and broker accounts considered active during 1983. 14. Account with the Department of The public entity
You must give your correct TIN, but you do not have to sign the Agriculture in the name of a public
certification. entity (such as a state or local
2. Interest, dividend, broker, and barter exchange accounts government, school district, or
opened after 1983 and broker accounts considered inactive during prison) that receives agricultural
1983. You must sign the certification or backup withholding will apply. If program payments
you are subject to backup withholding and you are merely providing
your correct TIN to the requester, you must cross out item 2 in the 15. Grantor trust filing under the Form The trust
certification before signing the form. 1041 Filing Method or the Optional
3. Real estate transactions.You must sign the certification. You may Form 1099 Filing Method 2 (see
cross out item 2 of the certification. Regulations section 1.671-4(b)(2)(i)(B))
4. Other payments.You must give your correct TIN, but you do not 1 List first and circle the name of the person whose number you furnish.
have to sign the certification unless you have been notified that you If only one person on a joint account has an SSN, that person’s number
have previously given an incorrect TIN. “Other payments” include must be furnished.
payments made in the course of the requester’s trade or business for 2 Circle the minor’s name and furnish the minor’s SSN.
rents, royalties, goods (other than bills for merchandise), medical and 3 You must show your individual name and you may also enter your
health care services (including payments to corporations), payments to
a nonemployee for services, payments made in settlement of payment business or DBA name on the “Business name/disregarded entity”
card and third party network transactions, payments to certain fishing name line. You may use either your SSN or EIN (if you have one), but the
boat crew members and fishermen, and gross proceeds paid to IRS encourages you to use your SSN.
attorneys (including payments to corporations). 4 List first and circle the name of the trust, estate, or pension trust. (Do
5. Mortgage interest paid by you, acquisition or abandonment of not furnish the TIN of the personal representative or trustee unless the
secured property, cancellation of debt, qualified tuition program legal entity itself is not designated in the account title.) Also see Special
payments (under section 529), ABLE accounts (under section 529A), rules for partnerships, earlier.
IRA, Coverdell ESA, Archer MSA or HSA contributions or
distributions, and pension distributions.You must give your correct *Note: The grantor also must provide a Form W-9 to trustee of trust.
TIN, but you do not have to sign the certification. Note: If no name is circled when more than one name is listed, the
number will be considered to be that of the first name listed.
What Name and Number To Give the Requester
For this type of account: Give name and SSN of: Secure Your Tax Records From Identity Theft
1. Individual The individual Identity theft occurs when someone uses your personal information
2. Two or more individuals (joint The actual owner of the account or, if such as your name, SSN, or other identifying information, without your
account) other than an account combined funds, the first individual on permission, to commit fraud or other crimes. An identity thief may use
maintained by an FFI the account1 your SSN to get a job or may file a tax return using your SSN to receive
a refund.
3. Two or more U.S. persons Each holder of the account To reduce your risk:
(joint account maintained by an FFI)
4. Custodial account of a minor The minor ² • Protect your SSN,
(Uniform Gift to Minors Act) • Ensure your employer is protecting your SSN, and
5. a. The usual revocable savings trust The grantor-trustee1 • Be careful when choosing a tax preparer.
(grantor is also trustee) 1 If your tax records are affected by identity theft and you receive a
b. So-called trust account that is not The actual owner notice from the IRS, respond right away to the name and phone number
a legal or valid trust under state law printed on the IRS notice or letter.
6. Sole proprietorship or disregarded The owner³ If your tax records are not currently affected by identity theft but you
entity owned by an individual think you are at risk due to a lost or stolen purse or wallet, questionable
credit card activity or credit report, contact the IRS Identity Theft Hotline
7. Grantor trust filing under Optional The grantor* at 1-800-908-4490 or submit Form 14039.
Form 1099 Filing Method 1 (see
Regulations section 1.671-4(b)(2)(i) For more information, see Pub. 5027, Identity Theft Information for
(A)) Taxpayers.
For this type of account: Give name and EIN of: Victims of identity theft who are experiencing economic harm or a
8. Disregarded entity not owned by an The owner systemic problem, or are seeking help in resolving tax problems that
individual have not been resolved through normal channels, may be eligible for
9. A valid trust, estate, or pension trust Legal entity4 Taxpayer Advocate Service (TAS) assistance. You can reach TAS by
calling the TAS toll-free case intake line at 1-877-777-4778 or TTY/TDD
10. Corporation or LLC electing The corporation 1-800-829-4059.
corporate status on Form 8832 or Protect yourself from suspicious emails or phishing schemes.
Form 2553 Phishing is the creation and use of email and websites designed to
11. Association, club, religious, The organization mimic legitimate business emails and websites. The most common act
charitable, educational, or other tax- is sending an email to a user falsely claiming to be an established
exempt organization legitimate enterprise in an attempt to scam the user into surrendering
private information that will be used for identity theft.
12. Partnership or multi-member LLC The partnership
13. A broker or registered nominee The broker or nominee
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Form W-9 (Rev. 11-2017) Page 6
The IRS does not initiate contacts with taxpayers via emails. Also, the Privacy Act Notice
IRS does not request personal detailed information through email or ask
taxpayers for the PIN numbers, passwords, or similar secret access Section 6109 of the Internal Revenue Code requires you to provide your
information for their credit card, bank, or other financial accounts. correct TIN to persons (including federal agencies) who are required to
If you receive an unsolicited email claiming to be from the IRS, file information returns with the IRS to report interest, dividends, or
forward this message to phishing@irs.gov. You may also report misuse certain other income paid to you; mortgage interest you paid; the
of the IRS name, logo, or other IRS property to the Treasury Inspector acquisition or abandonment of secured property; the cancellation of
General for Tax Administration (TIGTA) at 1-800-366-4484. You can debt; or contributions you made to an IRA, Archer MSA, or HSA. The
forward suspicious emails to the Federal Trade Commission at person collecting this form uses the information on the form to file
spam@uce.gov or report them at www.ftc.gov/complaint. You can information returns with the IRS, reporting the above information.
contact the FTC at www.ftc.gov/idtheft or 877-IDTHEFT (877-438-4338). Routine uses of this information include giving it to the Department of
If you have been the victim of identity theft, see www.IdentityTheft.gov Justice for civil and criminal litigation and to cities, states, the District of
and Pub. 5027. Columbia, and U.S. commonwealths and possessions for use in
administering their laws. The information also may be disclosed to other
Visit www.irs.gov/IdentityTheft to learn more about identity theft and countries under a treaty, to federal and state agencies to enforce civil
how to reduce your risk. and criminal laws, or to federal law enforcement and intelligence
agencies to combat terrorism. You must provide your TIN whether or
not you are required to file a tax return. Under section 3406, payers
must generally withhold a percentage of taxable interest, dividend, and
certain other payments to a payee who does not give a TIN to the payer.
Certain penalties may also apply for providing false or fraudulent
information.
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Department of the Treasury
Internal Revenue Service
Instructions for
the Requester of
Forms W–8BEN,
W–8BEN–E, W–8ECI,
W–8EXP, and W–8IMY
(Rev. April 2018)
Section references are to the Internal Revenue Code 2017-41 I.R.B. 275, providing revised guidance for certain
unless otherwise noted. withholding agents to obtain and report taxpayer
Future developments. For the latest information about identification numbers and dates of birth of their account
developments related to the Forms W-8 and their holders and on March 5, 2018, the Treasury Department
instructions for requesters, such as legislation enacted and the IRS issued supplemental guideline in Notice
after they were published, go to IRS.gov/UAC/About- 2018-20, 2018-12 I.R.B. 444. See Foreign TINs and
Form-W8. Notes for Validating Form W-8BEN-E, later, for the
revised requirements for certain withholding agents to
obtain on Form W-8 an account holder’s foreign TIN and,
What's New for an individual, date of birth.
On January 6, 2017, the Treasury Department and the Purpose of Instructions
IRS finalized certain regulations under chapter 3 (TD
These instructions supplement the instructions for the
9808) and chapter 4 (TD 9809) and published temporary
forms listed below and provide notes to assist withholding
regulations under chapters 3 and 4 to supplement certain
agents and foreign financial institutions (FFIs) in validating
provisions of those final regulations. Among other things,
the forms for chapters 3 and 4 purposes. These
the final and temporary regulations under chapters 3 and
instructions also outline the due diligence requirements
4 modified certain requirements with respect to the
applicable to withholding agents for establishing a
collection of Forms W-8, the contents of the forms, their
beneficial owner’s foreign status and claim for reduced
validity periods, and the due diligence requirements of
withholding under an income tax treaty. These instructions
withholding agents. Forms W-8 (and their instructions)
are not inclusive of all requirements that may apply to a
were updated in June and July 2017, generally to reflect
withholding agent for validating Forms W-8. A withholding
the amendments to the regulations under chapters 3 and
agent should also reference the applicable regulations
4.
under chapters 3 and 4 and the instructions for each Form
On January 24, 2017, the Treasury Department and the W-8 listed below.
IRS finalized certain regulations under sections 871(m) Form W-8BEN, Certificate of Foreign Status of
and 1441 (TD 9815) and published temporary regulations Beneficial Owner for United States Tax Withholding and
under section 871(m) to supplement certain provisions of Reporting (Individuals).
those final regulations. Among other things, the final and Form W-BEN-E, Certificate of Status of Beneficial
temporary regulations under sections 871(m) and 1441 Owner for United States Tax Withholding and Reporting
modified the rules for withholding and reporting certain (Entities).
payments made to qualified derivative dealers (QDDs). Form W-8ECI, Certificate of Foreign Person's Claim
The Treasury Department and the IRS also issued Notice That Income Is Effectively Connected With the Conduct of
2017-42, 2017-34 I.R.B. 212, which announced certain a Trade or Business in the United States.
intended amendments to the regulations, such as Form W-8EXP, Certificate of Foreign Government or
delaying until 2019 withholding under chapters 3 and 4 on Other Foreign Organization for United States Tax
dividends paid to a QDD in its equity derivatives dealer Withholding and Reporting.
capacity. Form W-8IMY, Certificate of Foreign Intermediary,
The transition rules related to the Qualified Securities Foreign Flow-Through Entity, or Certain U.S. Branches for
Lender (QSL) regime described in Notice 2010-46, United States Tax Withholding and Reporting.
2010-24 I.R.B. 757, have been extended to include For definitions of terms not defined in these
payments made in calendar years 2018 and 2019. See instructions, see the Forms W-8 and their accompanying
Notice 2018-05, 2018-6 I.R.B. 341. Therefore, withholding instructions.
agents may accept and rely on a valid Form W-8IMY on
which an entity represents its chapter 3 status as a QSL Throughout these instructions, a reference to or
until December 31, 2019. TIP mention of “Form W-8” includes Forms W-8BEN,
W-8BEN-E, W-8ECI, W-8EXP, and W-8IMY.
In addition, on September 25, 2017, the Treasury
Department and the IRS released Notice 2017-46,
Apr 18, 2018 Cat. No. 26698G
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These instructions reflect the regulatory changes include amounts that are not FDAP as well as other
described earlier that are relevant to Forms W-8 and specific items of income described in Regulations section
certain other changes reflected on the most current 1.1441-2 (such as interest on bank deposits and short
revisions to the Form W-8 series published as of the date term OID).
of publication of these instructions. Thus, different rules
may apply to withholding agents with respect to prior For purposes of sections 1441 and 1442, if you are a
revisions of Forms W-8 for which these regulatory withholding agent, you must withhold 30% of any payment
changes did not yet apply, and different requirements may of an amount subject to chapter 3 withholding made to a
apply to future revisions of these forms. See Requesting payee that is a foreign person unless you can reliably
Prior Versions of Form W-8, later, including the limitations associate the payment with documentation (for example,
on such use. Form W-8 or Form W-9, Request for Taxpayer
Identification Number and Certification) upon which you
can rely to treat the payment as made to (a) a payee that
is a U.S. person or (b) a beneficial owner that is a foreign
Who Is a Withholding Agent? person entitled to a reduced rate of, or exemption from,
Any person, U.S. or foreign, in whatever capacity acting, withholding. In certain circumstances, however, you may
that has control, receipt, custody, disposal, or payment of be allowed to associate a payment with documentary
an amount subject to withholding for chapter 3 purposes evidence rather than a Form W-8 for a payment made
or a withholdable payment for chapter 4 purposes is a outside the United States with respect to an offshore
withholding agent. The withholding agent may be an obligation under Regulations section 1.6049-5(c)(1). A
individual, corporation, partnership, trust, association, or withholding agent must also withhold under section 1443
any other entity, including (but not limited to) any foreign on certain payments to foreign tax-exempt organizations
intermediary, foreign partnership, or U.S. branch of certain that are unrelated business taxable income or subject to
foreign banks and insurance companies. If several the 4% excise tax imposed by section 4948.
persons qualify as withholding agents for a single
However, a withholding agent making a payment to a
payment, the tax required to be withheld must only be
foreign person need not withhold under chapter 3 if the
withheld once. Generally, the person who pays (or causes
foreign person assumes responsibility for withholding on
to be paid) an amount subject to withholding under
the payment as a qualified intermediary (QI) (other than a
chapter 3 or a withholdable payment to the foreign person
QI that is acting as a QDD for payments with respect to
(or to its agent) must withhold. See the Instructions for
underlying securities that are subject to withholding), or if
Form 1042, Annual Withholding Tax Return for U.S.
the foreign person is a withholding foreign partnership
Source Income of Foreign Persons, and Form 1042-S,
(WP), or a withholding foreign trust (WT) that has provided
Foreign Person's U.S. Source Income Subject to
a valid Form W-8IMY certifying to such status. For 2017
Withholding, for return filing and information reporting
and 2018, however, a withholding agent is not required to
obligations with respect to payments made to foreign
withhold on dividends paid to a QI acting as a QDD.
persons.
Withholding under chapter 3 is also not required if the
For effectively connected taxable income (ECTI) payment is made to a U.S. branch of a foreign insurance
allocable to a foreign partner, the partnership is generally company or foreign bank or a territory financial institution
the withholding agent and must file Form 8804, Annual that agrees to be treated as a U.S. person under the
Return for Partnership Withholding Tax (Section 1446); requirements of Regulations section 1.1441-1(b)(2)(iv)(A)
Form 8805, Foreign Partner's Information Statement of and provides a valid Form W-8IMY certifying to such
Section 1446 Withholding Tax; and Form 8813, status.
Partnership Withholding Tax Payment Voucher (Section
1446). Chapter 4 Responsibilities
For purposes of chapter 4, if you are a withholding agent,
you must withhold 30% of any payment that is a
Responsibilities of a Withholding withholdable payment (as defined in Regulations section
Agent To Obtain Form W-8 1.1473-1(a)) made to a nonparticipating FFI that is not an
exempt beneficial owner or to a non-financial foreign
Chapter 3 Responsibilities entity (NFFE) that is not an excepted NFFE and does not
(Other Than Section 1446) disclose its substantial U.S. owners (or certify that it has
Generally, an amount is subject to withholding for no substantial U.S. owners). In addition, if you are a
purposes of chapter 3 if it is an amount from sources withholding agent and also a participating FFI, you must
within the United States that is fixed or determinable withhold to the extent required under Regulations section
annual or periodical (FDAP) income. FDAP income is all 1.1471-4(b) and the FFI agreement, which, in addition to
income included in gross income, including interest (and the requirements described in the previous sentence,
original issue discount (OID)), dividends, rents, royalties, require withholding on withholdable payments made to
and compensation. FDAP income does not include most recalcitrant account holders.
gains from the sale of property (including market discount You must determine if a payment is a withholdable
and option premiums) or items of income excluded from payment without regard to any exceptions from
gross income without regard to the U.S. or foreign status withholding applicable under chapter 3. For each such
of the owner of the income, such as interest under section withholdable payment, you must obtain a Form W-8 (or
103(a). Amounts subject to chapter 3 withholding do not other documentation permitted under Regulations section
-2- Inst. for the Requester of Forms W-8 (Rev. April 2018)
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1.1471-3(d)) upon which you are permitted to rely under FFI documenting account holders. If you are an FFI
chapter 4 to determine the chapter 4 status of a payee maintaining a financial account, you may be required to
that is a foreign person for purposes of whether perform due diligence procedures to identify and
withholding applies under chapter 4. Thus, a document the account holder under the chapter 4
determination of whether a Form W-8 is valid for purposes regulations or an applicable intergovernmental agreement
of providing an exemption from chapter 4 withholding is a (IGA) even if you are not making a payment to the account
separate determination from whether the Form W-8 may holder that is subject to withholding. You may use Form
be relied upon to provide an exemption from (or reduction W-8 to document the chapter 4 status of an account
in) withholding under chapter 3. For purposes of holder and to validate a claim of foreign status made by
determining whether withholding under chapter 4 applies the account holder, such as when the account has certain
to a payment to a QI, WP, or WT, the exceptions in U.S. indicia. For example, a participating FFI may treat an
chapter 3 for QIs, WPs, and WTs will apply, provided the individual account holder claiming foreign status that has
entity includes its chapter 4 status on Form W-8IMY. See U.S. indicia (as described in Regulations section
also Notes for Validating Form W-8IMY under Form 1.1471-4(c)(5)(iv)(B)) as a foreign person for purposes of
W-8IMY, later, for the requirements for withholdable the FFI’s U.S. account reporting requirements (that is,
payments made to certain U.S. branches that act as Form 8966) when the individual provides a Form W-8BEN
intermediaries. and certain documentary evidence establishing foreign
status.
Section 1446 Responsibilities
If you are an FFI documenting an account holder of an
Generally, under section 1446, a partnership that
account that you determine is excepted as a financial
allocates ECTI to a foreign partner must withhold at the
account under Regulations section 1.1471-5(b)(2), a Form
highest tax rate applicable to that person for the type of
W-8 (or other permitted documentation for chapter 4
income allocated (for example, ordinary income or capital
purposes) is not required unless the form is associated
gains) in accordance with the provisions of Regulations
with amounts subject to withholding under chapter 3. In
sections 1.1446-1 through 1.1446-6. Unless the
such a case, a valid chapter 4 status (including that the
partnership is a publicly traded partnership, the
account is not a financial account) is not required to be
partnership must withhold in the year the ECTI is allocable
provided on the form.
to the foreign partner, rather than the year in which the
distribution is made. The partnership may rely on Requesting Form W-8
documentation (for example, Form W-8 or Form W-9) to
Generally, if you are making a payment of an amount
determine if the partner is foreign or domestic and the
subject to chapter 3 withholding or a withholdable
type of partner (for example, individual or corporate) and
payment, you must withhold as required at the 30% rate
whether the partner qualifies for certain tax preferential
under chapter 3 or 4 unless you can reliably associate the
rates (for example, capital gains and collectibles). The
payment with a Form W-8 or other permitted
documentation must contain a U.S. TIN for the partner.
documentation to permit withholding at a reduced rate or
Generally, a foreign person that is a partner in a
an exemption from withholding. You can reliably associate
partnership that submits a Form W-8 for purposes of
a payment with a Form W-8 if you hold a valid form that
section 1441 or 1442 will satisfy the documentation
contains the information required for purposes of
requirements under section 1446. However, a partnership
chapter 3 or 4 (as applicable), you can reliably determine
that knows or has reason to know that the documentation
how much of the payment relates to the form, and you
provided is incorrect or unreliable must presume the
may rely upon the form under the due diligence
partner is foreign. Additionally, a partnership may rely on
requirements. See Due Diligence Requirements in
other means to determine the non-foreign status of a
General, later.
partner, but will only be protected from liability (including
penalties) if such determination is correct. A partnership is You should request a Form W-8 from any person to
in no event required to rely on other means to determine whom you are making a payment that you believe to be a
the non-foreign status of a partner and may demand that foreign person. You should request the form before
the partner provide an acceptable certificate (for example, making a payment so that you have the form when you
a Form W-8BEN). make the payment. See, however, Regulations sections
1.1441-1(b)(7)(ii) and 1.1471-3(c)(7)(ii) for when you may
Other Uses of Form W-8 be able to rely on a Form W-8 obtained after the date of a
Chapter 61 and section 3406. The Form W-8 you payment to support reduced withholding for chapter 3 or 4
collect may also be used to establish a person's status for purposes.
purposes of domestic information reporting under A withholding agent or payor that fails to obtain a valid
chapter 61 and backup withholding under section 3406, Form W-8 or Form W-9 and fails to withhold as required
including for a payment settlement entity to determine under the presumption rules may be assessed tax at the
whether a participating payee is a foreign person for 30% rate under chapter 3 or 4 or the 28% backup
purposes of section 6050W. In general, if you receive a withholding rate under section 3406, as well as interest
Form W-8 that you can reliably associate with the and penalties for lack of compliance. If you are a
payment, you are exempt from reporting the payment on a partnership allocating income that is effectively connected
Form 1099 and withholding under section 3406. with the conduct of the partnership’s U.S. trade or
business and you fail to withhold as required under
section 1446, you will be liable for the tax required to be
Inst. for the Requester of Forms W-8 (Rev. April 2018) -3-
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withheld. In addition, you may be liable for interest, Requesting Prior Versions of Form W-8
penalties, and additions to the tax even if there is no If the IRS issues an updated version of a Form W-8, you
underlying tax liability due from a foreign partner on its may accept the prior version of the form until the later of
allocable share of the partnership’s ECTI. six full months after the revision date shown on the form or
If you are a withholding agent making a payment of an the end of the calendar year the updated form is issued
amount subject to chapter 3 withholding or a withholdable (based on the revision date shown on the form), unless
payment and you make the payment to an intermediary, the IRS has issued guidance that affects the period for
you must obtain documentation from such intermediary acceptance of the prior version (for example, if a new
(including the intermediary’s chapter 4 status if the payee status is required under revised regulations that is
payment is a withholdable payment), as well as any not in the prior version and is relevant to the payee’s
required documentation for the beneficial owner(s) of the claim). You were allowed to accept a Form W-8BEN with
payment to the extent required under the chapter 3 or 4 a revision date of February 2014 until December 31, 2017.
regulations.
