BACKUP WITHHOLDING FOR MISSING AND INCORRECT NAME/TIN(S)

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BACKUP WITHHOLDING
FOR MISSING AND
INCORRECT NAME/TIN(S)
(Including instructions for reading tape cartridges and CD/DVD Formats)
Publication 1281 (Rev. 08-2014) 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)
TABLE OF CONTENTS PAGE
Part 1- Introduction
• Backup Withholding Rate3
Part 2 - Frequently Asked Questions4
Part 3 - Where to Call for Help9
Part 4 - Actions for Missing TINs and Incorrect Name/TIN Combinations
10
• CP2100 Notice10
• Missing TIN(s)10
• Incorrect Name/TIN Combinations10
• First “B” Notice12
• Second “B” Notice13
• Third and Subsequent Notices13
Part 5 -The IRS Matching Process/ Name Controls
14
Part 6 -Flow Charts16
• First “B” Notice Copy18
• Second “B” Notice Copy21
Part 7- Name Compression Specifications for “B” Notice Tape Cartridges
22
Part 8 - Instructions for Reading Tape Cartridges
23
Part 9 - Instructions for Reading CD/DVD media
26
Part 10 - Other Forms30
• Instructions for the Requester of Form W-9
• Form W-9
• Form W-8 Series and Instructions
2
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, OID, 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 28%, effective for all subject payments after December 31, 2002.
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PART 2. FREQUENTLY ASKED QUESTIONS
1. Q… What is backup withholding?
AA… 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)?
AA… 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)?
AA… 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?
AA… 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) Interest reportable on Form 1099-INT, Interest Income.
c) Dividends reportable on Form 1099-DIV, Dividends and Distributions.
d) Patronage dividends paid in money or qualified check reportable on Form 1099-PATR, Taxable
Distributions Received From Cooperatives.
e) Original issue discount reportable on Form 1099-OID, Original Issue Discount, if the payment is in
cash.
f) Gross proceeds reportable on Form 1099-B, Proceeds From Broker and Barter Exchange
Transactions.
g) 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.
h) Gross payments reportable on Form 1099-K, Payment Card and Third Party Network
Transactions.
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5. Q… Can a payee claim he or she is exempt from backup withholding?
AA… 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?
AA… 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?
AA… 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?
AA… 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?
AA… 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?
AA… 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?
AA… 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?
AA… 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 is a “B” Notice?
AA… 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.
14. Q… When do I send a “B” Notice to a payee?
AA… 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.
15. Q… How do I know which “B” Notice to send?
AA… 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
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
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clearly marked “IMPORTANT TAX INFORMATION ENCLOSED” or “IMPORTANT TAX RETURN
DOCUMENT ENCLOSED.”
16. 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?
AA… 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.
17. Q… What should I do if a “B” Notice is returned as “undeliverable”?
AA… 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.
18. Q… After I receive a CP2100 or CP2100A Notice, when do I start and stop backup withholding?
AA… 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 30day periods.
19. Q… What are the first and second annual solicitation requirements?
AA… 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
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.
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20. Q… Does a CP2100 or CP2100A Notice indicate whether it is the first or second notification of an
incorrect TIN for a specific account?
AA… No. The backup withholding regulations require that payers be responsible for tracking the status of
the notices they receive.
21. 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?
AA… 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.
22. Q… Why are accounts I corrected still on the listing of missing or incorrect TIN(s)?
AA… 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.
23. Q… What should I do if a TIN was actually on file but was omitted from the Form 1099 or reported
incorrectly?
AA… Make any required change to your records and use the correct information on future filings. Do not
send a “B” Notice to the payee.
24. Q… What should I do if this is the first notification and the Form W-9 is returned with the same
incorrect information?
AA… Keep the Form W-9 on file to show that the payee certified the Name/TIN combination. Do not
backup withhold.
25. 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?
AA… Send it and try to get the correct TIN. Also, note your records to track the notice for the “two-inthree 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.
26. Q… Can a sole proprietor have an SSN or does he or she need an EIN?
AA… 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.
27. Q… Should I backup withhold on a payee who is a nonresident alien?
AA… 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.
28. Q… Can a Form W-9 for one account be used to correct all accounts?
AA… Yes, if the payer required a payee to file only one Form W-9 for all accounts or instruments of the
payee.
29. Q… Can a payee be subject to backup withholding for more than one reason?
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AA… Yes. However, backup withhold for only one reason at a time.
