Certificate of Foreign Person's Claim That Income Is Effectively  
Form  W-8ECI                Connected With the Conduct of a Trade or Business in the United States
(Rev. October 2021)                         ▶ Section references are to the Internal Revenue Code.                                                 OMB No. 1545-1621
Department of the Treasury      ▶Go   to www.irs.gov/FormW8ECI for instructions and the latest information.   
Internal Revenue Service        ▶ 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):
           Partnership                                        Simple trust                                  Complex trust             Tax-exempt organization 
           Foreign Government - Controlled Entity             Grantor trust                                 Central bank of issue 
           Foreign Government - Integral Part                 International organization                    Corporation 
           Private foundation                                 Individual                                    Estate 
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)             SSN or ITIN               EIN 
8a    Foreign tax identifying number (FTIN)                                  8b Check if FTIN not legally required        . .     . . .          . . . .     .   .
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). 

12    Check here to certify that: you are a dealer in securities (as defined in section 475(c)(1)); you are a transferor of an interest in a publicly traded partnership 
      (PTP) claiming an exception from withholding under Regulations section 1.1446(f)-4(b)(6); and any gain from the transfer of the PTP interest associated 
      with this form is effectively connected with the conduct of a trade or business within the United States without regard to section 864(c)(8).  .       .   .
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.
                    I certify that I have the capacity to sign for the person identified on line 1 of this form. 

                  Signature of beneficial owner (or individual authorized to sign for the beneficial owner)          Print name                    Date (MM-DD-YYYY)
For Paperwork Reduction Act Notice, see separate instructions.                           Cat. No. 25045D                            Form  W-8ECI  (Rev. 10-2021)