Due Diligence
Do not send Forms W-8 to the IRS. Instead, keep the
forms in your records for as long as they may be relevant Requirements in General
to the determination of your liability under section 1461 When you receive a completed Form W-8, you must
(for amounts subject to chapter 3 withholding), section review it for completeness and accuracy with respect to
1474 (for withholdable payments), or Regulations section the claims made on the form, as well as any information
1.1471-4(c)(2)(iv) (for an FFI documenting account attached to the form, such as withholding statements and
holders). beneficial owner withholding certificates associated with a
Form W-8IMY. In general, you may rely on the information
Form W-8 provided or signed electronically. You may
and certifications provided on the form unless you have
rely on a valid Form W-8 received by facsimile or scanned
actual knowledge or reason to know that the information is
and furnished to you by email unless you know that the
unreliable or incorrect. If you know or have reason to know
person transmitting the Form W-8 is not authorized to do
that any information is unreliable or incorrect, you must
so.
obtain a new Form W-8 or other appropriate
You may also rely on an otherwise valid Form W-8 documentation. You may accept a valid Form W-8 for
received electronically from a third-party repository if the chapter 3 or 61 purposes (or for backup withholding
form was uploaded or provided to the third-party purposes) that does not contain a valid chapter 4 status
repository and there are processes in place to ensure that with respect to payments that are not withholdable
the withholding certificate can be reliably associated with payments.
a specific request from you and a specific authorization
from the person providing the form (or an agent of the Reason to know. In general, you have reason to know
person providing the form) for you to receive the that a Form W-8 is unreliable or incorrect if:
withholding certificate. You may also rely on a withholding The form is incomplete with respect to any item that is
statement received from a third-party repository if the relevant to the claims made;
intermediary provides a Form W-8IMY and withholding The form contains any information that is inconsistent
statement through the repository, provides an updated with the claims made;
withholding statement to you in the event of any change in The form lacks information necessary to establish that
the information previously provided, and ensures there the beneficial owner is entitled to a reduced rate of
are processes in place to update you when there is a new withholding; or
withholding statement (and Forms W-8, as necessary) in You have other account information that is inconsistent
the event of any change that would affect the validity of with the claims made, or you have knowledge of relevant
the prior forms or withholding statement. For purposes of facts or statements contained in the withholding certificate
this paragraph, a third party repository is an entity that or other documentation that would cause a reasonably
maintains withholding certificates but is not an agent of prudent person in your position to question the claims
the applicable withholding agent or the person providing made. For example, if you have information in your
the certificate. See Regulations section 1.1441-1(e)(4)(iv) records that contradicts information provided on the form,
(E) for the complete requirements for relying on a you may not rely on the form.
withholding certificate from a third-party repository.
With respect to a claim for benefits under an income tax
If you are a withholding agent that maintains a system treaty, your reason to know requirement that the treaty
for furnishing Forms W-8 electronically, you must satisfy claim is unreliable or incorrect includes when the
the requirements of Regulations section 1.1441-1(e)(4)(iv) beneficial owner claims benefits under a treaty that does
(B). You may otherwise accept a Form W-8 with an not exist or is not in force. For this purpose, you may use
electronic signature if the Form W-8 reasonably the list maintained at IRS.gov/businesses/international-
demonstrates that the form has been electronically signed businesses/united-states-income-tax-treaties-a-to-z to
by a person authorized to do so (for example, with a time check whether a treaty exists and is in force.
and date stamp and statement that the form has been
electronically signed). You may not treat a Form W-8 with If you are a financial institution (as defined in
a typed name in the signature line as validly signed Regulations section 1.1471-5(e)), insurance company, or
without further information supporting that the signature is broker or dealer in securities maintaining an account for a
an electronic signature. direct account holder that is the beneficial owner of the
-4- Inst. for the Requester of Forms W-8 (Rev. April 2018)
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payment, and you make a payment of U.S. source FDAP (1)), you classify the entity as a resident of the country in
income to the direct account holder, you have reason to which the account is maintained, you are required to
know that a Form W-8 that is a beneficial owner report a payment made to the entity annually on a tax
withholding certificate (excluding Form W-8ECI) is information statement that is filed with the tax authority of
unreliable or incorrect for establishing foreign status (or the country in which the obligation is maintained, and that
residency in a treaty country in item 4, directly below) only country has an income tax treaty or tax information
if one or more of the following circumstances exist. See exchange agreement in effect with the United States.
also Regulations section 1.441-7(b)(3)(ii) for special rules 2. The form is provided with respect to an offshore
that apply to preexisting obligations (as defined for such obligation (as defined in Regulations section 1.6049-5(c)
purpose). (1)) and the direct account holder has provided standing
1. You have classified the account holder claiming instructions directing you to pay amounts from its account
foreign status as a U.S. person in your account to an address in, or an account maintained in, the United
information, the Form W-8 has a current permanent States, unless the account holder provides either a
residence address or a current mailing address in the reasonable explanation in writing that supports its foreign
United States, you have a current residence or current status or documentary evidence establishing its foreign
mailing address in the United States as part of the status (as described in Regulations section 1.1471-3(c)(5)
account information, the direct account holder notifies you (i)).
of a new residence or mailing address in the United 3. The Form W-8BEN is provided by an individual that
States, or, only to the extent described in Regulations is a direct account holder and is used to establish foreign
section 1.1441-7(b)(5), you have a U.S. telephone status and you have, either on accompanying
number as the sole telephone number for the account documentation or as part of your account information, an
holder. However: unambiguous indication of a place of birth for the
a. An individual who has provided a Form W-8BEN individual in the United States, unless you have in your
may be treated as a foreign person if: possession or obtain documentary evidence (described in
i. You have in your possession or obtain documentary Regulations section 1.1471-3(c)(5)(i)(B)) evidencing
evidence establishing foreign status (as described in citizenship in a country other than the United States and
Regulations section 1.1471-3(c)(5)(i)) that does not either:
contain a U.S. address, and the individual provides you a. A copy of the individual’s Certificate of Loss of
with a reasonable explanation, in writing, supporting his or Nationality of the United States, or
her claim of foreign status; b. A reasonable written explanation of the account
ii. For a payment made outside the U.S. with respect holder’s renunciation of U.S. citizenship or the reason the
to an offshore obligation (as defined in Regulations account holder did not obtain U.S. citizenship at birth.
section 1.6049-5(c)(1)), you have in your possession or 4. The Form W-8 is provided by a direct account
obtain documentary evidence establishing foreign status holder and is used to establish residence in a treaty
(as described in Regulations section 1.1471-3(c)(5)(i)) country and:
that does not contain a U.S. address;
a. The permanent residence address on the form is
iii. For a payment made with respect to an offshore not in the treaty country or the direct account holder
obligation (as defined in Regulations section 1.6049-5(c) notifies you of a new permanent residence address that is
(1)), you classify the individual as a resident of the country not in the treaty country, unless the direct account holder
where the obligation is maintained, you are required to provides a reasonable explanation for the permanent
report payments made to the individual annually on a tax residence address outside the treaty country or you have
information statement that is filed with the tax authority of in your possession, or obtain, documentary evidence
the country in which the obligation is maintained, and that (described in Regulations section 1.1471-3(c)(5)(i)) that
country has an income tax treaty or information exchange establishes residency in the treaty country.
agreement in effect with the United States; or
b. The permanent residence address is in the treaty
iv. For a case in which you have classified the account country, but the mailing address on the form is not in the
holder as a U.S. person in your account information, you treaty country or you have a current mailing address that
have in your possession or obtain documentary evidence is not in the treaty country as part of your account
(as described in Regulations section 1.1471-3(c)(5)(i)(B)) information for the direct account holder, unless:
evidencing citizenship in a country other than the United
i. You have in your possession, or obtain,
States.
documentary evidence (as described in Regulations
b. You may treat an entity that has provided you with a section 1.1471-3(c)(5)(i)) supporting the claim of
Form W-8BEN-E as a foreign person if you do not know or residence in the treaty country and the additional
have reason to know that the entity is a flow-through entity documentation does not contain an address outside the
and: treaty country;
i. You have in your possession or obtain ii. You have in your possession, or obtain,
documentation establishing foreign status that documentation that establishes that the direct account
substantiates that the entity is actually organized or holder is an entity organized in a treaty country (or an
created under the laws of a foreign country; or entity managed and controlled in a treaty country, if
ii. For a payment made with respect to an offshore required by the applicable treaty);
obligation (as defined in Regulations section 1.6049-5(c)
Inst. for the Requester of Forms W-8 (Rev. April 2018) -5-
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iii. You know that the address outside the treaty Requirements for Obtaining and Verifying a
country (other than a P.O. box or in-care-of address) is a Global Intermediary Identification Number
branch of the direct account holder that is a resident of the
(GIIN)
treaty country; or
If you receive a Form W-8BEN-E, W-8IMY, or W-8EXP
iv. The direct account holder provides a written from an entity payee claiming certain chapter 4 statuses,
statement that reasonably establishes entitlement to you must obtain and verify the entity’s GIIN against the
treaty benefits. published IRS FFI list. See Regulations section
c. The direct account holder has standing instructions 1.1471-3(e)(3). You must obtain and verify the GIIN for the
for you to pay amounts from the account to an address or following chapter 4 statuses.
account outside the treaty country unless the account Participating FFIs (including reporting Model 2 FFIs),
holder provides a reasonable explanation, in writing, Registered deemed-compliant FFIs (including reporting
establishing the account holder's residence in the Model 1 FFIs),
applicable treaty country or you have in your possession Direct reporting NFFEs,
or obtain documentary evidence (described in Sponsored direct reporting NFFEs, and
Regulations section 1.1471-3(c)(5)(i)) establishing the Certain nonreporting IGA FFIs (as described below).
account holder’s residence in the applicable treaty
country. If you receive a Form W-8BEN-E or Form W-8IMY from
a nonreporting IGA FFI that is a trustee-documented trust
Where required, a reasonable explanation supporting that indicates its trustee is foreign, you must obtain a GIIN
an individual’s claim of foreign status means a written of the trustee on the form.
statement prepared by the individual, or, in the alternative,
a checklist provided by you and completed by the If you receive a Form W-8 from a nonreporting IGA FFI
individual stating that the individual meets one of the that checks Model 2 IGA in Part XII of Form W-8BEN-E,
requirements listed in Regulations section 1.1441-7(b) Part XIX of Form W-8IMY, or Part III, line 15 of Form
(12)(i) through (iv). W-8EXP (as applicable), and identifies a category of entity
that is a registered deemed-compliant FFI under Annex II
Hold mail instruction. An address that is provided of an applicable Model 2 IGA, you must obtain and verify
subject to an instruction to hold all mail to that address is the GIIN of the nonreporting IGA FFI against the published
not a permanent residence address, such that you may IRS FFI list. Additionally, if you receive a Form W-8BEN-E
not rely upon the Form W-8. However, the address can be or Form W-8IMY from a nonreporting IGA FFI that
used as a permanent residence address if the person has provides a citation to a section of the Regulations for its
provided you with the documentary evidence that is registered deemed-compliant status in Part XII of Form
permitted under Regulations section 1.1441-1(c)(38)(ii). If, W-8BEN-E or Part XIX of Form W-8IMY (as applicable) or
after a Form W-8 is provided, a person’s permanent the FFI identifies itself as a registered deemed-complaint
residence address is subsequently subject to a hold mail FFI in Part I, line 4, of Form W-8EXP, you must obtain and
instruction, this is a change in circumstances requiring the verify the GIIN of the nonreporting IGA FFI against the
person to provide the documentary evidence described in published IRS FFI list. See Regulations sections
the preceding sentence in order to use the address as a 1.1471-1(b)(83) for the definition of nonreporting IGA FFI
permanent residence address. and 1.1471-3(d)(7)(i) for the documentation requirements
For additional information on the standards of for nonreporting IGA FFIs.
knowledge for chapter 3 purposes for relying on a claim of
For an entity claiming status as a certified
foreign status or a claim of residency in a treaty country,
deemed-compliant FFI that is a sponsored, closely held
see Regulations section 1.1441-7(b). For additional
investment vehicle described in Regulations section
information on the standards of knowledge for Forms W-8
1.1471-5(f)(2)(iii) on a Form W-8BEN-E or Form W-8IMY,
provided for chapter 4 purposes, see Regulations section
you must obtain the GIIN for the sponsoring entity and
1.1471-3(e).
verify it against the published IRS FFI list. For an entity
Dual claims under a tax treaty. If you are making claiming status as a sponsored investment entity or
payments to a foreign entity that is simultaneously controlled foreign corporation described in Regulations
claiming a reduced rate of tax under a tax treaty on its own section 1.1471-5(f)(1)(i)(F), you must obtain and verify the
behalf and a separate treaty claim on behalf of its interest GIIN of the sponsored investment entity or controlled
holders for different payments or for different portions of foreign corporation against the published IRS FFI list, not
the same payment, you may accept the dual claims even the GIIN of the sponsoring entity.
though you hold different withholding certificates that
require you to treat the entity inconsistently. Alternatively, If you receive a Form W-8BEN-E, Form W-8IMY, or
you may choose to apply only the claim made by the Form W-8EXP from an entity payee that is claiming
entity, provided that the entity may be treated as the chapter 4 status as a participating FFI (including a
beneficial owner of the income. If, however, inconsistent reporting Model 2 FFI), registered deemed-compliant FFI
claims are made for the same portion of a payment, you (including a reporting Model 1 FFI and a sponsored FFI
may either reject both claims and request consistent described in the Treasury regulations under section
claims for that portion of the payment, or you may choose 1471), direct reporting NFFE, sponsored direct reporting
which reduction in rate to apply. NFFE, or nonreporting IGA FFI required to provide a GIIN
(as described earlier) that contains “Applied for” in the box
for the GIIN, the payee must provide its GIIN within 90
days of providing the form. A Form W-8 from such a
-6- Inst. for the Requester of Forms W-8 (Rev. April 2018)
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payee that does not include a GIIN, or includes a GIIN that W-8BEN because he or she is not claiming treaty benefits.
does not appear on the published IRS FFI list, will be Later, the investor purchases U.S. stock and claims treaty
invalid for purposes of chapter 4 beginning on the date benefits on dividend income. The withholding agent must
that is 90 days after the date the form is provided. See obtain a new Form W-8BEN at that time that provides the
Regulations section 1.1471-3(e)(3)(iii) and (iv). information required in Part II to be able to withhold based
on the treaty claim and not at the 30% withholding tax
You may only accept a Form W-8BEN-E or Form rate.
W-8IMY with Part II completed if the entity shown in Part II
is an FFI that is a branch of the entity identified in Part II, Changes in circumstances for chapter 4 purposes.
line 1, and the branch is receiving a withholdable For chapter 4 purposes, a change in circumstances
payment, or if the entity shown in Part II is a disregarded generally occurs when there is a change in a person’s
entity that is identified in Part I, line 3, as receiving the chapter 4 status. You must treat a Form W-8 as invalid
payment. If you receive a Form W-8BEN-E or Form when you know or have reason to know of a change in
W-8IMY from a branch (other than a U.S. branch) or circumstances that affects the correctness of the form.
disregarded entity described in the preceding sentence However, you may continue to treat an FFI as having the
that is receiving a payment associated with the form, you same chapter 4 status that it had prior to the change in
must verify the GIIN of the branch (unless the branch is circumstances until the earlier of 90 days from the date of
treated as a nonparticipating FFI) or disregarded entity the change or the date that new documentation is
that is provided in Part II against the published IRS FFI list obtained.
and not that of the entity identified in Part I, line 1. In such You are not considered to have reason to know of a
a case, you may accept the form without a GIIN on line 9a change in circumstances if an FFI’s chapter 4 status
(for Form W-8BEN-E) or line 9 (for Form W-8IMY). If you changes solely because the jurisdiction where the FFI is
receive a Form W-8BEN-E from a U.S. branch, the branch resident, organized, or located is treated as having an IGA
may provide the GIIN of any other branch of the FFI in effect or if the jurisdiction had a Model 2 IGA in effect
(including the GIIN for the FFI’s residence country). A U.S. and is later treated as having a Model 1 IGA in effect. If
branch providing a Form W-8IMY is not required to such change in circumstances occurs, the FFI may
provide a GIIN. provide you with oral or written confirmation (including by
email) of its new chapter 4 status rather than providing a
Presumption Rules new Form W-8, and you must retain a record of this
If you do not receive a valid Form W-8 or Form W-9 that confirmation.
you may rely upon under the due diligence requirements, If an FFI is resident, organized, or located in a
or cannot otherwise determine whether a payment should jurisdiction that is treated as having an IGA in effect, and
be treated as made to a U.S. or foreign person, you must the jurisdiction’s status on the Treasury Department’s IGA
apply the presumption rules provided in the Regulations list (located at www.treasury.gov/resource-center/tax-
under sections 1441, 1446, 1471, 6045, and 6049. If the policy/treaties/pages/FATCA.aspx) is later updated to
presumption rules are applied to treat a person as a indicate that it is no longer treated as having an IGA in
foreign person, the 30% withholding rate applies and effect, you will have reason to know of a change in
cannot be reduced (for example, no treaty rate). You may circumstances with respect to the FFI’s chapter 4 status
not rely on the presumption rules if you have actual on the date that the jurisdiction ceases to be treated as
knowledge that a higher withholding rate is applicable. If having an IGA in effect. See Announcement 2016–27,
you determine that you are making a withholdable 2016-33 I.R.B. 238. If such change in circumstances
payment to an entity and cannot reliably associate the occurs, the FFI may provide you with oral or written
payment with a Form W-8 or other permitted confirmation (including by email) of its new chapter 4
documentation that is valid for chapter 4 purposes, you status rather than providing a new Form W-8, and you
are required to treat the entity payee as a nonparticipating must retain a record of this confirmation.
FFI.
When To Request a New Form W-8 Period of Validity
Request a new Form W-8: Generally, a Form W-8 is valid from the date signed until
Before the expiration of the validity period of an existing the last day of the third succeeding calendar year unless a
Form W-8 (when applicable); change in circumstances occurs that makes any
If the existing form does not support a claim of reduced information on the form incorrect. For example, a Form
rate or is incomplete with respect to any claim made on W-8BEN signed on September 30, 2018, generally
the form (such as may result, for example, from a new remains valid through December 31, 2021. However,
regulatory requirement relevant to the Form W-8); or under certain conditions a Form W-8 will be valid
If you know or have reason to know of a change in indefinitely unless there has been a change in
circumstances that makes any information on the current circumstances. For example, a Form W-8BEN and
form unreliable or incorrect for purposes of chapter 3 or 4 documentary evidence supporting an individual’s claim of
(to the extent applicable) based on the claims made on foreign status (other than the portion of the form making a
the form. claim for treaty benefits) are indefinitely valid if the form
Example. A foreign individual investor opens an and documentary evidence are provided within 30 days of
account with a broker to purchase U.S. Treasury bonds each other. A Form W-8BEN-E and documentary
and provides Form W-8BEN to obtain the portfolio interest evidence supporting an entity’s claim of foreign status
exemption. The investor does not complete Part II of Form (other than the portion of the form making a claim for
Inst. for the Requester of Forms W-8 (Rev. April 2018) -7-
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treaty benefits) that are received by a withholding agent The account holder is a government, international
before the validity period of either the form or the organization, foreign central bank of issue, or resident of a
documentary evidence would otherwise expire are U.S. territory; or
indefinitely valid. A Form W-8IMY is valid indefinitely as You obtain a reasonable explanation for why the
described in this paragraph, but see Notes for Validating account holder has not been issued a foreign TIN.