30. Q… How do I get an EIN?
AA… 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).
31. Q… What form do I use to report backup withholding?
AA… 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.
32. Q… How is a Name/TIN mismatch identified?
AA… 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.
33. Q… What amount is subject to backup withholding with respect to security sales made through
margin accounts?
AA… 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.
34. Q… In what manner should a payer treat erroneously withheld tax?
AA… 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.
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:
The Information Reporting Program Centralized Customer Service Site
Telephone
(866) 455-7438 (TOLL FREE) / (304) 263-8700 (not toll free)
Hours
8:30 am to 4:30 pm Monday through Friday, ET
E-Mail
[email protected]
Access this publication on-line at www.irs.gov/pub/irs-pdf/p1281.pdf.
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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:
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.
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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.
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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.
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
13
“first” notice.
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
14
provide either SSN or EIN (TIN) information.
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.),
15
Part 6. FLOWCHARTS
FLOWCHARTING for INCORRECT NAME/TINs
Does the
Name/TIN and the
account number on
the notice match
your records?
Incorrect
Name/TIN
Is this the first
notification?
YES
NO
Is the mismatch due
to IRS processing?
This is the
second
notification
within a three
year period.
NO
YES
YES
Send the first
B-Notice with
Form W-9 to
the payee.
No action
required.
Send the
second
B-Notice to
the payee.
NO
Is the mismatch
due to an error in
your submission?
YES
Mismatch due
to record
update.
Did the
payee return
a copy of his or her
Social Security card
OR a 147C within 30
business
days?
Did the payee
return a certified
W-9 within 30
business days?
NO
No action
required.
NO
YES
YES
NO
Correct your
records if
necessary.
Begin backup
withholdiing
within/by 30
business days.
Update your
records with
the certified
Name/TIN.
Stop backup
withholding if
already begun.
16
Update your
records
Begin backup
withholdiing
within/by 30
business days.
FLOWCHARTING for MISSING TINs
Missing TIN
Is the missing TIN
due to an error in
your submission?
NO
Are you backup
withholding on the
account?
Correct your
records if
necessary.
NO
Have you
requested a TIN?
YES
NO
YES
Annual
solicitation
request for TIN,
remit backup
withholding on
Form 945.
Continue to
backup withhold
until a TIN is
received.
Continue to
backup
withhold until
a TIN is
received.
Begin backup
withholding.
YES
Did you receive a
response?
NO
Remit backup
withholding on
Form 945.
Continue to
backup
withhold until
a TIN is
received.
YES
Update your
records and
STOP backup
withholding.
17
Make annual
solicitations
for TIN as
required to
avoid penalty.
may be dropped during the development of name controls. For example, we dropped the period in St.
Bernard’s Methodist Church.
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
18
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 agree
1. Contact your local SSA office to ascertain
with the last name and SSN on your social
whether the information on SSA’s records is
security card
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 from the
2. Put your name and SSN, as shown on your
SSN on your social security card, but the last
social security card, on the enclosed Form
name is the same
W-9, following the instructions on the form,
sign it, and send it to us. You do not need to
contact SSA.
3. The last name on your account is different from
3. Take one of the following steps (but not both):
the last name on your social security card, but
(a) If the last name on your account is correct,
the SSN is the same on both
contact SSA to correct 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.
19
4. Both the last name and SSN on your account
are different from the last name and SSN on
your social security card
4. (a) If the last name and SSN on your social
security card are correct, put that 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.
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.
20
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.
21
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.
22
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”.
23
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).
24
PAYER “A” RECORD
TAPE POSITION
1
2-16
FIELD TITLE
RECORD TYPE
ACCESS KEY
17-18
SERVICE CENTER
LENGTH DESCRIPTION AND REMARKS
1
AN “A” WILL BE ENTERED
15
NUMBER USED BY THE IRS TO GROUP
A PAYER’S INFORMATION RETURN
TRANSMITTALS.
2
TWO DIGIT SERVICE CENTER CODES:
19-27
PAYER’S EIN
9
28-67
68-75
PAYER’S NAME
NUMBER OF
DOCUMENTS
40
8
76-83
BWH TIN STATUS 1 CNT
8
84-91
BWH TIN STATUS 2 CNT 8
92-99
BWH TIN STATUS 3 CNT
8
100
101-104
105-208
FILLER
TAX YEAR
FILLER
1
4
104
BROOKHAVEN 19
CINCINNATI 17
MEMPHIS 49
OGDEN 29
PHILADELPHIA 28
THE NINE DIGIT NUMBER ASSIGNED BY THE
IRS.