Form W-8IMY, later, for the validity period for a Form
A reasonable explanation that an account holder does
W-8IMY provided by a QDD. For further information on
not have a foreign TIN must address why the account
the period of validity for a Form W-8 for chapter 3
holder was not issued a foreign TIN only to the extent
purposes, see Regulations section 1.1441-1(e)(4)(ii), and
provided in the instructions for the applicable Form W-8. If
for chapter 4 purposes, see Regulations section
an account holder provides an explanation other than the
1.1471-3(c)(6)(ii).
one described in the instructions for the applicable Form
W-8, you must determine whether the explanation is
Forms Received That Are Not Dated or That reasonable. You may accept an explanation that is written
Contain Inconsequential Errors or Omissions in the line on the form for a foreign TIN, in the margins of
If a Form W-8 is valid except that the person providing the the form, or on a separate attached statement associated
form has not dated the form, you may date the form from with the form. If the account holder writes the explanation
the day you receive it and measure the validity period on the line for foreign TINs or in the margins of the form,
from that date. Generally, you may treat a withholding the account holder may shorten it to “not legally required”.
certificate as valid if it contains an error or omission that is See Notice 2017-46 for transitional rules for withholding
inconsequential and you have sufficient documentation on agents to obtain foreign TINs for accounts documented
file to supplement the missing information. However, a with otherwise valid Forms W-8 that were signed before
failure to establish an entity type or make a required January 1, 2018. See also Notice 2017-46 for the
certification is not inconsequential. For example, if an standards of knowledge (including when there is a change
entity receiving a withholdable payment selects a certified in circumstances) with respect to the foreign TIN
deemed-compliant FFI status on line 5 of Form requirement. See Notice 2018-20 for additional
W-8BEN-E but does not complete the corresponding information on the IRS list of jurisdictions for which
required certifications in Part V, the form is invalid for withholding agents are not required to obtain foreign TINs.
chapter 4 purposes. On the other hand, if you receive a
Form W-8 for which the person signing the form does not Alternative Certifications
also print a name before the signature when required on Under an Applicable IGA
the form, you are not required to treat the form as
incomplete if you have documentation or information If you are an FFI subject to a Model 1 or Model 2 IGA
supporting the identity of the person signing the form. An using Form W-8BEN-E or Form W-8IMY to document
abbreviation of a country of residence on Form W-8BEN account holders pursuant to the due diligence
is an inconsequential error if it is an ambiguous requirements of Annex I of an applicable IGA, you may
abbreviation. For further information about withholding request alternative certifications from your account
certificates that contain inconsequential errors, see holders in accordance with the requirements of, and
Regulations sections 1.1441-1(b)(7)(iv) for chapter 3 definitions applicable to, the IGA instead of the
purposes and 1.1471-3(c)(7)(i) for chapter 4 purposes. certifications on Form W-8BEN-E or W-8IMY. You should
provide those certifications to account holders from whom
Foreign TINs you request a Form W-8BEN-E or W-8IMY, and the
If you are a U.S. office or branch of a depository account holder should attach the completed certification
institution, custodial institution, investment entity, or to the Form W-8BEN-E or W-8IMY in lieu of completing a
specified insurance company (each as defined in certification otherwise required. In such a case, you must
Regulations section 1.1471-5(e)) documenting an account provide a written statement to the account holder stating
holder (as defined in Regulations section 1.1471-5(a)(3)) that you have provided the alternative certification to meet
of an account that is a financial account (as defined in your due diligence requirements under an applicable IGA
Regulations section 1.1471-5(b)) you must obtain the and you must associate the certification with the Form
account holder’s TIN for its jurisdiction of tax residence W-8BEN-E or W-8IMY.
(foreign TIN) on a Form W-8 that is a beneficial owner If you are a withholding agent (including an FFI), you
withholding certificate in order for the form to be valid for a may also request and rely upon an alternative certification
payment of U.S. source income reportable on Form from an entity account holder to establish that the account
1042-S (as determined before the application of this holder is a NFFE (rather than a financial institution) under
requirement), unless: an applicable IGA. An entity providing such a certification
The account holder is resident of a jurisdiction that is will still be required, however, to provide its chapter 4
not listed in section 3 of Revenue Procedure 2017-46, status (that is, the type of NFFE) in Part I, line 5, as
2017-43 I.R.B. 372, which may be further updated in determined under the regulations if you are a withholding
future published guidance; agent other than an FFI documenting an account holder
The account holder is resident in a jurisdiction that has under Annex 1 of an applicable IGA. For example, if you
been identified by the IRS on a list of jurisdictions for are a U.S. withholding agent that receives a Form
which witholding agents are not required to obtain foreign W-8BEN-E or W-8IMY from an entity account holder
TINs; certifying to its status as a passive NFFE, you may
request a written certification that the entity is not a
-8- Inst. for the Requester of Forms W-8 (Rev. April 2018)
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financial institution as defined under the IGA applicable to Line 10 (Special rates and conditions). If the
the entity and document it under the regulations by beneficial owner is required to explain the additional
obtaining the NFFE's certification of its chapter 4 status in conditions in the treaty that it meets to be eligible for the
Part I, line 5. In the case of an FFI documenting an rate of withholding on line 10, you may accept a brief
account holder under Annex 1 of an applicable IGA explanation for this purpose. You may accept a treaty
however, a nonprofit organization treated as an active claim without this explanation under an interest or
NFFE under the Annex may provide an FFI with an dividends (other than dividends subject to a preferential
alternative certification that it is an NFFE that qualifies as rate based on ownership) article of a treaty or other
a nonprofit organization under an applicable IGA. In such income article, unless such article requires additional
a case, the nonprofit organization will not be required to representations.
check a box in Part I, line 5, and the FFI may treat the
entity as an excepted NFFE. Form W–8BEN–E
If you receive an alternative certification under an You should request Form W-8BEN-E from any foreign
applicable IGA described in the preceding paragraphs, entity for the purposes described previously in these
you may rely on such certification unless you know or instructions for Form W-8BEN or if the payee is to
have reason to know the certification is incorrect. establish that certain income from notional principal
contracts is not effectively connected with the conduct of
a U.S. trade or business (for reporting on Form 1042-S).
Rules for Specific Types of Forms W–
See Regulations section 1.1441-4.
8
Notes for Validating Form W-8BEN-E
Form W–8BEN
You should request Form W-8BEN from any foreign Part I, Line 4 (Chapter 3 status). If you receive a Form
individual for the purposes described previously in these W-8BEN-E from an entity that indicates in Part I, line 4,
instructions (that is, if you are making a payment subject that it is a disregarded entity, partnership, simple trust, or
to chapter 3 withholding or a withholdable payment; if you grantor trust, and the entity has checked “No” in Part I,
are a partnership documenting a partner for purposes of line 4 (regarding the entity’s claim of treaty benefits), you
section 1446; if a payee claims foreign status for purposes should not accept the Form W-8BEN-E if the form is used
of domestic information reporting and backup withholding; with respect to reportable amounts or withholdable
or if you are an FFI using this form to document an payments. In such a case, you should request the entity
account for purposes of chapter 4). complete a Form W-8IMY if the entity is a partnership,
simple trust, or grantor trust, or have the owner of a
disregarded entity complete the appropriate Form W-8. If
Notes for Validating Form W-8BEN
you are an FFI documenting an entity account holder
Line 6 (Foreign TIN). If you do not obtain a foreign TIN solely for chapter 4 purposes (that is, you are not required
(or a reasonable explanation for why the account holder to document the payee for purposes of withholding or
has not been issued a foreign TIN) on line 6 (or on a domestic information reporting), the entity does not need
separate statement) when required (see Foreign TINs, to provide a chapter 3 status on line 4 of the form.
earlier), you must treat the form as invalid for payments of Part I, Line 9b (Foreign TIN). If you do not obtain a
U.S. source income reportable on Form 1042-S (as foreign TIN (or a reasonable explanation for why the
determined before the application of this requirement). account holder has not been issued a foreign TIN) on
Line 8 (Date of birth). If you are a U.S. office or branch line 9b (or on a separate statement) when required (see
of a depository institution, custodial institution, investment Foreign TINs, earlier), you must treat the form as invalid
entity, or specified insurance company (each as defined in for payments of U.S. source income reportable on Form
Regulations section 1.1471-5(e)) documenting an 1042-S (as determined before the application of this
individual account holder (as defined in Regulations requirement).
section 1.1471-5(a)(3)) of an account that is a financial Part II (Disregarded Entity or Branch Receiving Pay-
account (as defined in Regulations section 1.1471-5(b)), ment). If you are making payments to multiple branches/
you must obtain the individual account holder’s date of disregarded entities that would be completing Part II, and
birth on the Form W-8BEN in order for the form to not be the Part I information for each branch/disregarded entity is
invalid for a payment of U.S. source income reportable on the same, instead of obtaining separate Forms W-8BEN-E
Form 1042-S (as determined before the application of this with respect to each branch/disregarded entity, you may
requirement). If the individual’s date of birth is not accept a single Form W-8BEN-E with a separate schedule
provided on the Form W-8BEN, the form is not invalid if attached that includes all of the information required by
you otherwise have the date of birth in your account files Part II for each branch/disregarded entity and you are able
for the account holder or you obtain the date of birth on a to allocate each payment to each branch/disregarded
written statement (including a written statement entity associated with the form. See Requirements for
transmitted by email) from the account holder and Obtaining and Verifying a Global Intermediary
associate the written statement with the Form W-8BEN. Identification Number (GIIN), earlier, for when a GIIN is
See Notice 2017-46 for transitional rules for withholding required when Part II is completed.
agents to obtain dates of birth for accounts documented
with otherwise valid Forms W-8 that were signed before Part III (Claim of Tax Treaty Benefits), Line 14(b). For
January 1, 2018. a Form W-8BEN-E obtained on or after January 1, 2017,
Inst. for the Requester of Forms W-8 (Rev. April 2018) -9-
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an entity claiming a reduced rate of withholding under an items of income identified on line 11 are effectively
income tax treaty that contains a limitation on benefits connected with the conduct of a trade or business within
article must identify the limitation on benefits provision the United States. Therefore, if a beneficial owner
that it satisfies by checking one of the boxes in line 14(b). provides you with a Form W-8ECI, you may treat all of the
In general, the entity is only required to check one box, U.S. source income identified on line 11 paid to that
even if it satisfies more than one provision. If the beneficial owner as effectively connected with the conduct
applicable treaty has no limitation on benefits article, the of a trade or business within the United States and not as
entity must check the box for “Other” and enter “N/A” in a withholdable payment for purposes of chapter 4.
the line provided. You may rely on the entity’s claim in Accordingly, a chapter 4 status is not required for a payee
line 14(b) unless you have actual knowledge that the who provides a valid Form W-8ECI unless you are an FFI
claim is incorrect. requesting a Form W-8ECI from an account holder for
Part III, Line 15 (Special rates and conditions). If the purposes of your chapter 4 due diligence requirements.
beneficial owner is required to explain the additional If you pay items of income that are not identified on
conditions in the treaty that it meets to be eligible for the line 11 by the beneficial owner as effectively connected
rate of withholding on line 15, you may accept a brief with the conduct of a trade or business within the United
explanation. You may accept a treaty claim without this States, generally you are required to obtain another type
explanation under an interest or dividends (other than of Form W-8 from the beneficial owner.
dividends subject to a preferential rate based on
Generally, you may not treat an amount as income
ownership) article of a treaty or other income article,
effectively connected with the conduct of a trade or
unless such article requires additional representations.
business within the United States unless the beneficial
Part IX, Line 24 (Owner-documented FFI). You may owner gives you a valid Form W-8ECI. However, there are
accept this certificate and treat an entity as an exceptions (described below) for income paid on notional
owner-documented FFI only if you are a designated principal contracts and payments made to certain U.S.
withholding agent under the chapter 4 regulations. Also, branches.
an owner-documented FFI that is a nonreporting IGA FFI
Notional principal contracts reportable on Form
must check “owner-documented FFI” (and not
1042-S. Withholding at a 30% rate is not required on
“nonreporting IGA FFI”) in line 5 and complete Part X. You
amounts paid under the terms of a notional principal
may accept a Form W-8BEN-E from an entity claiming
contract whether or not a Form W-8ECI is provided
status as an owner-documented FFI that does not check
(except when a payment made under such contract is
box 24d in Part X regardless of whether you know that the
U.S. source income, such as a dividend equivalent
entity is a trust that has one or more contingent
amount under section 871(m)). However, if the income is
beneficiaries.
effectively connected with the conduct of a U.S. trade or
Form W–8ECI business, it is reportable by you on Form 1042-S
(regardless of whether the payment is U.S. source
You should request Form W-8ECI from any foreign person income). You must treat income as effectively connected
or organization to which you are making a payment if it is with the conduct of a U.S. trade or business, even if a
the beneficial owner of the income (or an entity engaged Form W-8ECI has not been received, if the income is paid
in a U.S. trade or business submitting the form on behalf to a qualified business unit of a foreign person located in
of its owners, partners, or beneficiaries) and claims that the United States or if the income is paid to a qualified
the income is effectively connected with the conduct of a business unit of a foreign person located outside the
trade or business in the United States. However, if you are United States and you know, or have reason to know, that
a partnership, you should request a Form W-8BEN or the payment is income effectively connected with the
W-8BEN-E (as applicable) from a foreign partner that is conduct of a U.S. trade or business. However, a payment
allocated income that is effectively connected with the is not treated as income effectively connected with the
conduct of the partnership's trade or business in the conduct of a U.S. trade or business if the payee provides
United States. Nevertheless, a foreign partner that has a Form W-8BEN-E representing that the payment is not
made an election under section 871(d) or section 882(d) income effectively connected with a U.S. trade or
must provide that election to the partnership along with a business or makes a representation in a master
Form W-8ECI. agreement that governs the transactions in notional
If you receive a Form W-8ECI without a U.S. TIN principal contracts between the parties (for example, an
entered on line 7, you may not treat the income as International Swaps and Derivatives Association
effectively connected with a U.S. trade or business and agreement), or in the confirmation on the particular
you must apply the appropriate presumption rules. If you notional principal contract transaction, that the payee is a
receive a Form W-8ECI without a foreign TIN (or a U.S. person or a non-U.S. branch of a foreign person.
reasonable explanation for why the account holder has
Payments to certain U.S. branches treated as effec-
not been issued a foreign TIN) on line 8 (or on a separate If you make a payment to a
tively connected income.
statement) when required (see Foreign TINs, earlier), you U.S. branch of a foreign bank or insurance company that
must treat the form as invalid for payments of U.S. source does not provide a withholding certificate but has provided
income reportable on Form 1042-S (as determined before an EIN, the payment is presumed to be effectively
the application of this requirement). connected with the conduct of a trade or business within
Your receipt of Form W-8ECI serves as a the United States even if the foreign person (or its U.S.
representation by the payee or beneficial owner that the branch) does not give you a Form W-8ECI. If you do not
-10- Inst. for the Requester of Forms W-8 (Rev. April 2018)
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obtain a Form W-8ECI or the U.S. branch’s EIN, the If you receive a Form W-8EXP without a foreign TIN (or
income paid cannot be treated as income effectively a reasonable explanation for why the account holder has
connected with a U.S. trade or business. not been issued a foreign TIN) on line 8b (or on a separate
statement) when required (see Foreign TINs, earlier), you
Form W–8EXP must treat the form as invalid for payments of U.S. source
You should request Form W-8EXP from any foreign income reportable on Form 1042-S (as determined before
government, international organization, foreign central the application of this requirement).
bank of issue, foreign tax-exempt organization, foreign
private foundation, or government of a U.S. possession to Form W–8IMY
which you are making a payment of an amount subject to You should request Form W-8IMY from any entity that is a
chapter 3 withholding if such person is claiming an QI (including a QI acting as a QDD), nonqualified
exemption from withholding under sections 1441, 1442, intermediary (including certain U.S. branches and territory
and 1443 pursuant to section 115(2), 501(c), 892, or 895, financial institutions), a withholding foreign partnership
or claiming a rate of withholding under section 1443(b). (WP), a withholding foreign trust (WT), or a flow-through
Except as provided below, you should request Form entity to which you make a withholdable payment or pay a
W-8EXP from a person claiming an exemption from reportable amount. A flow-through entity includes a
withholding under chapter 4 as an exempt beneficial foreign partnership (other than a WP), a foreign simple or
owner or tax-exempt organization under section 501(c) or grantor trust (other than a WT), and, for any payments for
that is claiming any other chapter 4 status shown on the which a treaty benefit is claimed, any entity to the extent it
form when also claiming a chapter 3 status described in is treated as fiscally transparent under the laws of the
the preceding sentence. In certain cases, a GIIN may be treaty jurisdiction, as provided in section 894 and the
required based on the chapter 4 status claimed on the regulations thereunder (without regard to whether it is
form. See the Requirements for Obtaining and Verifying a fiscally transparent under the laws of the United States).
Global Intermediary Identification Number (GIINs), earlier. Before January 1, 2020, Form W-8IMY may also be
If you are an FFI documenting an account holder that is provided by an entity to claim chapter 3 status as a
a tax-exempt organization or exempt beneficial owner qualified securities lender (QSL) with respect to payments
(each as defined for chapter 4 purposes) to which you do of U.S. source substitute dividends and may be relied
not pay amounts subject to withholding under chapter 3, upon regardless of whether the QSL acts as an
you may require that the account holder complete Form intermediary with respect to substitute dividends
W-8BEN-E (rather than Form W-8EXP) to establish its associated with the form. You may accept a Form W-8IMY
status for chapter 4 purposes. from an individual acting as an agent or intermediary (as
appropriately amended to account for individual status),
A Form W-8EXP submitted by a foreign person that is a but you are not required to obtain such form if you are able
partner in a partnership for purposes of withholding under to associate payments you make to the person(s) for
sections 1441 through 1443 will also establish that whom the individual acts.
partner's foreign status for purposes of section 1446.
However, except as provided in Regulations section You may accept multiple Forms W-8IMY from an
1.1446-3(c)(3) (regarding certain tax-exempt intermediary that is acting in multiple capacities (for
organizations described in section 501(c)), the example, as a QI for one account but a nonqualified
submission of Form W-8EXP will have no effect on intermediary or QDD for another account). However, a QI
whether the partner is subject to withholding under section may provide you with a single Form W-8IMY that covers
1446. more than one category of QI shown on the form provided
that it properly identifies to you the accounts and/or
You may treat a payee as an international organization transactions on a withholding statement. You may accept
without requiring a Form W-8EXP if the payee is a single Form W-8IMY for multiple branches of the entity
designated as an international organization by an providing the form if the information in Part I is the same
executive order (pursuant to 22 U.S.C. 288 through for each branch and a separate schedule is attached that
288(f)) and other facts surrounding the payment includes all of the Part II information on each branch and
reasonably indicate that the beneficial owner of the sufficient information to associate the payments with each
payment is an international organization. With regard to branch.
amounts derived from bankers' acceptances for chapter 3
purposes, you may treat a payee as a foreign central bank The chapter 4 status of an intermediary or flow-through
of issue without requiring a Form W-8EXP if the name of entity is required on Part I of the form if the form is
the payee and other facts surrounding the payment associated with a withholdable payment. Part II must be
reasonably indicate that the beneficial owner of the completed when a withholdable payment is made to a
payment is a foreign central bank of issue. branch or disregarded entity described in Part II of the
form.
A U.S. TIN is required if the beneficial owner is claiming
an exemption or reduced rate of withholding based solely Generally, for purposes of both chapters 3 and 4,
on a claim of tax-exempt status under section 501(c) or except to the extent otherwise provided in the Regulations
private foundation status. However, a U.S. TIN is not under sections 1441 or 1471, a Form W-8IMY must be
required from a foreign private foundation that is subject to associated with a withholding statement and withholding
the 4% excise tax on gross investment income (under certificates (or documentary evidence, where permitted)
section 4948(a)) that would be exempt from withholding for the beneficial owners. Generally, the withholding
except for section 4948(a) (for example, portfolio interest). statement must allocate the payment to each payee (or
Inst. for the Requester of Forms W-8 (Rev. April 2018) -11-
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pool of payees, where permitted, as described later), must indicate its entity classification on line 16b of the
provide the rate of withholding for each payee (or pool of form. If you are making such payment that is an amount
payees), and provide certain identification information on subject to chapter 3 withholding to a QI that is acting as a
each payee that is not included in a pool. See Regulations QDD and the QDD is claiming treaty benefits applicable to
section 1.1441-1(e)(3)(iv)(C)(3) for the allowance for a the status identified on line 16b on the payment, you may
withholding agent to accept an alternative withholding treat the Form W-8IMY as a beneficial owner withholding
statement from a nonqualified intermediary (which also certificate and provide such benefits if the QDD provides a
applies to a flow-through entity). statement associated to the Form W-8IMY that includes
the necessary information with respect to the treaty claim
If you are a participating FFI or registered required in Part III of Form W-8BEN-E. In such case, the
deemed-compliant FFI, you may also request Form portion of the certificate making a claim for treaty benefits
W-8IMY from an intermediary or flow-through entity that is is valid until the end of the third calendar year following
an account holder to establish its chapter 4 status or the year in which the Form W-8IMY is signed (unless a
status under an applicable IGA even when no payments change in circumstances occurs sooner), and the
subject to withholding or domestic information reporting validation rules for a treaty claim apply. A QDD may
are made to the account. In such a case, a withholding instead provide a separate Form W-8BEN-E to make the
statement is not required. treaty claim. You may otherwise treat a Form W-8IMY
provided by a QDD (other than a flow-through entity or
Notes for Validating Form W-8IMY disregarded entity) as a beneficial owner withholding
certificate for establishing foreign status of the QDD for a
QIs, WPs, and WTs (in general). A QI, WP, or WT
payment of U.S. source FDAP income (as long as the
acting in its capacity as such must provide the EIN that
QDD provides its foreign TIN (when required) on a QDD
was issued to the entity in such capacity (that is, its
withholding statement or a separate statement). A QDD
QI-EIN, WP-EIN, or WT-EIN) on Form W-8IMY and not
that is receiving payments that it beneficially owns that are
any other EIN it may have in its nonqualified intermediary,
not covered by its QI agreement should provide the
nonwithholding foreign partnership, or nonwithholding
appropriate Form W-8 based on its status (and not Form
foreign trust capacity. Because status as a QI, WP, or WT
W-8IMY). The QDD must provide to you a withholding
for a financial institution is limited to certain classes of
statement to identify the home office or branch that is
FFIs, if you are making a withholdable payment to a QI,
treated as the owner for U.S. income tax purposes and, in
WP, or WT that is a financial institution, you must verify
certain circumstances (described in the instructions for
that the QI, WP, or WT certifies its status as one of the
Form W-8IMY), the QDD’s foreign TIN (or a reasonable
permitted classes in Regulations sections 1.1441-1(e)(5)
explanation for why it has not been issued a foreign TIN, if
(ii) (for a QI), 1.1441-5(c)(2)(ii) (for a WP), or 1.1441-5(e)
required). Notwithstanding the preceding sentence, you
(5)(v) (for a WT) and provides its GIIN (except in the case
are not required to obtain a QDD withholding statement if
of certain foreign central banks of issue and retirement
the branch or home office of the QDD is identified on the
funds).
form and the form is provided only for payments
If a QI checks line 15b of Part III of the form to certify beneficially owned by the QDD (and a foreign TIN is
that it assumes primary Form 1099 reporting and backup provided when required). See Foreign TINs, earlier, for
withholding responsibility, you may accept the form even if when you must treat the form as invalid if a foreign TIN or
you do not know if there are any U.S. accounts receiving reasonable explanation is not provided.
reportable payments at the time of the certification. If a QI QIs assuming withholding on payments of
does not check line 15b or 15c of Part III of the form, you substitute interest. If a QI represents its status as a QI
must confirm that the QI is not receiving payments for U.S. on a Form W-8IMY with respect to payments of interest
accounts that are reportable on Form 1099, and the QI and substitute interest and checks line 15g of Part III of
must provide an updated Form W-8IMY or must provide a the form, you may treat the QI as assuming withholding for
withholding statement if it allocates payments to such payments of interest and substitute interest it receives
accounts for which it does not assume primary from you in connection with a sale-repurchase or similar
withholding responsibility. A QI may check line 15e of Part agreement, a securities lending transaction, or collateral
III of the form to indicate that it allocates a portion of the that the QI holds in connection with its activities as a
payment to a chapter 4 withholding rate pool of U.S. dealer in securities.
payees that includes account holders of another
intermediary or flow-through entity even if the withholding QSLs. If you make payment of a U.S. source substitute
statement does not show any intermediaries or dividend to a QSL (prior to January 1, 2020), the QSL is
flow-through entities at the time the certification is required to provide its U.S. TIN. If you make a payment to
provided. However, a QI is not required to check line 15e a QSL (prior to January 1, 2020) that is a withholdable
of Part III of the form until it provides a withholding payment, you must collect a Form W-8IMY that includes
statement identifying an intermediary or flow-through the QSL’s chapter 4 status and GIIN (as applicable) to
entity that receives a payment allocated to a chapter 4 avoid withholding under chapter 4. A QSL that is a QI
withholding rate pool of U.S. payees. should check line 15f of Part III of the form and a QSL that
QIs acting as QDDs. You should only accept a Form is a nonqualified intermediary should check line 17d of
W-8IMY from a QI acting as a QDD to the extent you are Part IV of the form. You may not associate a Form
making payments with respect to potential section 871(m) W-8IMY from a QSL with a payment of a substitute
transactions or underlying securities to the QDD when the dividend on or after January 1, 2020, and you should
entity claims QDD status in Part III of the form. A QDD obtain a revised withholding certificate.
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For information on transition rules for 2018 and 2019 requirements of (and documentation or information that is
for withholding agents to apply with respect to QSLs, see publicly available that determines the chapter 4 status of
Notice 2018-05. the payee permitted under) an applicable IGA for an
U.S. branches. If you make a payment to a U.S. branch account holder, and you may rely upon such status and
of a foreign bank or insurance company that represents documentation, provided that you have the information
that it is acting as an intermediary and has agreed to be necessary to report on Form 1042-S. Additionally, see
treated as a U.S. person, you are not required to obtain Alternative Certifications Under an Applicable IGA, earlier,
the GIIN or chapter 4 status of the entity, but you must for further details on alternative certifications.
obtain the U.S. branch’s EIN. If you make a withholdable In general, if you make a withholdable payment to an
payment after June 30, 2017, to a U.S. branch of an FFI intermediary or flow-through entity that is a participating
that is acting as an intermediary and that does not agree FFI or registered deemed-compliant FFI, the FFI may
to be treated as a U.S. person, the branch must provide its provide an FFI withholding statement that allocates a
EIN (but does not need to provide a GIIN or chapter 4 portion of the payment to a chapter 4 withholding rate
status) and certify that the branch is applying the rules pool. If an intermediary provides with its Form W-8IMY an
described in Regulations section 1.1471-4(d)(2)(iii)(C) by FFI withholding statement that allocates a portion of the
checking the box on line 19c in Part VI of the form. If you payment to a chapter 4 withholding rate pool of U.S.
do not obtain the certification from a U.S. branch payees, the FFI must provide a chapter 4 status on line 5.
described in the preceding sentence, you must treat the If the intermediary described in the preceding sentence is
branch as a nonparticipating FFI and withhold under a nonqualified intermediary, it must provide the
chapter 4 on withholdable payments made to the branch. certification required in Part IV with respect to its
You are not required to treat as invalid a Form W-8IMY compliance with the requirements of Regulations section
from an account holder that completes Part VI of the form 1.6049-4(c)(4) (or similar requirements under chapter 61
(to the extent required) but does not complete Part II of for a payment other than interest). If the intermediary is a
the form. QI, it must certify that it meets the requirements of
Regulations section 1.6049-4(c)(4)(iii) and, to the extent
Territory financial institutions acting as intermedia- the U.S. payees are account holders of an intermediary or
ries. If you make a payment to a territory financial flow-through entity receiving a payment from the QI, the
institution acting as an intermediary, you must obtain the QI has obtained or will obtain documentation sufficient to
territory financial institution’s EIN if it agrees to be treated establish each such intermediary or flow-through entity
as a U.S. person for chapters 3 and 4. You are not status as a participating FFI, registered
required to obtain a GIIN from a territory financial deemed-compliant FFI, or FFI that is a QI. An allocation of
institution. a payment shown on a withholding statement and made
Participating FFIs and registered deemed-compliant on or after April 1, 2017, to a nonqualified intermediary,
FFIs that are flow-through entities or acting as inter- nonwithholding foreign partnership, or nonwithholding
mediaries. If a participating FFI or registered foreign trust of an amount subject to chapter 3 withholding
deemed-compliant FFI that is an intermediary or to a chapter 4 withholding rate pool of U.S. payees must
flow-through entity provides you with a withholding identify the payees consistent with the description in
statement and documentation for its account holders or Regulations section 1.1471-3(c)(3)(iii)(B)(2)(iii)
payees, you are not required to verify the information on (describing account holders of an FFI that is a non-U.S.
the account holders or payees provided in the payor that are not subject to withholding under chapter 3
documentation for chapter 4 purposes unless the or 4 or under section 3406, and that are holders of U.S.
information in the documentation is facially incorrect, and accounts reported by the FFI under its FATCA
you are not required to obtain additional documentation requirements as a participating FFI or registered
for an account holder or payee in addition to the deemed-compliant FFI).
withholding certificate unless you are obtaining the Section 1446 requirements. You should request Form
documentation for purposes of chapter 3 or 61, or unless W-8IMY for purposes of section 1446 only from a foreign
you know that the documentation review conducted by the upper-tier partnership or foreign grantor trust. Generally,
participating FFI or registered deemed-compliant FFI was for purposes of section 1446, the Form W-8IMY submitted
not adequate for purposes of chapter 4. See Regulations by these entities is used to transmit the forms of the
section 1.1441-7(b)(10) for the due diligence owners of these entities. The other forms should be
requirements for indirect account holders for purposes of accompanied with the information necessary to reliably
chapter 3 and see Regulations section 1.1471-3(e)(4)(vi) associate your effectively connected partnership items
(B) for standards that apply in such case to determine with the upper-tier partners, in the case of a foreign
whether chapter 4 withholding applies. You may rely on upper-tier partnership, and the grantor or other owner, in
documentation that does not include a chapter 4 status for the case of a foreign grantor trust. Then you must look
an account holder of an intermediary or flow-through through these entities to the beneficial owners when
entity that is an FFI when the withholding statement determining your section 1446 tax obligation. A domestic
provided by such entity indicates that the payment is upper-tier partnership may also provide you this
made to an account excluded as a financial account under information. Under those circumstances you may, but are
Regulations section 1.1471-5(b)(2). not required to, pay the section 1446 withholding tax of
An intermediary or flow-through entity that is a the foreign partners of the domestic upper-tier
participating FFI or registered deemed-compliant FFI may partnership. See Regulations section 1.1446-5.
provide a status for chapter 4 purposes found under the
Inst. for the Requester of Forms W-8 (Rev. April 2018) -13-
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Requirements for Hybrid and Reverse Hybrid A form that satisfies these substitute forms
Entities requirements may be treated as a similar agreed form for
purposes of an applicable IGA unless the partner
A hybrid entity is an entity that is treated as fiscally
jurisdiction declines such treatment.
transparent under the Code but is not treated as fiscally
transparent under the tax laws of a country with which the A substitute form does not need to contain all of the
United States has an income tax treaty. provisions contained on the official form, so long as it
contains those provisions that are relevant to the
If you are making a payment to a foreign hybrid entity
transaction for which it is furnished. You may omit the
that is making a claim for treaty benefits on its own behalf,
chapter 4 certifications on your substitute form if such
the hybrid entity should provide a Form W-8BEN-E to
certifications are not required based on the payments
claim treaty benefits. If the hybrid entity is a flow-through
made to the payees. If you are an FFI documenting the
entity (not a disregarded entity) claiming treaty benefits on
chapter 4 status of your account holders under your
its own behalf on a payment that is a withholdable
chapter 4 requirements or an applicable IGA, however,
payment, it should also provide you a Form W-8IMY
you may not omit the chapter 4 certifications. If you are
(including its chapter 4 status) along with a withholding
making a withholdable payment, you may choose to
statement (if required) establishing the chapter 4 status of
provide a substitute form that does not include all of the
each of its partners or owners to determine whether
chapter 4 statuses provided on the Form W-8, but the
withholding applies to any portion of the payment.
substitute form must include any chapter 4 status for
Allocation information is not required on this withholding
which withholding may apply.
statement unless one or more partners or owners are
subject to chapter 4 withholding. If the hybrid entity is a You may incorporate a substitute Form W-8 into other
disregarded entity claiming treaty benefits on a payment business forms you customarily use, such as account
that is a withholdable payment, unless the disregarded signature cards, provided the required certifications are
entity is treated as the payee for chapter 4 purposes and clearly set forth. However, you may not:
has its own GIIN, the single owner should provide a Form 1. Use a substitute form that requires the payee, by
W-8BEN-E or Form W-8BEN (as applicable) to you along signing, to agree to provisions unrelated to the required
with the Form W-8BEN-E for the hybrid entity. Line 10 of certifications; or
the Form W-8BEN-E may be used by the hybrid entity to
2. Imply that a person may be subject to 30%
associate the Forms W-8.
withholding or backup withholding unless that person
A foreign reverse hybrid entity is an entity that is a agrees to provisions on the substitute form that are
corporation for U.S. tax purposes but is fiscally unrelated to the required certifications.
transparent under the tax laws of a country with which the
A substitute Form W-8 is valid only if it contains the
United States has an income tax treaty. If a foreign
same penalties of perjury statement and certifications as
reverse hybrid entity is receiving a payment for which the
the official forms and the required signature. However, if
entity is claiming a reduced rate of withholding for its
the substitute form is contained in some other business
owners, you must obtain from the entity a Form W-8IMY
form, the words “information on this form” may be
(including its chapter 4 status if the payment is a
modified to refer to that portion of the business form
withholdable payment) along with a withholding statement
containing the substitute form information. The design of
and documentation for each owner for which the entity
the substitute form must be such that the information and
claims treaty benefits. If a foreign reverse hybrid entity is
certifications that are being attested to by the penalties of
receiving a withholdable payment and is not claiming
perjury statement clearly stand out from any other
treaty benefits on behalf of any of its owners, you should
information contained in the form.
obtain only a Form W-8BEN-E from the entity to establish
its chapter 4 status. Content of Substitute Form
Substitute Form W-8BEN. The substitute Form
Substitute Forms W-8 for
W-8BEN must contain all of the information required in
Payments of Reportable Amounts Part I, lines 1 through 8. The certifications in Part II must
be included in a substitute form only if treaty benefits are
and Withholdable Payments
claimed, and then only to the extent that the certifications
You may develop and use your own Form W-8 (a are required. For example, Form W-8BEN, line 10 (special
substitute form) for chapters 3 and 4 purposes if its rates and conditions), is not required if the form is being
content is substantially similar to the IRS's official Form requested from an individual receiving a payment of U.S.
W-8 (to the extent required by these instructions), it source dividends from stocks that are actively traded on
satisfies certain certification requirements, and it includes an established securities market. The substitute Form
a signature under a penalties of perjury statement that is W-8BEN must include a statement that if the person
identical to the one stated on the official form. You may providing the form is a resident in a FATCA partner
develop and use a substitute form that is in a foreign jurisdiction (that is, a Model 1 IGA jurisdiction with
language provided that you make an English translation of reciprocity), certain tax account information may be
the form and its contents available to the IRS upon provided to the jurisdiction of residence.
request. You may combine multiple Forms W-8 into a
single substitute form. The substitute form must contain the penalties of
perjury statement identical to the statement on the official
Form W-8BEN. Additionally, if the substitute form is
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incorporated into other business forms, the following the form. For example, if a withholding agent is
statement must be presented in the same manner as the documenting a beneficial owner that is a foreign
penalties of perjury statement and must appear government for purposes of both chapters 3 and 4, the
immediately above the single signature line: “The Internal withholding agent may use a substitute Form W-8EXP
Revenue Service does not require your consent to any that contains the required information in Part I, plus the
provisions of this document other than the certifications required statements and certifications from Parts II and III
required to establish your status as a non-U.S. individual that are related to foreign governments, and does not
and, if applicable, obtain a reduced rate of withholding.” need to include the statements and certifications for other
Substitute Form W-8BEN-E. The substitute Form types of entities that would otherwise be providing the
W-8BEN-E must contain all of the information required in Form W-8EXP.
Part I, lines 1 through 6, and lines 8 and 9 if a U.S. or If the substitute form is incorporated into other business
foreign TIN or a GIIN is required. See however, Substitute forms, the following statement must be presented in the
Forms W-8 for Payments of Reportable Amounts and same manner as the penalties of perjury statement and
Withholdable Payments, earlier, for when you may omit a must appear immediately above the single signature line:
chapter 4 certification on a substitute Form W-8. The “The Internal Revenue Service does not require your
certifications in Part II must be included in a substitute consent to any provisions of this document other than the
form if you are making a withholdable payment to a certifications required to establish your status as a foreign
disregarded entity or a branch that must be reported in government, international organization, foreign central
Part II. The certifications in Part III must be included only if bank of issue, foreign tax-exempt organization, foreign
treaty benefits are claimed, and then only to the extent private foundation, or government of a U.S. possession,
that the certifications are required. See Alternative and your chapter 4 status (if required).”