SELF-EXPLANATORY.
THE NUMBER OF INFORMATION RETURNS
WITH MISSING AND INCORRECT TINS
ASSOCIATED WITH THIS PAYER. IT WILL BE
RIGHT JUSTIFIED AND ZERO FILLED.
THE NUMBER OF DOCUMENTS SENT TO THE
PAYER WITH A BWH-TIN-STATUS-INDEQUAL
TO “1” (SEE PAYER “B” RECORD). IT WILL BE
RIGHT JUSTIFIED AND ZERO FILLED.
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.
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.
BLANK FILLED
TAX YEAR DOCUMENTS WERE SUBMITTED
BLANK FILLED
25
PAYER “B” RECORD
TAPE POSITION
1
2-10
11
FIELD TITLE
RECORD TYPE
TIN
BWH TIN STATUS
LENGTH
1
9
1
12-16
17-18
TCC
DOC TYPE
5
2
19-38
39-78
79-118
119-158
159-188
189-190
191-195
196
ACCOUNT NUMBER
NAME LINE 1
NAME LINE 2
STREET ADDRESS
CITY
STATE CODE
ZIP CODE
TIN INDICATOR
20
40
40
40
30
2
5
1
197-200
201-208
PAYER OFFICE CODE
SEQUENCE NUMBER
4
8
DESCRIPTION AND REMARKS
A “B” WILL BE ENTERED.
THE PAYEE’S TIN.
“1” MISSING TIN “2” NOT CURRENTLY ISSUED
TIN “3” INCORRECT NAME/TIN
TRANSMITTER CONTROL CODE
“10” = Form 1099-K “79” = Form 1099-B “91” =
Form 1099-DIV “92” = Form 1099-INT “95” = Form
1099-MISC “96” = Form 1099-OID “97” = Form
1099-PATR
PAYEE’S ACCOUNT NUMBER FROM PAYER
PAYEE’S NAME LINE 1
PAYEE’S NAME LINE 2
PAYEE’S STREET ADDRESS
PAYEE’S CITY
PAYEE’S STATE CODE
PAYEE’S ZIP CODE
“1” = payer indicated EIN
“2” = payer indicated SSN
“0” = no TIN indicated
ALPHANUMERIC
SEQUENCE NUMBER WITHIN PAYER
PAYER “C” RECORD
TAPE POSITION
1
2-33
FIELD TITLE
RECORD TYPE
RECORD COUNTS
LENGTH
1
32
34-208
FILLER
175
26
DESCRIPTION AND REMARKS
A “C” WILL BE ENTERED
COUNTS AS DESCRIBED IN POSITIONS 68-99
OF THE PAYER “A” RECORD
BLANK FILLED
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 extension 3 to receive your encryption key. 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 extension 5 to receive your encryption key. 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.
27
PAYER “A” RECORD FILE
POSITION
1
2
3-17
FIELD TITLE
RECORD TYPE
Pipe Code
ACCESS KEY
LENGTH
1
1
15
18
19-20
Pipe Code
SERVICE CAMPUS
1
2
21
22-30
31
32-71
72
73-80
Pipe Code
PAYER’S TIN
Pipe Code
PAYER’S NAME
Pipe Code
NUMBER OF
DOCUMENTS
1
9
1
40
1
8
81
82-89
Pipe Code
BWH TIN STATUS 1 CNT
1
8
90
91-98
Pipe Code
BWH TIN STATUS 2 CNT
1
8
99
100-107
Pipe Code
BWH TIN STATUS 3 CNT
1
8
108
109
110
111-114
Pipe Code
FILLER
Pipe Code
TAX YEAR
1
1
1
4
DESCRIPTION AND REMARKS
AN “A” WILL BE ENTERED
“|”
NUMBER USED BY THE IRS TO GROUP A PAYER’S
INFORMATION RETURN TRANSMITTAL
“|”
TWO DIGIT SERVICE CAMPUS CODE
BROOKHAVEN=19
CINCINNATI = 17
MEMPHIS = 49
OGDEN = 29
PHILADELPHIA = 28
“|”
THE NINE DIGIT NUMBER ASSIGNED BY THE IRS
“|”
SELF-EXPLANATORY
“|”
THE NUMBER OF INFORMATION RETURNS WITH
MISSING AND INCORRECT TINS ASSOCIATED WITH
THIS PAYER. IT WILL BE RIGHT JUSTIFIED AND ZERO
FILLED
“|”
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
“|”
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.