Certifications Under an Applicable IGA, earlier, in these Substitute Form W-8IMY. The substitute Form W-8IMY
instructions, for circumstances in which the chapter 4 must contain all of the information required in Part I, lines
certifications may be replaced with alternative 1 through 6, line 8 (if a U.S. TIN is required), and line 9 (if
certifications. a GIIN is required). See however, Substitute Forms W-8
If the substitute form is incorporated into other business for Payments of Reportable Amounts and Withholdable
forms, the following statement must be presented in the Payments, earlier, for when you may omit a chapter 4
same manner as the penalties of perjury statement and certification on a substitute Form W-8. The information
must appear immediately above the single signature line: required in Part II must be included in a substitute form if
“The Internal Revenue Service does not require your you are making a withholdable payment to a disregarded
consent to any provisions of this document other than the entity that has its own GIIN or a branch (including a
certifications required to establish your status as a branch that is a disregarded entity that does not have its
non-U.S. person, establish your chapter 4 status (if own GIIN) operating in a jurisdiction other than the
required), and, if applicable, obtain a reduced rate of jurisdiction of residence of the entity named in Part I of the
withholding.” form. The substitute Form W-8IMY must also contain all of
Substitute Form W-8ECI. The substitute Form W-8ECI the statements and certifications relevant to chapter 3
must contain all of the information required in Part I other contained in Parts III through VIII if you are making a
than line 9. The certifications in Part II of Form W-8ECI payment subject to withholding under chapter 3 and the
must be included in a substitute form. statements and certifications relevant to the chapter 4
status contained in Parts IX through XXVIII for the
If the substitute form is incorporated into other business intermediary or flow-through entity providing the form if
forms, the following statement must be presented in the you are making a withholdable payment or if you are an
same manner as the penalties of perjury statement and FFI documenting your account holders for purposes of
must appear immediately above the single signature line: chapter 4 or an applicable IGA. For example, if the only
“The Internal Revenue Service does not require your intermediaries to which a U.S. withholding agent makes
consent to any provisions of this document other than the payments are qualified intermediaries that are
certifications required to establish your status as a participating FFIs, the withholding agent may use a
non-U.S. person and that the income for which this form is substitute Form W-8IMY that contains only the required
provided is effectively connected with the conduct of a information from Part I (including line 9 to collect the
trade or business within the United States.” intermediaries’ GIINs), plus the statements and
Substitute Form W-8EXP. The substitute Form W-8EXP certifications from Part III. A substitute Form W-8IMY must
must contain all of the information required in Part I, lines also incorporate the same attachments as the official form
1 through 5, line 7 (if a U.S. TIN is required), and line 8. (such as a withholding statement and beneficial owner
See however, Substitute Forms W-8 for Payments of documentation, to the extent otherwise required). You
Reportable Amounts and Withholdable Payments, earlier, may also include any information in a substitute Form
for when you may omit a chapter 4 certification on a W-8IMY, or require any information to be associated with
substitute Form W-8. The substitute Form W-8EXP must the form, that is reasonably related to your obligation to
also contain all of the statements and certifications withhold and correctly report payments.
contained in Parts II and III, as applicable, with respect to If the substitute form is incorporated into other business
the purpose for which the form is provided, but a specific forms, the following statement must be presented in the
statement or certification needs to be included (in its same manner as the penalties of perjury statement and
entirety) only if it is relevant to the type of entity providing must appear immediately above the single signature line:
Inst. for the Requester of Forms W-8 (Rev. April 2018) -15-
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“The Internal Revenue Service does not require your birth. The form may also request other information
consent to any provisions of this document other than the required for purposes of tax or anti-money laundering
certifications required to establish: (1) your status as a (AML) due diligence in the United States or in other
qualified intermediary, a nonqualified intermediary, a countries. A form that satisfies these requirements may be
specific type of U.S. branch, a withholding foreign treated as a similar agreed form for purposes of an
partnership, a withholding foreign trust, a nonwithholding applicable IGA unless the partner jurisdiction declines
foreign partnership, a nonwithholding foreign simple trust, such treatment.
or a nonwithholding foreign grantor trust; (2) your
Generally, a non-IRS form for individuals must contain
chapter 4 status; and/or (3) prior to January 1, 2020, your
a signed and dated certification made under penalties of
status as a qualified securities lender.”
perjury that the information provided on the form is
Non-IRS Form for Individuals Not accurate and will be updated by the individual within 30
days of a change in circumstances that causes the form to
Receiving Reportable Amounts
become incorrect. However, the signed certification
If you are an FFI documenting an account holder that is an provided on a form need not be signed under penalties of
individual and you are not making a payment of a perjury if the form is accompanied by documentary
reportable amount to such account holder, you may use a evidence that supports the individual’s claim of foreign
non-IRS form rather than a substitute Form W-8BEN. The status. Such documentary evidence may be the same
form must include the name and address of the individual documentary evidence that is used to support foreign
that is the payee or beneficial owner, all countries in which status in the case of a payee whose account has U.S.
the individual is resident for tax purposes, the individual’s indicia as described in Regulations sections 1.1471-3(e)
country of birth, a taxpayer identification number, if any, and 1.1471-4(c)(4)(i)(A).
for each country of residence, and the individual’s date of
-16- Inst. for the Requester of Forms W-8 (Rev. April 2018)
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Form W-8BEN Certificate of Foreign Status of Beneficial Owner for United
States Tax Withholding and Reporting (Individuals)
(Rev. July 2017) a For use by individuals. Entities must use Form W-8BEN-E. OMB No. 1545-1621
a
Department of the Treasury Go to www.irs.gov/FormW8BEN for instructions and the latest information.
Internal Revenue Service a Give this form to the withholding agent or payer. Do not send to the IRS.
Do NOT use this form if: Instead, use Form:
• You are NOT an individual . . ............................... W-8BEN-E
• You are a U.S. citizen or other U.S. person, including a resident alien individual . . ................. W-9
• You are a beneficial owner claiming that income is effectively connected with the conduct of trade or business within the U.S.
(other than personal services) . ................................W-8ECI
• You are a beneficial owner who is receiving compensation for personal services performed in the United States . ...... 8233 or W-4
• You are a person acting as an intermediary ............................. W-8IMY
Note: If you are resident in a FATCA partner jurisdiction (i.e., a Model 1 IGA jurisdiction with reciprocity), certain tax account information may be
provided to your jurisdiction of residence.
Part I Identification of Beneficial Owner (see instructions)
1 Name of individual who is the beneficial owner 2 Country of citizenship
3 Permanent residence address (street, apt. or suite no., or rural route). Do not use a P.O. box or in-care-of address.
City or town, state or province. Include postal code where appropriate. Country
4 Mailing address (if different from above)
City or town, state or province. Include postal code where appropriate. Country
5 U.S. taxpayer identification number (SSN or ITIN), if required (see instructions) 6 Foreign tax identifying number (see instructions)
7 Reference number(s) (see instructions) 8 Date of birth (MM-DD-YYYY) (see instructions)
Part II Claim of Tax Treaty Benefits (for chapter 3 purposes only) (see instructions)
9 I certify that the beneficial owner is a resident of within the meaning of the income tax
treaty between the United States and that country.
10 Special rates and conditions (if applicable—see instructions): The beneficial owner is claiming the provisions of Article and paragraph
of the treaty identified on line 9 above to claim a % rate of withholding on (specify type of income):
.
Explain the additional conditions in the Article and paragraph the beneficial owner meets to be eligible for the rate of withholding:
Part III Certification
Under penalties of perjury, I declare that I have examined the information on this form and to the best of my knowledge and belief it is true, correct, and complete. I further
certify under penalties of perjury that:
• I am the individual that is the beneficial owner (or am authorized to sign for the individual that is the beneficial owner) of all the income to which this form relates or
am using this form to document myself for chapter 4 purposes,
• The person named on line 1 of this form is not a U.S. person,
• The income to which this form relates is:
(a) not effectively connected with the conduct of a trade or business in the United States,
(b) effectively connected but is not subject to tax under an applicable income tax treaty, or
(c) the partner’s share of a partnership's effectively connected income,
• The person named on line 1 of this form is a resident of the treaty country listed on line 9 of the form (if any) within the meaning of the income tax treaty between
the United States and that country, and
• For broker transactions or barter exchanges, the beneficial owner is an exempt foreign person as defined in the instructions.
Furthermore, I authorize this form to be provided to any withholding agent that has control, receipt, or custody of the income of which I am the beneficial owner or
any withholding agent that can disburse or make payments of the income of which I am the beneficial owner. I agree that I will submit a new form within 30 days
if any certification made on this form becomes incorrect.
F
Sign Here
Signature of beneficial owner (or individual authorized to sign for beneficial owner) Date (MM-DD-YYYY)
Print name of signer Capacity in which acting (if form is not signed by beneficial owner)
For Paperwork Reduction Act Notice, see separate instructions. Cat. No. 25047Z Form W-8BEN (Rev. 7-2017)
Printed on recycled paper
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Certificate of Foreign Person's Claim That Income Is
Form W-8ECI Effectively Connected With the Conduct of a Trade or
(Rev. July 2017) Business in the United States OMB No. 1545-1621
a Section references are to the Internal Revenue Code.
Department of the Treasury aGo to www.irs.gov/FormW8ECI for instructions and the latest information.
Internal Revenue Service a Give this form to the withholding agent or payer. Do not send to the IRS.
Note: Persons submitting this form must file an annual U.S. income tax return to report income claimed to be effectively
connected with a U.S. trade or business. See instructions.
Do not use this form for: Instead, use Form:
• A beneficial owner solely claiming foreign status or treaty benefits ................. W-8BEN or W-8BEN-E
• A foreign government, international organization, foreign central bank of issue, foreign tax-exempt organization, foreign private
foundation, or government of a U.S. possession claiming the applicability of section(s) 115(2), 501(c), 892, 895, or 1443(b) . . .. W-8EXP
Note: These entities should use Form W-8ECI if they received effectively connected income and are not eligible to claim an exemption for chapter 3
or 4 purposes on Form W-8EXP.
• A foreign partnership or a foreign trust (unless claiming an exemption from U.S. withholding on income effectively connected with the
conduct of a trade or business in the United States) . . . .................. W-8BEN-E or W-8IMY
• A person acting as an intermediary .............................. W-8IMY
Note: See instructions for additional exceptions.
Part I Identification of Beneficial Owner (see instructions)
1 Name of individual or organization that is the beneficial owner 2 Country of incorporation or organization
3 Name of disregarded entity receiving the payments (if applicable)
4 Type of entity (check the appropriate box): Individual Corporation
Partnership Simple trust Complex trust Estate
Government Grantor trust Central bank of issue Tax-exempt organization
Private foundation International organization
5 Permanent residence address (street, apt. or suite no., or rural route). Do not use a P.O. box or in-care-of address.
City or town, state or province. Include postal code where appropriate. Country
6 Business address in the United States (street, apt. or suite no., or rural route). Do not use a P.O. box or in-care-of address.
City or town, state, and ZIP code
7 U.S. taxpayer identification number (required—see instructions) 8 Foreign tax identifying number
SSN or ITIN EIN
9 Reference number(s) (see instructions) 10 Date of birth (MM-DD-YYYY)
11 Specify each item of income that is, or is expected to be, received from the payer that is effectively connected with the conduct of a trade or
business in the United States (attach statement if necessary).
Part II Certification
Under penalties of perjury, I declare that I have examined the information on this form and to the best of my knowledge and belief it is true, correct, and
complete. I further certify under penalties of perjury that:
• I am the beneficial owner (or I am authorized to sign for the beneficial owner) of all the payments to which this form relates,
• The amounts for which this certification is provided are effectively connected with the conduct of a trade or business in the United States,
• The income for which this form was provided is includible in my gross income (or the beneficial owner’s gross income) for the taxable year, and
• The beneficial owner is not a U.S. person.
Sign Furthermore, I authorize this form to be provided to any withholding agent that has control, receipt, or custody of the payments of which I am the
Here beneficial owner or any withholding agent that can disburse or make payments of the amounts of which I am the beneficial owner.
I agree that I will submit a new form within 30 days if any certification made on this form becomes incorrect.
Signature of beneficial owner (or individual authorized to sign for the beneficial owner) Print name Date (MM-DD-YYYY)
I certify that I have the capacity to sign for the person identified on line 1 of this form.
For Paperwork Reduction Act Notice, see separate instructions. Cat. No. 25045D Form W-8ECI (Rev. 7-2017)
Printed on recycled paper
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Form W-8BEN-E Certificate of Status of Beneficial Owner for
(Rev. July 2017) United States Tax Withholding and Reporting (Entities) OMB No. 1545-1621
▶
Department of the Treasury For use by entities. Individuals must use Form W-8BEN. ▶ Section references are to the Internal Revenue Code.
▶ Go to www.irs.gov/FormW8BENE for instructions and the latest information.
Internal Revenue Service ▶ Give this form to the withholding agent or payer. Do not send to the IRS.
Do NOT use this form for: Instead use Form:
• U.S. entity or U.S. citizen or resident . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . W-9
• A foreign individual . . . . . . . . . . . . . . . . . . . . . . . . . . . . W-8BEN (Individual) or Form 8233
• A foreign individual or entity claiming that income is effectively connected with the conduct of trade or business within the U.S.
(unless claiming treaty benefits) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . W-8ECI
• A foreign partnership, a foreign simple trust, or a foreign grantor trust (unless claiming treaty benefits) (see instructions for exceptions) . . W-8IMY
• A foreign government, international organization, foreign central bank of issue, foreign tax-exempt organization, foreign private foundation, or
government of a U.S. possession claiming that income is effectively connected U.S. income or that is claiming the applicability of section(s) 115(2),
501(c), 892, 895, or 1443(b) (unless claiming treaty benefits) (see instructions for other exceptions) . . . . . . . . . W-8ECI or W-8EXP
• Any person acting as an intermediary (including a qualified intermediary acting as a qualified derivatives dealer) . . . . . . . . . W-8IMY
Part I Identification of Beneficial Owner
1 Name of organization that is the beneficial owner 2 Country of incorporation or organization
3 Name of disregarded entity receiving the payment (if applicable, see instructions)
4 Chapter 3 Status (entity type) (Must check one box only): Corporation Disregarded entity Partnership
Simple trust Grantor trust Complex trust Estate Government
Central Bank of Issue Tax-exempt organization Private foundation International organization
If you entered disregarded entity, partnership, simple trust, or grantor trust above, is the entity a hybrid making a treaty
claim? If "Yes" complete Part III. Yes No
5 Chapter 4 Status (FATCA status) (See instructions for details and complete the certification below for the entity's applicable status.)
Nonparticipating FFI (including an FFI related to a Reporting IGA Nonreporting IGA FFI. Complete Part XII.
FFI other than a deemed-compliant FFI, participating FFI, or Foreign government, government of a U.S. possession, or foreign
exempt beneficial owner). central bank of issue. Complete Part XIII.
Participating FFI. International organization. Complete Part XIV.
Reporting Model 1 FFI. Exempt retirement plans. Complete Part XV.
Reporting Model 2 FFI. Entity wholly owned by exempt beneficial owners. Complete Part XVI.
Registered deemed-compliant FFI (other than a reporting Model 1 Territory financial institution. Complete Part XVII.
FFI, sponsored FFI, or nonreporting IGA FFI covered in Part XII). Excepted nonfinancial group entity. Complete Part XVIII.
See instructions. Excepted nonfinancial start-up company. Complete Part XIX.
Sponsored FFI. Complete Part IV. Excepted nonfinancial entity in liquidation or bankruptcy.
Certified deemed-compliant nonregistering local bank. Complete Complete Part XX.
Part V. 501(c) organization. Complete Part XXI.
Certified deemed-compliant FFI with only low-value accounts. Nonprofit organization. Complete Part XXII.
Complete Part VI. Publicly traded NFFE or NFFE affiliate of a publicly traded
Certified deemed-compliant sponsored, closely held investment corporation. Complete Part XXIII.
vehicle. Complete Part VII. Excepted territory NFFE. Complete Part XXIV.
Certified deemed-compliant limited life debt investment entity. Active NFFE. Complete Part XXV.
Complete Part VIII. Passive NFFE. Complete Part XXVI.
Certain investment entities that do not maintain financial accounts. Excepted inter-affiliate FFI. Complete Part XXVII.
Complete Part IX. Direct reporting NFFE.
Owner-documented FFI. Complete Part X. Sponsored direct reporting NFFE. Complete Part XXVIII.
Restricted distributor. Complete Part XI. Account that is not a financial account.
6 Permanent residence address (street, apt. or suite no., or rural route). Do not use a P.O. box or in-care-of address (other than a registered address).
City or town, state or province. Include postal code where appropriate. Country
7 Mailing address (if different from above)
City or town, state or province. Include postal code where appropriate. Country
8 U.S. taxpayer identification number (TIN), if required 9a GIIN b Foreign TIN
10 Reference number(s) (see instructions)
Note: Please complete remainder of the form including signing the form in Part XXX.
For Paperwork Reduction Act Notice, see separate instructions. Cat. No. 59689N Form W-8BEN-E (Rev. 7-2017)
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Form W-8BEN-E (Rev. 7-2017) Page 2
Part II Disregarded Entity or Branch Receiving Payment. (Complete only if a disregarded entity with a GIIN or a
branch of an FFI in a country other than the FFI's country of residence. See instructions.)
11 Chapter 4 Status (FATCA status) of disregarded entity or branch receiving payment
Branch treated as nonparticipating FFI. Reporting Model 1 FFI. U.S. Branch.
Participating FFI. Reporting Model 2 FFI.
12 Address of disregarded entity or branch (street, apt. or suite no., or rural route). Do not use a P.O. box or in-care-of address (other than a
registered address).
City or town, state or province. Include postal code where appropriate.
Country
13 GIIN (if any)
Part III Claim of Tax Treaty Benefits (if applicable). (For chapter 3 purposes only.)
14 I certify that (check all that apply):
a The beneficial owner is a resident of within the meaning of the income tax
treaty between the United States and that country.
b The beneficial owner derives the item (or items) of income for which the treaty benefits are claimed, and, if applicable, meets the
requirements of the treaty provision dealing with limitation on benefits. The following are types of limitation on benefits provisions that may
be included in an applicable tax treaty (check only one; see instructions):
Government Company that meets the ownership and base erosion test
Tax exempt pension trust or pension fund Company that meets the derivative benefits test
Other tax exempt organization Company with an item of income that meets active trade or business test
Publicly traded corporation Favorable discretionary determination by the U.S. competent authority received
Subsidiary of a publicly traded corporation Other (specify Article and paragraph):
c The beneficial owner is claiming treaty benefits for U.S. source dividends received from a foreign corporation or interest from a U.S. trade
or business of a foreign corporation and meets qualified resident status (see instructions).
15 Special rates and conditions (if applicable—see instructions):
The beneficial owner is claiming the provisions of Article and paragraph
of the treaty identified on line 14a above to claim a % rate of withholding on (specify type of income):
Explain the additional conditions in the Article the beneficial owner meets to be eligible for the rate of withholding:
Part IV Sponsored FFI
16 Name of sponsoring entity:
17 Check whichever box applies.
I certify that the entity identified in Part I:
• Is an investment entity;
• Is not a QI, WP (except to the extent permitted in the withholding foreign partnership agreement), or WT; and
• Has agreed with the entity identified above (that is not a nonparticipating FFI) to act as the sponsoring entity for this entity.
I certify that the entity identified in Part I:
• Is a controlled foreign corporation as defined in section 957(a);
• Is not a QI, WP, or WT;
• Is wholly owned, directly or indirectly, by the U.S. financial institution identified above that agrees to act as the sponsoring entity for this entity; and
• Shares a common electronic account system with the sponsoring entity (identified above) that enables the sponsoring entity to identify all
account holders and payees of the entity and to access all account and customer information maintained by the entity including, but not
limited to, customer identification information, customer documentation, account balance, and all payments made to account holders or
payees.
Form W-8BEN-E (Rev. 7-2017)
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Form W-8BEN-E (Rev. 7-2017) Page 3
Part V Certified Deemed-Compliant Nonregistering Local Bank
18 I certify that the FFI identified in Part I:
• Operates and is licensed solely as a bank or credit union (or similar cooperative credit organization operated without profit) in its country of
incorporation or organization;
• Engages primarily in the business of receiving deposits from and making loans to, with respect to a bank, retail customers unrelated to such
bank and, with respect to a credit union or similar cooperative credit organization, members, provided that no member has a greater than 5%
interest in such credit union or cooperative credit organization;
• Does not solicit account holders outside its country of organization;
• Has no fixed place of business outside such country (for this purpose, a fixed place of business does not include a location that is not
advertised to the public and from which the FFI performs solely administrative support functions);
• Has no more than $175 million in assets on its balance sheet and, if it is a member of an expanded affiliated group, the group has no more
than $500 million in total assets on its consolidated or combined balance sheets; and
• Does not have any member of its expanded affiliated group that is a foreign financial institution, other than a foreign financial institution that
is incorporated or organized in the same country as the FFI identified in Part I and that meets the requirements set forth in this part.
Part VI Certified Deemed-Compliant FFI with Only Low-Value Accounts
19 I certify that the FFI identified in Part I:
• Is not engaged primarily in the business of investing, reinvesting, or trading in securities, partnership interests, commodities, notional
principal contracts, insurance or annuity contracts, or any interest (including a futures or forward contract or option) in such security,
partnership interest, commodity, notional principal contract, insurance contract or annuity contract;
• No financial account maintained by the FFI or any member of its expanded affiliated group, if any, has a balance or value in excess of
$50,000 (as determined after applying applicable account aggregation rules); and
• Neither the FFI nor the entire expanded affiliated group, if any, of the FFI, have more than $50 million in assets on its consolidated or
combined balance sheet as of the end of its most recent accounting year.
Part VII Certified Deemed-Compliant Sponsored, Closely Held Investment Vehicle
20 Name of sponsoring entity:
21 I certify that the entity identified in Part I:
• Is an FFI solely because it is an investment entity described in Regulations section 1.1471-5(e)(4);
• Is not a QI, WP, or WT;
• Will have all of its due diligence, withholding, and reporting responsibilities (determined as if the FFI were a participating FFI) fulfilled by the
sponsoring entity identified on line 20; and
• 20 or fewer individuals own all of the debt and equity interests in the entity (disregarding debt interests owned by U.S. financial institutions,
participating FFIs, registered deemed-compliant FFIs, and certified deemed-compliant FFIs and equity interests owned by an entity if that
entity owns 100% of the equity interests in the FFI and is itself a sponsored FFI).