“|”
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.
“|”
BLANK FILLED
“|”
TAX YEAR DOCUMENTS WERE SUBMITTED
28
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
“|”
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
“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
29
PAYER “C” RECORD FILE
POSITION
RECORD FILE FIELD
TITLE
RECORD TYPE
Pipe Code
NUMBER OF
DOCUMENTS
LENGTH DESCRIPTION AND REMARKS
11
12-19
Pipe Code
BWH TIN STATUS
1
8
20
21-28
1 CNT
Pipe Code BWH TIN
STATUS 2 CNT
1
8
29
30-37
Pipe Code
BWH TIN STATUS 3 CNT
1
8
1
2
3-10
1
1
8
A “C” WILL BE ENTERED
“|”
THE NUMBER OF INFORMATION RETURNS WITH
MISSING AND INCORRECT TINS ASSOCIATED WITH
THIS PAYER. IT WILL BE RIGHT JUSTIFIED AND ZERO
FILLED
“|”
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
“|”
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
“|”
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.
30
PART10. 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-8ECI, W-8EXP and W-8IMY
• Form W-8BEN, Certificate of Foreign Status of Beneficial Owner for United States Tax Withholding
• 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
31
Instructions for the
Requester of Form W-9
Department of the Treasury
Internal Revenue Service
(Rev. August 2013)
Request for Taxpayer Identification Number
and Certification
Section references are to the Internal Revenue Code unless
otherwise noted.
What's New
Foreign Account Tax Compliance Act (FATCA). FATCA
requires a participating foreign financial institution to report all
U.S. account holders that are specified U.S. persons. Form
W-9 and the Instructions for the Requester of Form W-9 have
been revised to expand the Exemptions box on the front of
the form to include entry for the Exempt payee code (if any)
and Exemption from FATCA Reporting Code (if any). The
references for the appropriate codes are in the Exemptions
section of Form W-9, and in the Payees Exempt from Backup
Withholding and Payees and Account Holders Exempt From
FATCA Reporting sections of these instructions.
The Certification section in Part II of Form W-9 has been
expanded to include certification of an exemption from
FATCA reporting.
Payment card and third party network transactions.
References to payments made in settlement of payment card
and third party network transactions have been added to the
Purpose of Form section of Form W-9. For more information,
see the Instructions for Form 1099-K, Payment Card and
Third Party Network Transactions on IRS.gov. Also, visit
www.irs.gov/1099k.
Future developments. The IRS has created a page on
IRS.gov for information about Form W-9 and its instructions,
at www.irs.gov/w9. Information about any future
developments affecting Form W-9 and its instructions (such
as legislation enacted after we release them) will be posted
on that page.
Reminders
The backup withholding rate is 28% for reportable
payments.
The IRS website offers TIN Matching e-services for certain
payers to validate name and TIN combinations. See
Taxpayer Identification Number (TIN) Matching
on page 4.
How Do I Know When To Use
Form W-9?
Use Form W-9 to request the taxpayer identification number
(TIN) of a U.S. person (including a resident alien) and to
request certain certifications and claims for exemption. (See
Purpose of Form on Form W-9.) Withholding agents may
require signed Forms W-9 from U.S. exempt recipients to
overcome a presumption of foreign status. For federal
purposes, a U.S. person includes but is not limited to:
An individual who is a U.S. citizen or U.S. resident alien,
A partnership, corporation, company, or association
created or organized in the United States or under the laws of
the United States,
Aug 30, 2013
Any estate (other than a foreign estate), or
A domestic trust (as defined in Regulations section
301.7701-7).
A partnership may require a signed Form W-9 from its
U.S. partners to overcome a presumption of foreign status
and to avoid withholding on the partner's allocable share of
the partnership's effectively connected income. For more
information, see Regulations section 1.1446-1.
Advise foreign persons to use the appropriate Form W-8
or Form 8233, Exemption From Withholding on
Compensation for Independent (and Certain Dependent)
Personal Services of a 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.