Part VIII Certified Deemed-Compliant Limited Life Debt Investment Entity
22 I certify that the entity identified in Part I:
• Was in existence as of January 17, 2013;
• Issued all classes of its debt or equity interests to investors on or before January 17, 2013, pursuant to a trust indenture or similar agreement; and
• Is certified deemed-compliant because it satisfies the requirements to be treated as a limited life debt investment entity (such as the
restrictions with respect to its assets and other requirements under Regulations section 1.1471-5(f)(2)(iv)).
Part IX Certain Investment Entities that Do Not Maintain Financial Accounts
23 I certify that the entity identified in Part I:
• Is a financial institution solely because it is an investment entity described in Regulations section 1.1471-5(e)(4)(i)(A), and
• Does not maintain financial accounts.
Part X Owner-Documented FFI
Note: This status only applies if the U.S. financial institution, participating FFI, or reporting Model 1 FFI to which this form is given has agreed that it will
treat the FFI as an owner-documented FFI (see instructions for eligibility requirements). In addition, the FFI must make the certifications below.
24a (All owner-documented FFIs check here) I certify that the FFI identified in Part I:
• Does not act as an intermediary;
• Does not accept deposits in the ordinary course of a banking or similar business;
• Does not hold, as a substantial portion of its business, financial assets for the account of others;
• Is not an insurance company (or the holding company of an insurance company) that issues or is obligated to make payments with respect to
a financial account;
• Is not owned by or in an expanded affiliated group with an entity that accepts deposits in the ordinary course of a banking or similar
business, holds, as a substantial portion of its business, financial assets for the account of others, or is an insurance company (or the holding
company of an insurance company) that issues or is obligated to make payments with respect to a financial account;
• Does not maintain a financial account for any nonparticipating FFI; and
• Does not have any specified U.S. persons that own an equity interest or debt interest (other than a debt interest that is not a financial
account or that has a balance or value not exceeding $50,000) in the FFI other than those identified on the FFI owner reporting statement.
Form W-8BEN-E (Rev. 7-2017)
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Form W-8BEN-E (Rev. 7-2017) Page 4
Part X Owner-Documented FFI (continued)
Check box 24b or 24c, whichever applies.
b I certify that the FFI identified in Part I:
• Has provided, or will provide, an FFI owner reporting statement that contains:
(i) The name, address, TIN (if any), chapter 4 status, and type of documentation provided (if required) of every individual and specified
U.S. person that owns a direct or indirect equity interest in the owner-documented FFI (looking through all entities other than specified
U.S. persons);
(ii) The name, address, TIN (if any), and chapter 4 status of every individual and specified U.S. person that owns a debt interest in the
owner-documented FFI (including any indirect debt interest, which includes debt interests in any entity that directly or indirectly owns
the payee or any direct or indirect equity interest in a debt holder of the payee) that constitutes a financial account in excess of
$50,000 (disregarding all such debt interests owned by participating FFIs, registered deemed-compliant FFIs, certified deemed-
compliant FFIs, excepted NFFEs, exempt beneficial owners, or U.S. persons other than specified U.S. persons); and
(iii) Any additional information the withholding agent requests in order to fulfill its obligations with respect to the entity.
• Has provided, or will provide, valid documentation meeting the requirements of Regulations section 1.1471-3(d)(6)(iii) for each person
identified in the FFI owner reporting statement.
c I certify that the FFI identified in Part I has provided, or will provide, an auditor's letter, signed within 4 years of the date of payment,
from an independent accounting firm or legal representative with a location in the United States stating that the firm or representative has
reviewed the FFI's documentation with respect to all of its owners and debt holders identified in Regulations section 1.1471-3(d)(6)(iv)(A)(2),
and that the FFI meets all the requirements to be an owner-documented FFI. The FFI identified in Part I has also provided, or will provide,
an FFI owner reporting statement of its owners that are specified U.S. persons and Form(s) W-9, with applicable waivers.
Check box 24d if applicable (optional, see instructions).
d I certify that the entity identified on line 1 is a trust that does not have any contingent beneficiaries or designated classes with unidentified
beneficiaries.
Part XI Restricted Distributor
25a (All restricted distributors check here) I certify that the entity identified in Part I:
• Operates as a distributor with respect to debt or equity interests of the restricted fund with respect to which this form is furnished;
• Provides investment services to at least 30 customers unrelated to each other and less than half of its customers are related to each other;
• Is required to perform AML due diligence procedures under the anti-money laundering laws of its country of organization (which is an FATF-
compliant jurisdiction);
• Operates solely in its country of incorporation or organization, has no fixed place of business outside of that country, and has the same
country of incorporation or organization as all members of its affiliated group, if any;
• Does not solicit customers outside its country of incorporation or organization;
• Has no more than $175 million in total assets under management and no more than $7 million in gross revenue on its income statement for
the most recent accounting year;
• Is not a member of an expanded affiliated group that has more than $500 million in total assets under management or more than $20 million
in gross revenue for its most recent accounting year on a combined or consolidated income statement; and
• Does not distribute any debt or securities of the restricted fund to specified U.S. persons, passive NFFEs with one or more substantial U.S.
owners, or nonparticipating FFIs.
Check box 25b or 25c, whichever applies.
I further certify that with respect to all sales of debt or equity interests in the restricted fund with respect to which this form is furnished that are made
after December 31, 2011, the entity identified in Part I:
b Has been bound by a distribution agreement that contained a general prohibition on the sale of debt or securities to U.S. entities and U.S.
resident individuals and is currently bound by a distribution agreement that contains a prohibition of the sale of debt or securities to any
specified U.S. person, passive NFFE with one or more substantial U.S. owners, or nonparticipating FFI.
c Is currently bound by a distribution agreement that contains a prohibition on the sale of debt or securities to any specified U.S. person,
passive NFFE with one or more substantial U.S. owners, or nonparticipating FFI and, for all sales made prior to the time that such a
restriction was included in its distribution agreement, has reviewed all accounts related to such sales in accordance with the procedures
identified in Regulations section 1.1471-4(c) applicable to preexisting accounts and has redeemed or retired any, or caused the restricted
fund to transfer the securities to a distributor that is a participating FFI or reporting Model 1 FFI securities which were sold to specified U.S.
persons, passive NFFEs with one or more substantial U.S. owners, or nonparticipating FFIs.
Form W-8BEN-E (Rev. 7-2017)
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Form W-8BEN-E (Rev. 7-2017) Page 5
Part XII Nonreporting IGA FFI
26 I certify that the entity identified in Part I:
• Meets the requirements to be considered a nonreporting financial institution pursuant to an applicable IGA between the United States and
. The applicable IGA is a Model 1 IGA or a Model 2 IGA; and
is treated as a under the provisions of the applicable IGA or Treasury regulations
(if applicable, see instructions);
• If you are a trustee documented trust or a sponsored entity, provide the name of the trustee or sponsor .
The trustee is: U.S. Foreign
Part XIII Foreign Government, Government of a U.S. Possession, or Foreign Central Bank of Issue
27 I certify that the entity identified in Part I is the beneficial owner of the payment, and is not engaged in commercial financial activities of a
type engaged in by an insurance company, custodial institution, or depository institution with respect to the payments, accounts, or
obligations for which this form is submitted (except as permitted in Regulations section 1.1471-6(h)(2)).
Part XIV International Organization
Check box 28a or 28b, whichever applies.
28a I certify that the entity identified in Part I is an international organization described in section 7701(a)(18).
b I certify that the entity identified in Part I:
• Is comprised primarily of foreign governments;
• Is recognized as an intergovernmental or supranational organization under a foreign law similar to the International Organizations Immunities
Act or that has in effect a headquarters agreement with a foreign government;
• The benefit of the entity's income does not inure to any private person; and
• Is the beneficial owner of the payment and is not engaged in commercial financial activities of a type engaged in by an insurance company,
custodial institution, or depository institution with respect to the payments, accounts, or obligations for which this form is submitted (except as
permitted in Regulations section 1.1471-6(h)(2)).
Part XV Exempt Retirement Plans
Check box 29a, b, c, d, e, or f, whichever applies.
29a I certify that the entity identified in Part I:
• Is established in a country with which the United States has an income tax treaty in force (see Part III if claiming treaty benefits);
• Is operated principally to administer or provide pension or retirement benefits; and
• Is entitled to treaty benefits on income that the fund derives from U.S. sources (or would be entitled to benefits if it derived any such income)
as a resident of the other country which satisfies any applicable limitation on benefits requirement.
b I certify that the entity identified in Part I:
• Is organized for the provision of retirement, disability, or death benefits (or any combination thereof) to beneficiaries that are former
employees of one or more employers in consideration for services rendered;
• No single beneficiary has a right to more than 5% of the FFI's assets;
• Is subject to government regulation and provides annual information reporting about its beneficiaries to the relevant tax authorities in the
country in which the fund is established or operated; and
(i) Is generally exempt from tax on investment income under the laws of the country in which it is established or operates due to its status
as a retirement or pension plan;
(ii) Receives at least 50% of its total contributions from sponsoring employers (disregarding transfers of assets from other plans described
in this part, retirement and pension accounts described in an applicable Model 1 or Model 2 IGA, other retirement funds described in
an applicable Model 1 or Model 2 IGA, or accounts described in Regulations section 1.1471-5(b)(2)(i)(A));
(iii) Either does not permit or penalizes distributions or withdrawals made before the occurrence of specified events related to retirement,
disability, or death (except rollover distributions to accounts described in Regulations section 1.1471-5(b)(2)(i)(A) (referring to retirement
and pension accounts), to retirement and pension accounts described in an applicable Model 1 or Model 2 IGA, or to other retirement
funds described in this part or in an applicable Model 1 or Model 2 IGA); or
(iv) Limits contributions by employees to the fund by reference to earned income of the employee or may not exceed $50,000 annually.
c I certify that the entity identified in Part I:
• Is organized for the provision of retirement, disability, or death benefits (or any combination thereof) to beneficiaries that are former
employees of one or more employers in consideration for services rendered;
• Has fewer than 50 participants;
• Is sponsored by one or more employers each of which is not an investment entity or passive NFFE;
• Employee and employer contributions to the fund (disregarding transfers of assets from other plans described in this part, retirement and
pension accounts described in an applicable Model 1 or Model 2 IGA, or accounts described in Regulations section 1.1471-5(b)(2)(i)(A)) are
limited by reference to earned income and compensation of the employee, respectively;
• Participants that are not residents of the country in which the fund is established or operated are not entitled to more than 20% of the fund's assets; and
• Is subject to government regulation and provides annual information reporting about its beneficiaries to the relevant tax authorities in the
country in which the fund is established or operates.
Form W-8BEN-E (Rev. 7-2017)
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Form W-8BEN-E (Rev. 7-2017) Page 6
Part XV Exempt Retirement Plans (continued)
d I certify that the entity identified in Part I is formed pursuant to a pension plan that would meet the requirements of section 401(a), other
than the requirement that the plan be funded by a trust created or organized in the United States.
e I certify that the entity identified in Part I is established exclusively to earn income for the benefit of one or more retirement funds
described in this part or in an applicable Model 1 or Model 2 IGA, or accounts described in Regulations section 1.1471-5(b)(2)(i)(A) (referring to
retirement and pension accounts), or retirement and pension accounts described in an applicable Model 1 or Model 2 IGA.
f I certify that the entity identified in Part I:
• Is established and sponsored by a foreign government, international organization, central bank of issue, or government of a U.S. possession
(each as defined in Regulations section 1.1471-6) or an exempt beneficial owner described in an applicable Model 1 or Model 2 IGA to provide
retirement, disability, or death benefits to beneficiaries or participants that are current or former employees of the sponsor (or persons
designated by such employees); or
• Is established and sponsored by a foreign government, international organization, central bank of issue, or government of a U.S. possession
(each as defined in Regulations section 1.1471-6) or an exempt beneficial owner described in an applicable Model 1 or Model 2 IGA to provide
retirement, disability, or death benefits to beneficiaries or participants that are not current or former employees of such sponsor, but are in
consideration of personal services performed for the sponsor.
Part XVI Entity Wholly Owned by Exempt Beneficial Owners
30 I certify that the entity identified in Part I:
• Is an FFI solely because it is an investment entity;
• Each direct holder of an equity interest in the investment entity is an exempt beneficial owner described in Regulations section 1.1471-6 or in
an applicable Model 1 or Model 2 IGA;
• Each direct holder of a debt interest in the investment entity is either a depository institution (with respect to a loan made to such entity) or an
exempt beneficial owner described in Regulations section 1.1471-6 or an applicable Model 1 or Model 2 IGA.
• Has provided an owner reporting statement that contains the name, address, TIN (if any), chapter 4 status, and a description of the type of
documentation provided to the withholding agent for every person that owns a debt interest constituting a financial account or direct equity
interest in the entity; and
• Has provided documentation establishing that every owner of the entity is an entity described in Regulations section 1.1471-6(b), (c), (d), (e),
(f) and/or (g) without regard to whether such owners are beneficial owners.
Part XVII Territory Financial Institution
31 I certify that the entity identified in Part I is a financial institution (other than an investment entity) that is incorporated or organized under
the laws of a possession of the United States.
Part XVIII Excepted Nonfinancial Group Entity
32 I certify that the entity identified in Part I:
• Is a holding company, treasury center, or captive finance company and substantially all of the entity's activities are functions described in
Regulations section 1.1471-5(e)(5)(i)(C) through (E);
• Is a member of a nonfinancial group described in Regulations section 1.1471-5(e)(5)(i)(B);
• Is not a depository or custodial institution (other than for members of the entity's expanded affiliated group); and
• Does not function (or hold itself out) as an investment fund, such as a private equity fund, venture capital fund, leveraged buyout fund, or any
investment vehicle with an investment strategy to acquire or fund companies and then hold interests in those companies as capital assets for
investment purposes.
Part XIX Excepted Nonfinancial Start-Up Company
33 I certify that the entity identified in Part I:
• Was formed on (or, in the case of a new line of business, the date of board resolution approving the new line of business)
(date must be less than 24 months prior to date of payment);
• Is not yet operating a business and has no prior operating history or is investing capital in assets with the intent to operate a new line of
business other than that of a financial institution or passive NFFE;
• Is investing capital into assets with the intent to operate a business other than that of a financial institution; and
• Does not function (or hold itself out) as an investment fund, such as a private equity fund, venture capital fund, leveraged buyout fund, or any
investment vehicle whose purpose is to acquire or fund companies and then hold interests in those companies as capital assets for investment purposes.
Part XX Excepted Nonfinancial Entity in Liquidation or Bankruptcy
34 I certify that the entity identified in Part I:
• Filed a plan of liquidation, filed a plan of reorganization, or filed for bankruptcy on ;
• During the past 5 years has not been engaged in business as a financial institution or acted as a passive NFFE;
• Is either liquidating or emerging from a reorganization or bankruptcy with the intent to continue or recommence operations as a nonfinancial
entity; and
• Has, or will provide, documentary evidence such as a bankruptcy filing or other public documentation that supports its claim if it remains in
bankruptcy or liquidation for more than 3 years.
Form W-8BEN-E (Rev. 7-2017)
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Form W-8BEN-E (Rev. 7-2017) Page 7
Part XXI 501(c) Organization
35 I certify that the entity identified in Part I is a 501(c) organization that:
• Has been issued a determination letter from the IRS that is currently in effect concluding that the payee is a section 501(c) organization that is
dated ; or
• Has provided a copy of an opinion from U.S. counsel certifying that the payee is a section 501(c) organization (without regard to whether the
payee is a foreign private foundation).
Part XXII Nonprofit Organization
36 I certify that the entity identified in Part I is a nonprofit organization that meets the following requirements.
• The entity is established and maintained in its country of residence exclusively for religious, charitable, scientific, artistic, cultural or educational purposes;
• The entity is exempt from income tax in its country of residence;
• The entity has no shareholders or members who have a proprietary or beneficial interest in its income or assets;
• Neither the applicable laws of the entity's country of residence nor the entity's formation documents permit any income or assets of the entity
to be distributed to, or applied for the benefit of, a private person or noncharitable entity other than pursuant to the conduct of the entity's
charitable activities or as payment of reasonable compensation for services rendered or payment representing the fair market value of property
which the entity has purchased; and
• The applicable laws of the entity's country of residence or the entity's formation documents require that, upon the entity's liquidation or
dissolution, all of its assets be distributed to an entity that is a foreign government, an integral part of a foreign government, a controlled entity
of a foreign government, or another organization that is described in this part or escheats to the government of the entity's country of
residence or any political subdivision thereof.
Part XXIII Publicly Traded NFFE or NFFE Affiliate of a Publicly Traded Corporation
Check box 37a or 37b, whichever applies.
37a I certify that:
• The entity identified in Part I is a foreign corporation that is not a financial institution; and
• The stock of such corporation is regularly traded on one or more established securities markets, including
(name one securities exchange upon which the stock is regularly traded).
b I certify that:
• The entity identified in Part I is a foreign corporation that is not a financial institution;
• The entity identified in Part I is a member of the same expanded affiliated group as an entity the stock of which is regularly traded on an
established securities market;
• The name of the entity, the stock of which is regularly traded on an established securities market, is ; and
• The name of the securities market on which the stock is regularly traded is .
Part XXIV Excepted Territory NFFE
38 I certify that:
• The entity identified in Part I is an entity that is organized in a possession of the United States;
• The entity identified in Part I:
(i) Does not accept deposits in the ordinary course of a banking or similar business;
(ii) Does not hold, as a substantial portion of its business, financial assets for the account of others; or
(iii) Is not an insurance company (or the holding company of an insurance company) that issues or is obligated to make payments with
respect to a financial account; and
• All of the owners of the entity identified in Part I are bona fide residents of the possession in which the NFFE is organized or incorporated.
Part XXV Active NFFE
39 I certify that:
• The entity identified in Part I is a foreign entity that is not a financial institution;
• Less than 50% of such entity's gross income for the preceding calendar year is passive income; and
• Less than 50% of the assets held by such entity are assets that produce or are held for the production of passive income (calculated as a
weighted average of the percentage of passive assets measured quarterly) (see instructions for the definition of passive income).
Part XXVI Passive NFFE
40a I certify that the entity identified in Part I is a foreign entity that is not a financial institution (other than an investment entity organized in a
possession of the United States) and is not certifying its status as a publicly traded NFFE (or affiliate), excepted territory NFFE, active
NFFE, direct reporting NFFE, or sponsored direct reporting NFFE.
Check box 40b or 40c, whichever applies.
b I further certify that the entity identified in Part I has no substantial U.S. owners (or, if applicable, no controlling U.S. persons); or
c I further certify that the entity identified in Part I has provided the name, address, and TIN of each substantial U.S. owner (or, if applicable,
controlling U.S. person) of the NFFE in Part XXIX.
Form W-8BEN-E (Rev. 7-2017)
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Form W-8BEN-E (Rev. 7-2017) Page 8
Part XXVII Excepted Inter-Affiliate FFI
41 I certify that the entity identified in Part I:
• Is a member of an expanded affiliated group;
• Does not maintain financial accounts (other than accounts maintained for members of its expanded affiliated group);
• Does not make withholdable payments to any person other than to members of its expanded affiliated group;
• Does not hold an account (other than depository accounts in the country in which the entity is operating to pay for expenses) with or receive
payments from any withholding agent other than a member of its expanded affiliated group; and
• Has not agreed to report under Regulations section 1.1471-4(d)(2)(ii)(C) or otherwise act as an agent for chapter 4 purposes on behalf of any financial
institution, including a member of its expanded affiliated group.
Part XXVIII Sponsored Direct Reporting NFFE (see instructions for when this is permitted)
42 Name of sponsoring entity:
43 I certify that the entity identified in Part I is a direct reporting NFFE that is sponsored by the entity identified on line 42.
Part XXIX Substantial U.S. Owners of Passive NFFE
As required by Part XXVI, provide the name, address, and TIN of each substantial U.S. owner of the NFFE. Please see the instructions for a definition of
substantial U.S. owner. If providing the form to an FFI treated as a reporting Model 1 FFI or reporting Model 2 FFI, an NFFE may also use this part for
reporting its controlling U.S. persons under an applicable IGA.
Name Address TIN
Part XXX Certification
Under penalties of perjury, I declare that I have examined the information on this form and to the best of my knowledge and belief it is true, correct, and complete. I further
certify under penalties of perjury that:
• The entity identified on line 1 of this form is the beneficial owner of all the income to which this form relates, is using this form to certify its status for chapter 4
purposes, or is a merchant submitting this form for purposes of section 6050W;
• The entity identified on line 1 of this form is not a U.S. person;
• The income to which this form relates is: (a) not effectively connected with the conduct of a trade or business in the United States, (b) effectively connected but is
not subject to tax under an income tax treaty, or (c) the partner's share of a partnership's effectively connected income; and
• For broker transactions or barter exchanges, the beneficial owner is an exempt foreign person as defined in the instructions.
Furthermore, I authorize this form to be provided to any withholding agent that has control, receipt, or custody of the income of which the entity on line 1 is the beneficial
owner or any withholding agent that can disburse or make payments of the income of which the entity on line 1 is the beneficial owner.
I agree that I will submit a new form within 30 days if any certification on this form becomes incorrect.
▲
Sign Here
Signature of individual authorized to sign for beneficial owner Print Name Date (MM-DD-YYYY)
I certify that I have the capacity to sign for the entity identified on line 1 of this form.
Form W-8BEN-E (Rev. 7-2017)
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Certificate of Foreign Government or Other Foreign
Form W-8EXP Organization for United States Tax
(Rev. July 2017)
Withholding and Reporting
(For use by foreign governments, international organizations, foreign central banks of issue, foreign OMB No. 1545-1621
tax-exempt organizations, foreign private foundations, and governments of U.S. possessions.)
a Go to www.irs.gov/FormW8EXP for instructions and the latest information.
Department of the Treasury a Section references are to the Internal Revenue Code.
Internal Revenue Service a Give this form to the withholding agent or payer. Do not send to the IRS.
Do not use this form for: Instead, use Form:
• A foreign government or other foreign organization that is not claiming the applicability of section(s) 115(2), 501(c), 892, 895,
or 1443(b) .................................. W-8BEN-E or W-8ECI
• A beneficial owner solely claiming foreign status or treaty benefits ................. W-8BEN or W-8BEN-E
• A foreign partnership or a foreign trust ......................... W-8BEN-E or W-8IMY
• A person claiming that income is effectively connected with the conduct of a trade or business in the United States ...... W-8ECI
• A person acting as an intermediary .............................. W-8IMY
Part I Identification of Beneficial Owner
1 Name of organization 2 Country of incorporation or organization
3 Type of Foreign government Foreign tax-exempt organization
entity International organization Foreign private foundation
Foreign central bank of issue (not wholly Government of a U.S. possession
owned by the foreign sovereign)
4 Chapter 4 Status (FATCA status):
Participating FFI. Foreign government (including a political subdivision),
Reporting Model 1 FFI. government of a U.S. possession, or foreign central bank of
Reporting Model 2 FFI. issue. Complete Part III.
Registered deemed-compliant FFI Exempt retirement plan of foreign government. Complete Part III.
(other than a Reporting Model 1 FFI). 501(c) organization. Complete Part III.
Nonreporting IGA FFI. Complete Part III. Passive NFFE. Complete Part III.
Territory financial institution. Complete Part III. Direct reporting NFFE.
International organization. Sponsored direct reporting NFFE. Complete Part III.
5 Permanent address (street, apt. or suite no., or rural route). Do not use a P.O. box or in-care-of address (other than a registered address).
City or town, state or province. Include postal code where appropriate. Country
6 Mailing address (if different from above).
City or town, state or province. Include postal or ZIP code where appropriate. Country
7 U.S. TIN, if required (see instructions) 8a GIIN b Foreign TIN (see instructions)
9 Reference number(s) (see instructions)
Part II Qualification Statement for Chapter 3 Status
10 For a foreign government:
a I certify that the entity identified in Part I is a foreign government within the meaning of section 892 and the payments are
within the scope of the exemption granted by section 892.
Check box 10b or box 10c, whichever applies.
b The entity identified in Part I is an integral part of the government of .
c The entity identified in Part I is a controlled entity of the government of .
11 For an international organization:
I certify that:
• The entity identified in Part I is an international organization within the meaning of section 7701(a)(18), and
• The payments are within the scope of the exemption granted by section 892.
12 For a foreign central bank of issue (not wholly owned by the foreign sovereign):
I certify that:
• The entity identified in Part I is a foreign central bank of issue,
• The entity identified in Part I does not hold obligations or bank deposits to which this form relates for use in
connection with the conduct of a commercial banking function or other commercial activity, and
• The payments are within the scope of the exemption granted by section 895.
For Paperwork Reduction Act Notice, see separate instructions. Cat. No. 25401F Form W-8EXP (Rev. 7-2017)
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Form W-8EXP (Rev. 7-2017) Page 2
Part II Qualification Statement for Chapter 3 Status (continued)
13 For a foreign tax-exempt organization, including foreign private foundations:
If any of the income to which this certification relates constitutes income includible under section 512 in computing the
entity’s unrelated business taxable income, attach a statement identifying the amounts.
Check either box 13a or box 13b.
a I certify that the entity identified in Part I has been issued a determination letter by the IRS dated
that is currently in effect and that concludes that it is an exempt organization described in section 501(c).
b I have attached to this form an opinion from U.S. counsel concluding that the entity identified in Part I is described in
section 501(c).
For section 501(c)(3) organizations only, check either box 13c or box 13d.
c If the determination letter or opinion of counsel concludes that the entity identified in Part I is described in section 501(c)(3),
I certify that the organization is not a private foundation described in section 509. I have attached an affidavit of the
organization setting forth sufficient facts for the IRS to determine that the organization is not a private foundation because it
meets one of the exceptions described in section 509(a)(1), (2), (3), or (4).
d If the determination letter or opinion of counsel concludes that the entity identified in Part I is described in section 501(c)(3),
I certify that the organization is a private foundation described in section 509.
14 For a government of a U.S. possession:
I certify that the entity identified in Part I is a government of a possession of the United States, or is a political subdivision
thereof, and is claiming the exemption granted by section 115(2).
Part III Qualification Statement for Chapter 4 Status (if required)
15 For a nonreporting IGA FFI:
I certify that the entity identified in Part I:
• Meets the requirements to be considered a nonreporting financial institution pursuant to an applicable IGA between the United States
and ;
• Is treated as a under the provisions of the applicable IGA (see instructions); and
• If you are an FFI treated as a registered deemed-compliant FFI under an applicable Model 2 IGA, provide your GIIN:
a .
16 For a territory financial institution:
I certify that the entity identified in Part I is a financial institution (other than an investment entity) that is incorporated or
organized under the laws of a possession of the United States.
17 For a foreign government (including a political subdivision), government of a U.S. possession, or foreign central bank of issue:
I certify that the entity identified in Part I is the beneficial owner of the payment and is not engaged in commercial financial
activities of a type engaged in by an insurance company, custodial institution, or depository institution with respect to the
payments, accounts, or obligations for which this form is submitted (except as permitted in Regulations section 1.1471-6(h)(2)).
18 For an exempt retirement plan of a foreign government:
I certify that the entity identified in Part I:
• Is established and sponsored by a foreign government, international organization, central bank of issue, or government of a
U.S. possession (each as defined in Regulations section 1.1471-6 or an applicable Model 1 or Model 2 IGA) to provide
retirement, disability, or death benefits to beneficiaries or participants that are current or former employees of the sponsor (or
persons designated by such employees); or
• Is established and sponsored by a foreign government, international organization, central bank of issue, or government of a
U.S. possession (each as defined in Regulations section 1.1471-6 or an applicable Model 1 or Model 2 IGA) to provide
retirement, disability, or death benefits to beneficiaries or participants that are not current or former employees of such
sponsor, but are in consideration of personal services performed for the sponsor.
19 For a 501(c) organization:
I certify that the entity identified in Part I is an entity described in section 501(c) but is not an insurance company described
in section 501(c)(15).
20 For a passive NFFE:
a I certify that the entity identified in Part I is a foreign entity that is not a financial institution (other than an investment entity
organized in a possession of the United States).
Check box 20b or 20c, whichever applies.
b I further certify that the entity identified in Part I has no substantial U.S. owners, or
c I further certify that the entity identified in Part I has provided a statement including the name, address, and TIN of each
substantial U.S. owner of the NFFE (see instructions).
21 Name of sponsoring entity:
I certify that the entity identified in Part I is a direct reporting NFFE that is sponsored by the entity identified in line 21.
Form W-8EXP (Rev. 7-2017)
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Form W-8EXP (Rev. 7-2017) Page 3
Part IV Certification
Under penalties of perjury, I declare that I have examined the information on this form and to the best of my knowledge and
belief it is true, correct, and complete. I further certify under penalties of perjury that:
• The organization for which I am signing is the beneficial owner of the income and other payments to which this form relates,
• The beneficial owner is not a U.S. person,
• For a beneficial owner that is a controlled entity of a foreign sovereign (other than a central bank of issue wholly owned by a
foreign sovereign), the beneficial owner is not engaged in commercial activities within or outside the United States, and
• For a beneficial owner that is a central bank of issue wholly owned by a foreign sovereign, the beneficial owner is not
engaged in commercial activities within the United States.
Furthermore, I authorize this form to be provided to any withholding agent that has control, receipt, or custody of the payments
of which I am the beneficial owner or any withholding agent that can disburse or make payments of the amounts of which I am
the beneficial owner.
I agree that I will submit a new form within 30 days if any certification made on this form becomes incorrect.
Sign F
Here Signature of authorized official Print name Date (MM-DD-YYYY)
I certify that I have the capacity to sign for the entity identified on line 1 of this form.
Form W-8EXP (Rev. 7-2017)
Printed on recycled paper
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Certificate of Foreign Intermediary, Foreign Flow-Through Entity, or Certain
Form W-8IMY U.S. Branches for United States Tax Withholding and Reporting
(Rev. June 2017) a Section references are to the Internal Revenue Code. OMB No. 1545-1621
Department of the Treasury a Go to www.irs.gov/FormW8IMY for instructions and the latest information.
Internal Revenue Service a Give this form to the withholding agent or payer. Do not send to the IRS.
Do not use this form for: Instead, use Form:
• A beneficial owner solely claiming foreign status or treaty benefits (other than a qualified intermediary (QI) acting as a qualified
derivatives dealer (QDD)) . . ........................... W-8BEN or W-8BEN-E
• A hybrid entity claiming treaty benefits on its own behalf (other than a QI acting as a QDD) ............... W-8BEN-E
• A foreign person claiming that income is effectively connected with the conduct of a trade or business in the United States . . . . . W-8ECI
• A disregarded entity with a single foreign owner that is the beneficial owner (other than a QI acting as a QDD) of the income to which this form
relates. Instead, the single foreign owner should use . . .................W-8BEN, W-8ECI, or W-8BEN-E
• A foreign government, international organization, foreign central bank of issue, foreign tax-exempt organization, foreign private foundation, or
government of a U.S. possession claiming the applicability of section(s) 115(2), 501(c), 892, 895, or 1443(b) . . ........ W-8EXP
• U.S. entity or U.S. citizen or resident ................................ W-9
• A foreign person documenting itself for purposes of section 6050W .............. W-8BEN, W-8BEN-E, or W-8ECI
Part I Identification of Entity
1 Name of organization that is acting as intermediary 2 Country of incorporation or organization
3 Name of disregarded entity (if applicable), see instructions
4 Chapter 3 Status (entity type) (Must check one box only.):
QI (including a QDD). Complete Part III. Withholding foreign trust. Complete Part VII.
Nonqualified intermediary. Complete Part IV. Nonwithholding foreign partnership. Complete Part VIII.
Territory financial institution. Complete Part V. Nonwithholding foreign simple trust. Complete Part VIII.
U.S. branch. Complete Part VI. Nonwithholding foreign grantor trust. Complete Part VIII.
Withholding foreign partnership. Complete Part VII.
5 Chapter 4 Status (FATCA status) (See instructions for details and complete the certification below for the entity’s applicable status.)
(Must check one box only.): Certain investment entities that do not maintain financial
Nonparticipating foreign financial institution (FFI) (including an FFI accounts. Complete Part XVI.
related to a Reporting IGA FFI other than a deemed-compliant FFI,
participating FFI, or exempt beneficial owner). Complete Part IX (if Owner-documented FFI. Complete Part XI.
applicable). Restricted distributor. Complete Part XVII.
Participating FFI. Foreign central bank of issue. Complete Part XVIII.
Reporting Model 1 FFI. Nonreporting IGA FFI. Complete Part XIX.
Reporting Model 2 FFI. Exempt retirement plans. Complete Part XX.
Registered deemed-compliant FFI (other than a reporting Model 1 FFI, Excepted nonfinancial group entity. Complete Part XXI.
sponsored FFI, or nonreporting IGA FFI covered in Part XIX). Excepted nonfinancial start-up company. Complete Part XXII.
Territory financial institution. Complete Part V. Excepted nonfinancial entity in liquidation or bankruptcy.
Sponsored FFI (other than a certified deemed-compliant sponsored, Complete Part XXIII.
closely held investment vehicle). Complete Part X. Publicly traded NFFE or NFFE affiliate of a publicly traded
Certified deemed-compliant nonregistering local bank. Complete Part XII. corporation. Complete Part XXIV.
Certified deemed-compliant FFI with only low-value accounts. Complete Part XIII. Excepted territory NFFE. Complete Part XXV.
Certified deemed-compliant sponsored, closely held investment Active NFFE. Complete Part XXVI.
vehicle. Complete Part XIV.
Passive NFFE. Complete Part XXVII.
Certified deemed-compliant limited life debt investment entity.
Complete Part XV. Direct reporting NFFE.
Sponsored direct reporting NFFE. Complete Part XXVIII.
6 Permanent residence address (street, apt. or suite no., or rural route). Do not use a P.O. box or in-care-of address (other than a registered address).
City or town, state or province. Include postal code where appropriate. Country
7 Mailing address (if different from above)
City or town, state or province. Include postal code where appropriate. Country
8 U.S. taxpayer identification number, if required a
QI-EIN WP-EIN WT-EIN EIN
9 GIIN (if applicable)
10 Reference number(s) (see instructions)
For Paperwork Reduction Act Notice, see separate instructions. Cat. No. 25402Q Form W-8IMY (Rev. 6-2017)
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Form W-8IMY (Rev. 6-2017) Page 2
Part II Disregarded Entity or Branch Receiving Payment. (Complete only if a disregarded entity with a GIIN or a
branch of an FFI in a country other than the FFI’s country of residence. Do not complete Part II for QDD
branches. See instructions.)
11 Chapter 4 Status (FATCA status) of disregarded entity or branch receiving payment.
Branch treated as nonparticipating FFI. Reporting Model 1 FFI. U.S. Branch.
Participating FFI. Reporting Model 2 FFI.
12 Address of branch (street, apt. or suite no., or rural route). Do not use a P.O. box or in-care-of address (other than a registered address).
City or town, state or province. Include postal code where appropriate. Country
13 GIIN (if any) a
Chapter 3 Status Certifications
Part III Qualified Intermediary
All Qualified Intermediaries
14 I certify that the entity identified in Part I (or branch, if relevant):
• Is a QI with respect to the accounts identified on line 10 or in a withholding statement associated with this form (as required) that is one
or more of the following:
(i) not acting for its own account;
(ii) a QDD receiving payments on underlying securities and/or potential section 871(m) transactions;
(iii) a QI assuming primary withholding responsibility for payments of substitute interest, as permitted by the QI Agreement.
• Has provided or will provide a withholding statement (as required) for purposes of chapters 3 and 4 that is subject to the certifications
made on this form.
Qualified Intermediaries not Acting as Qualified Derivatives Dealers (check all that apply)
15a I certify that the entity identified in Part I of this form assumes primary withholding responsibility for purposes of chapters 3 and 4 for each
account identified on a withholding statement attached to this form (or, if no withholding statement is attached to this form, for all accounts).
b I certify that the entity identified in Part I of this form assumes primary Form 1099 reporting and backup withholding responsibility or
reporting responsibility as a participating FFI or registered deemed-compliant FFI with respect to accounts that it maintains that are held
by specified U.S. persons as permitted under Regulations sections 1.6049-4(c)(4)(i) or (c)(4)(ii) in lieu of Form 1099 reporting for each
account identified on a withholding statement attached to this form (or, if no withholding statement is attached to this form, for all
accounts).
c I certify that the entity identified in Part I of this form does not assume primary Form 1099 reporting and backup withholding responsibility.
d (Complete only to the extent the entity identified in Part I of this form does not assume primary Form 1099 reporting and backup
withholding responsibility.) If the entity identified in Part I of this form has allocated or will allocate a portion of a payment to a chapter 4
withholding rate pool of U.S. payees on a withholding statement associated with this form, I certify that the entity meets the requirements
of Regulations section 1.6049-4(c)(4)(iii) with respect to any account holder of an account it maintains that is included in such a withholding
rate pool.
e (Complete only to the extent the entity identified in Part I of this form does not assume primary Form 1099 reporting and backup
withholding responsibility.) If the entity identified in Part I of this form has allocated or will allocate a portion of a payment to a chapter 4
withholding rate pool of U.S. payees on a withholding statement associated with this form, to the extent the U.S. payees are account
holders of an intermediary or flow-through entity receiving a payment from the entity, I certify that the entity has obtained, or will obtain,
documentation sufficient to establish each such intermediary or flow-through entity status as a participating FFI, registered deemed-
compliant FFI, or FFI that is a QI.
f I certify that the entity identified in Part I of this form is acting as a qualified securities lender with respect to payments associated with this
form that are U.S. source substitute dividends received from the withholding agent.
g I certify that the entity identified in Part I of this form assumes primary withholding responsibility for purposes of chapters 3 and 4 and
primary Form 1099 reporting and backup withholding responsibility for all payments of substitute interest associated with this form, as
permitted by the QI Agreement.
Qualified Derivatives Dealers
16a I certify that each QDD identified in Part I of this form or on a withholding statement associated with this form meets the requirements to
act as a QDD and assumes primary withholding and reporting responsibilities under chapters 3, 4, and 61 and section 3406 with respect
to any payments it makes with respect to potential section 871(m) transactions.
b Entity classification of QDD:
Corporation Partnership Disregarded Entity
Form W-8IMY (Rev. 6-2017)
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Form W-8IMY (Rev. 6-2017) Page 3
Part IV Nonqualified Intermediary
Check all that apply.
17a (All nonqualified intermediaries and QIs that are not acting in their capacity as such check here.) I certify that the entity identified in Part I of
this form is not acting as a qualified intermediary with respect to each account(s) for which this form is provided and is not acting for its
own account.
b I certify that the entity identified in Part I of this form is using this form to transmit withholding certificates and/or other documentation and
has provided, or will provide, a withholding statement, as required.
c I certify that the entity identified in Part I of this form meets the requirements of Regulations section 1.6049-4(c)(4)(iii) with respect to any
account holder of an account it maintains that is included in a withholding rate pool of U.S. payees provided on a withholding statement
associated with this form.
d I certify that the entity identified in Part I of this form is acting as a qualified securities lender with respect to payments associated with this
form that are U.S. source substitute dividends received from the withholding agent.
Part V Territory Financial Institution
18a I certify that the entity identified in Part I is a financial institution (other than an investment entity that is not also a depository institution,
custodial institution, or specified insurance company) that is incorporated or organized under the laws of a possession of the United States.
Check box 18b or 18c, whichever applies.
b I further certify that the entity identified in Part I is using this form as evidence of its agreement with the withholding agent to be treated as
a U.S. person for purposes of chapters 3 and 4 with respect to any payments associated with this withholding certificate.
c I further certify that the entity identified in Part I:
• Is using this form to transmit withholding certificates and/or other documentation for the persons for whom it receives a payment; and
• Has provided or will provide a withholding statement, as required.
Part VI Certain U.S. Branches
19a I certify that the entity identified in Part I is receiving payments that are not effectively connected with the conduct of a trade or business in
the United States.
Check box 19b or 19c, whichever applies.
b I certify that the entity identified in Part I is a U.S. branch of a foreign bank or insurance company described in Regulations
section 1.1441-1(b)(2)(iv)(A) that is using this form as evidence of its agreement with the withholding agent to be treated as a U.S. person
with respect to any payments associated with this withholding certificate.
c I certify that the entity identified in Part I:
• Is using this form to transmit withholding certificates and/or other documentation for the persons for whom the branch receives a
payment;
• Has provided or will provide a withholding statement, as required; and
• In the case of a withholdable payment, is applying the rules described in Regulations section 1.1471-4(d)(2)(iii)(C).
Part VII Withholding Foreign Partnership (WP) or Withholding Foreign Trust (WT)
20 I certify that the entity identified in Part I is a withholding foreign partnership or a withholding foreign trust that is compliant with the terms
of its WP or WT agreement.
Part VIII Nonwithholding Foreign Partnership, Simple Trust, or Grantor Trust
Check all that apply.
21a I certify that the entity identified in Part I:
• Is a nonwithholding foreign partnership, a nonwithholding foreign simple trust, or a nonwithholding foreign grantor trust and is providing
this form for payments that are not effectively connected, or are not treated as effectively connected, with the conduct of a trade or
business in the United States; and
• Is using this form to transmit withholding certificates and/or other documentation and has provided or will provide a withholding
statement, as required for purposes of chapters 3 and 4, that is subject to the certifications made on this form.
b I certify that the entity identified in Part I is a foreign partnership that is a partner in a lower-tier partnership and is providing this Form
W-8IMY for purposes of section 1446.
Form W-8IMY (Rev. 6-2017)
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Form W-8IMY (Rev. 6-2017) Page 4
Chapter 4 Status Certifications
Part IX Nonparticipating FFI with Exempt Beneficial Owners
22 I certify that the entity identified in Part I is using this form to transmit withholding certificates and/or other documentation and has provided
or will provide a withholding statement that indicates the portion of the payment allocated to one or more exempt beneficial owners.
Part X Sponsored FFI
23a Name of sponsoring entity: a
Check box 23b or 23c, whichever applies.
b I certify that the entity identified in Part I:
• Is an investment entity;
• Is not a QI, WP (except to the extent permitted in the withholding foreign partnership agreement), or WT; and
• Has agreed with the entity identified above (that is not a nonparticipating FFI) to act as the sponsoring entity for this entity.
c I certify that the entity identified in Part I:
• Is a controlled foreign corporation as defined in section 957(a);
• Is not a QI, WP, or WT;
• Is wholly owned, directly or indirectly, by the U.S. financial institution identified above that agrees to act as the sponsoring entity for this
entity; and
• Shares a common electronic account system with the sponsoring entity (identified above) that enables the sponsoring entity to identify all
account holders and payees of the entity and to access all account and customer information maintained by the entity including, but not
limited to, customer identification information, customer documentation, account balance, and all payments made to account holders or
payees.
Part XI Owner-Documented FFI
Note: This status only applies if the U.S. financial institution, participating FFI, reporting Model 1 FFI, or reporting Model 2 FFI to which this form is
given has agreed that it will treat the FFI as an owner-documented FFI. The owner-documented FFI must make the certifications below.
24a I certify that the FFI identified in Part I:
• Does not act as an intermediary;
• Does not accept deposits in the ordinary course of a banking or similar business;
• Does not hold, as a substantial portion of its business, financial assets for the account of others;
• Is not an insurance company (or the holding company of an insurance company) that issues or is obligated to make payments with
respect to a financial account;
• Is not affiliated with an entity (other than an FFI that is also treated as an owner-documented FFI) that accepts deposits in the ordinary
course of a banking or similar business, holds, as a substantial portion of its business, financial assets for the account of others, or is an
insurance company (or the holding company of an insurance company) that issues or is obligated to make payments with respect to a
financial account; and
• Does not maintain a financial account for any nonparticipating FFI.
Check box 24b or 24c, whichever applies.
b I certify that the FFI identified in Part I:
• Has provided, or will provide, an FFI owner reporting statement (including any applicable owner documentation) that contains:
(i) The name, address, TIN (if any), chapter 4 status, and type of documentation provided (if required) of every individual and specified
U.S. person that owns a direct or indirect equity interest in the owner-documented FFI (looking through all entities other than
specified U.S. persons);
(ii) The name, address, TIN (if any), chapter 4 status, and type of documentation provided (if required) of every individual and specified
U.S. person that owns a debt interest in the owner-documented FFI (including any indirect debt interest, which includes debt interests
in any entity that directly or indirectly owns the payee or any direct or indirect equity interest in a debt holder of the payee) that
constitutes a financial account in excess of $50,000 (disregarding all such debt interests owned by participating FFIs, registered
deemed-compliant FFIs, certified deemed-compliant FFIs, excepted NFFEs, exempt beneficial owners, or U.S. persons other than
specified U.S. persons); and
(iii) Any additional information the withholding agent requests in order to fulfill its obligations with respect to the entity.
c I certify that the FFI identified in Part I:
• Has provided, or will provide, an auditor’s letter, signed no more than 4 years prior to the date of payment, from an independent
accounting firm or legal representative with a location in the United States stating that the firm or representative has reviewed the FFI’s
documentation with respect to all of its owners and debt holders identified in Regulations section 1.1471-3(d)(6)(iv)(A)(2) and that the FFI
meets all the requirements to be an owner-documented FFI. The FFI identified in Part I has also provided, or will provide, an FFI owner
reporting statement and Form W-9, with applicable waivers, as described in Regulations section 1.1471-3(d)(6)(iv).
Form W-8IMY (Rev. 6-2017)
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Part XII Certified Deemed-Compliant Nonregistering Local Bank
25 I certify that the FFI identified in Part I:
• Operates and is licensed solely as a bank or credit union (or similar cooperative credit organization operated without profit) in its country
of incorporation or organization;
• Engages primarily in the business of receiving deposits from and making loans to, with respect to a bank, retail customers unrelated to
such bank and, with respect to a credit union or similar cooperative credit organization, members, provided that no member has a greater
than 5% interest in such credit union or cooperative credit organization;
• Does not solicit account holders outside its country of organization;
• Has no fixed place of business outside such country (for this purpose, a fixed place of business does not include a location that is not
advertised to the public and from which the FFI performs solely administrative support functions);
• Has no more than $175 million in assets on its balance sheet and, if it is a member of an expanded affiliated group, the group has no
more than $500 million in total assets on its consolidated or combined balance sheets; and
• Does not have any member of its expanded affiliated group that is an FFI, other than an FFI that is incorporated or organized in the same
country as the FFI identified in Part I and that meets the requirements set forth in this Part XII.
Part XIII Certified Deemed-Compliant FFI With Only Low-Value Accounts
26 I certify that the FFI identified in Part I:
• Is not engaged primarily in the business of investing, reinvesting, or trading in securities, partnership interests, commodities, notional
principal contracts, insurance or annuity contracts, or any interest (including a futures or forward contract or option) in such security,
partnership interest, commodity, notional principal contract, insurance contract, or annuity contract;
• No financial account maintained by the FFI or any member of its expanded affiliated group, if any, has a balance or value in excess of
$50,000 (as determined after applying applicable account aggregation rules); and
• Neither the FFI nor the FFI’s entire expanded affiliated group, if any, has more than $50 million in assets on its consolidated or combined
balance sheet as of the end of its most recent accounting year.
Part XIV Certified Deemed-Compliant Sponsored, Closely Held Investment Vehicle
27a Name of sponsoring entity: a
b I certify that the FFI identified in Part I:
• Is an FFI solely because it is an investment entity described in Regulations section 1.1471-5(e)(4);
• Is not a QI, WP, or WT;
• Will have all of its due diligence, withholding, and reporting responsibilities (determined as if the FFI were a participating FFI) fulfilled by
the sponsoring entity identified on line 27a; and
• 20 or fewer individuals own all of the debt and equity interests in the entity (disregarding debt interests owned by U.S. financial
institutions, participating FFIs, registered deemed-compliant FFIs, and certified deemed-compliant FFIs and equity interests owned by an
entity that owns 100% of the equity interests in the FFI identified in Part I and is itself a sponsored FFI).
Part XV Certified Deemed-Compliant Limited Life Debt Investment Entity
28 I certify that the FFI identified in Part I:
• Was in existence as of January 17, 2013;
• Issued all classes of its debt or equity interests to investors on or before January 17, 2013, pursuant to a trust indenture or similar
agreement; and
• Is certified deemed-compliant because it satisfies the requirements to be treated as a limited life debt investment entity (such as the
restrictions with respect to its assets and other requirements under Regulations section 1.1471-5(f)(2)(iv)).
Part XVI Certain Investment Entities That Do Not Maintain Financial Accounts
29 I certify that the entity identified in Part I:
• Is a financial institution solely because it is an investment entity described in Regulations section 1.1471-5(e)(4)(i)(A); and
• Does not maintain financial accounts.
Part XVII Restricted Distributor
30a (All restricted distributors check here.) I certify that the entity identified in Part I:
• Operates as a distributor with respect to debt or equity interests of the restricted fund with respect to which this form is furnished;
• Provides investment services to at least 30 customers unrelated to each other and less than half of its customers are related to each
other;
• Is required to perform AML due diligence procedures under the anti-money laundering laws of its country of organization (which is a
FATF-compliant jurisdiction);
• Operates solely in its country of incorporation or organization, has no fixed place of business outside of that country, and has the same
country of incorporation or organization as all members of its affiliated group, if any;
• Does not solicit customers outside its country of incorporation or organization;
• Has no more than $175 million in total assets under management and no more than $7 million in gross revenue on its income statement
for the most recent accounting year;
• Is not a member of an expanded affiliated group that has more than $500 million in total assets under management or more than $20
million in gross revenue for its most recent accounting year on a combined or consolidated income statement; and
• Does not distribute any debt or securities of the restricted fund to specified U.S. persons, passive NFFEs with one or more substantial
U.S. owners, or nonparticipating FFIs.
Form W-8IMY (Rev. 6-2017)
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Form W-8IMY (Rev. 6-2017) Page 6
Part XVII Restricted Distributor (continued)
Check box 30b or 30c, whichever applies.
I further certify that with respect to all sales of debt or equity interests in the restricted fund with respect to which this form is furnished that are made
after December 31, 2011, the entity identified in Part I:
b Has been bound by a distribution agreement that contained a general prohibition on the sale of debt or securities to U.S. entities and U.S.
resident individuals and is currently bound by a distribution agreement that contains a prohibition of the sale of debt or securities to any
specified U.S. person, passive NFFE with one or more substantial U.S. owners, or nonparticipating FFI.
c Is currently bound by a distribution agreement that contains a prohibition on the sale of debt or securities to any specified U.S. person,
passive NFFE with one or more substantial U.S. owners, or nonparticipating FFI and, for all sales made prior to the time that such a
restriction was included in its distribution agreement, has reviewed all accounts related to such sales in accordance with the procedures
identified in Regulations section 1.1471-4(c) applicable to preexisting accounts and has redeemed or retired any securities which were sold
to specified U.S. persons, passive NFFEs with one or more substantial U.S. owners, or nonparticipating FFIs, or will transfer the securities
to a distributor that is a participating FFI, reporting Model 1 FFI, or reporting Model 2 FFI.
Part XVIII Foreign Central Bank of Issue
31 I certify that the entity identified in Part I is treated as the beneficial owner of the payment solely for purposes of chapter 4 under
Regulations section 1.1471-6(d)(4).
Part XIX Nonreporting IGA FFI
32 I certify that the entity identified in Part I:
• Meets the requirements to be considered a nonreporting financial institution pursuant to an applicable IGA between the United States and
. The
applicable IGA is a Model 1 IGA or a Model 2 IGA; and is treated as a
under the provisions of the applicable IGA or Treasury regulations (if applicable, see instructions); and
• If you are a trustee documented trust or sponsored entity, provide the name of the trustee or sponsor
The trustee is: U.S. Foreign
Part XX Exempt Retirement Plans
Check box 33a, b, c, d, e, or f, whichever applies.
33a I certify that the entity identified in Part I:
• Is established in a country with which the United States has an income tax treaty in force;
• Is operated principally to administer or provide pension or retirement benefits; and
• Is entitled to treaty benefits on income that the fund derives from U.S. sources (or would be entitled to benefits if it derived any such
income) as a resident of the other country which satisfies any applicable limitation on benefits requirement.
b I certify that the entity identified in Part I:
• Is organized for the provision of retirement, disability, or death benefits (or any combination thereof) to beneficiaries that are former
employees of one or more employers in consideration for services rendered;
• No single beneficiary has a right to more than 5% of the FFI’s assets;
• Is subject to government regulation and provides annual information reporting about its beneficiaries to the relevant tax authorities in the
country in which the fund is established or operated; and
(i) Is generally exempt from tax on investment income under the laws of the country in which it is established or operates due to its
status as a retirement or pension plan;
(ii) Receives at least 50% of its total contributions from sponsoring employers (disregarding transfers of assets from other plans
described in this part, retirement and pension accounts described in an applicable Model 1 or Model 2 IGA, other retirement funds
described in an applicable Model 1 or Model 2 IGA, or accounts described in Regulations section 1.1471-5(b)(2)(i)(A));
(iii) Either does not permit or penalizes distributions or withdrawals made before the occurrence of specified events related to
retirement, disability, or death (except rollover distributions to accounts described in Regulations section 1.1471-5(b)(2)(i)(A)
(referring to retirement and pension accounts), to retirement and pension accounts described in an applicable Model 1 or Model 2
IGA, or to other retirement funds described in this part or in an applicable Model 1 or Model 2 IGA); or
(iv) Limits contributions by employees to the fund by reference to earned income of the employee or may not exceed $50,000 annually.
c I certify that the entity identified in Part I:
• Is organized for the provision of retirement, disability, or death benefits (or any combination thereof) to beneficiaries that are former
employees of one or more employers in consideration for services rendered;
• Has fewer than 50 participants;
• Is sponsored by one or more employers, each of which is not an investment entity or passive NFFE;
• Employee and employer contributions to the fund (disregarding transfers of assets from other plans described in this part, retirement and
pension accounts described in an applicable Model 1 or Model 2 IGA, or accounts described in Regulations section 1.1471-5(b)(2)(i)(A)) are
limited by reference to earned income and compensation of the employee, respectively;
• Participants that are not residents of the country in which the fund is established or operated are not entitled to more than 20% of the
fund’s assets; and
• Is subject to government regulation and provides annual information reporting about its beneficiaries to the relevant tax authorities in the
country in which the fund is established or operates.
d I certify that the entity identified in Part I is formed pursuant to a pension plan that would meet the requirements of section 401(a), other
than the requirement that the plan be funded by a trust created or organized in the United States.
Form W-8IMY (Rev. 6-2017)
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Form W-8IMY (Rev. 6-2017) Page 7
Part XX Exempt Retirement Plans (continued)
e I certify that the entity identified in Part I is established exclusively to earn income for the benefit of one or more retirement funds described
in this part or in an applicable Model 1 or Model 2 IGA, accounts described in Regulations section 1.1471-5(b)(2)(i)(A) (referring to
retirement and pension accounts), or retirement and pension accounts described in an applicable Model 1 or Model 2 IGA.
f I certify that the entity identified in Part I:
• Is established and sponsored by a foreign government, international organization, central bank of issue, or government of a U.S.
possession (each as defined in Regulations section 1.1471-6) or an exempt beneficial owner described in an applicable Model 1 or Model
2 IGA to provide retirement, disability, or death benefits to beneficiaries or participants that are current or former employees of the sponsor
(or persons designated by such employees); or
• Is established and sponsored by a foreign government, international organization, central bank of issue, or government of a U.S.
possession (each as defined in Regulations section 1.1471-6) or an exempt beneficial owner described in an applicable Model 1 or Model
2 IGA to provide retirement, disability, or death benefits to beneficiaries or participants that are not current or former employees of such
sponsor, but are in consideration of personal services performed for the sponsor.
Part XXI Excepted Nonfinancial Group Entity
34 I certify that the entity identified in Part I:
• Is a holding company, treasury center, or captive finance company and substantially all of the entity’s activities are functions described in
Regulations section 1.1471-5(e)(5)(i)(C) through (E);
• Is a member of a nonfinancial group described in Regulations section 1.1471-5(e)(5)(i)(B);
• Is not a depository or custodial institution (other than for members of the entity’s expanded affiliated group); and
• Does not function (or hold itself out) as an investment fund, such as a private equity fund, venture capital fund, leveraged buyout fund, or
any investment vehicle with an investment strategy to acquire or fund companies and then hold interests in those companies as capital
assets for investment purposes.
Part XXII Excepted Nonfinancial Start-Up Company
35 I certify that the entity identified in Part I:
• Was formed on (or in the case of a new line of business, the date of board resolution approving the new line of business)
(date must be less than 24 months prior to date of payment);
• Is not yet operating a business and has no prior operating history or is investing capital in assets with the intent to operate a new line of
business other than that of a financial institution or passive NFFE; and
• Does not function (or hold itself out) as an investment fund, such as a private equity fund, venture capital fund, leveraged buyout fund, or
any investment vehicle whose purpose is to acquire or fund companies and then hold interests in those companies as capital assets for
investment purposes.
Part XXIII Excepted Nonfinancial Entity in Liquidation or Bankruptcy
36 I certify that the entity identified in Part I:
• Filed a plan of liquidation, filed a plan for reorganization, or filed for bankruptcy on the following date: ;
• Has not been engaged during the past 5 years in business as a financial institution or acted as a passive NFFE;
• Is either liquidating or emerging from a reorganization or bankruptcy with the intent to continue or recommence operations as a
nonfinancial entity; and
• Has provided, or will provide, documentary evidence such as a bankruptcy filing or other public documentation that supports its claim if
it remains in bankruptcy or liquidation for more than 3 years.
Part XXIV Publicly Traded NFFE or NFFE Affiliate of a Publicly Traded Corporation
Check box 37a or 37b, whichever applies.
37a I certify that:
• The entity identified in Part I is a foreign corporation that is not a financial institution; and
• The stock of such corporation is regularly traded on one or more established securities markets, including .
b I certify that:
• The entity identified in Part I is a foreign corporation that is not a financial institution;
• The entity identified in Part I is a member of the same expanded affiliated group as an entity the stock of which is regularly traded on an
established securities market;
• The name of the entity, the stock of which is regularly traded on an established securities market, is ; and
• The name of the securities market on which the stock is regularly traded is a .
Part XXV Excepted Territory NFFE
38 I certify that:
• The entity identified in Part I is an entity that is organized in a possession of the United States;
• All of the owners of the entity identified in Part I are bona fide residents of the possession in which the NFFE is organized or incorporated;
and
• The entity identified in Part I:
(i) Does not accept deposits in the ordinary course of a banking or similar business;
(ii) Does not hold, as a substantial portion of its business, financial assets for the account of others; and
(iii) Is not an insurance company (or the holding company of an insurance company) that issues or is obligated to make payments with
respect to a financial account.
Form W-8IMY (Rev. 6-2017)
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Form W-8IMY (Rev. 6-2017) Page 8
Part XXVI Active NFFE
39 I certify that:
• The entity identified in Part I is a foreign entity that is not a financial institution;
• Less than 50% of such entity’s gross income for the preceding calendar year is passive income; and
• Less than 50% of the assets held by such entity are assets that produce or are held for the production of passive income (calculated as a
weighted average of the percentage of passive assets measured quarterly). See the instructions for the definition of passive income.
Part XXVII Passive NFFE
40 I certify that the entity identified in Part I:
• Is a foreign entity that is not a financial institution (this category includes an entity organized in a possession of the United States that
engages (or holds itself out as being engaged) primarily in the business of investing, reinvesting, or trading in securities, partnership
interests, commodities, notional principal contracts, insurance or annuity contracts, or any interest in such security, partnership interest,
commodity, notional principal contract, insurance contract, or annuity contract); and
• Is using this form to transmit withholding certificates and/or other documentation and has provided or will provide a withholding
statement, as required.
Part XXVIII Sponsored Direct Reporting NFFE
41 Name of sponsoring entity: a
42 I certify that the entity identified in Part I is a direct reporting NFFE that is sponsored by the entity identified on line 41.
Part XXIX Certification
Under penalties of perjury, I declare that I have examined the information on this form, and to the best of my knowledge and belief, it is true, correct,
and complete. Furthermore, I authorize this form to be provided to any withholding agent that has control, receipt, or custody of the income for which I
am providing this form or any withholding agent that can disburse or make payments of the amounts for which I am providing this form.
I agree that I will submit a new form within 30 days if any certification made on this form becomes incorrect.
F
Sign Here
Signature of authorized official Print Name Date (MM-DD-YYYY)
Form W-8IMY (Rev. 6-2017)
Printed on recycled paper
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