Also, a nonresident alien individual may, under certain
circumstances, claim treaty benefits on scholarships and
fellowship grant income. See Pub. 515 or Pub. 519, U.S. Tax
Guide for Aliens, for more information.
Electronic Submission of Forms W-9
Requesters may establish a system for payees and payees'
agents to submit Forms W-9 electronically, including by fax.
A requester is anyone required to file an information return. A
payee is anyone required to provide a taxpayer identification
number (TIN) to the requester.
Payee's agent. A payee's agent can be an investment
advisor (corporation, partnership, or individual) or an
introducing broker. An investment advisor must be registered
with the Securities and Exchange Commission (SEC) under
the Investment Advisers Act of 1940. The introducing broker
is a broker-dealer that is regulated by the SEC and the
National Association of Securities Dealers, Inc., and that is
not a payer. Except for a broker who acts as a payee's agent
for “readily tradable instruments,” the advisor or broker must
show in writing to the payer that the payee authorized the
advisor or broker to transmit the Form W-9 to the payer.
Electronic system. Generally, the electronic system must:
Ensure the information received is the information sent,
and document all occasions of user access that result in the
submission;
Make reasonably certain that the person accessing the
system and submitting the form is the person identified on
Form W-9, the investment advisor, or the introducing broker;
Provide the same information as the paper Form W-9;
Be able to supply a hard copy of the electronic Form W-9 if
the Internal Revenue Service requests it; and
Require as the final entry in the submission an electronic
signature by the payee whose name is on
Form W-9 that authenticates and verifies the submission.
The electronic signature must be under penalties of perjury
and the perjury statement must contain the language of the
paper Form W-9.
Cat. No. 20479P
TIP
For Forms W-9 that are not required to be signed,
the electronic system need not provide for an
electronic signature or a perjury statement.
from all other information contained on the substitute form.
Additionally, the following statement must be presented to
stand out in the same manner as described above and must
appear immediately above the single signature line:
For more details, see the following.
Announcement 98-27, which is on page 30 of Internal
Revenue Bulletin 1998-15 at www.irs.gov/pub/irs-irbs/
irb98-15.pdf.
Announcement 2001-91, which is on page 221 of Internal
Revenue Bulletin 2001-36 at www.irs.gov/pub/irs-irbs/
irb01-36.pdf.
“The Internal Revenue Service does not require your
consent to any provision of this document other than the
certifications required to avoid backup withholding.”
If you use a substitute form, you are required to provide
the Form W-9 instructions to the payee only if he or she
requests them. However, if the IRS has notified the payee
that backup withholding applies, then you must instruct the
payee to strike out the language in the certification that
relates to underreporting. This instruction can be given orally
or in writing. See item 2 of the Certification on Form W-9. You
can replace “defined below” with “defined in the instructions”
in item 3 of the Certification on Form W-9 when the
instructions will not be provided to the payee except upon
request. For more information, see Rev. Proc. 83-89,1983-2
C.B. 613; amplified by Rev. Proc. 96-26, which is on page 22
of Internal Revenue Bulletin 1996-8 at www.irs.gov/pub/irsirbs/irb96-08.pdf.
Individual Taxpayer Identification
Number (ITIN)
Form W-9 (or an acceptable substitute) is used by persons
required to file information returns with the IRS to get the
payee's (or other person's) correct name and TIN. For
individuals, the TIN is generally a social security number
(SSN).
However, in some cases, individuals who become U.S.
resident aliens for tax purposes are not eligible to obtain an
SSN. This includes certain resident aliens who must receive
information returns but who cannot obtain
an SSN.
TIN Applied for
For interest and dividend payments and certain payments
with respect to readily tradable instruments, the payee may
return a properly completed, signed Form W-9 to you with
“Applied For” written in Part I. This is an “awaiting-TIN”
certificate. The payee has 60 calendar days, from the date
you receive this certificate, to provide a TIN. If you do not
receive the payee's TIN at that time, you must begin backup
withholding on payments.
These individuals must apply for an ITIN on Form W-7,
Application for IRS Individual Taxpayer Identification
Number, unless they have an application pending for an
SSN. Individuals who have an ITIN must provide it on Form
W-9.
Substitute Form W-9
You may develop and use your own Form W-9 (a substitute
Form W-9) if its content is substantially similar to the official
IRS Form W-9 and it satisfies certain certification
requirements.
Reserve rule. You must backup withhold on any reportable
payments made during the 60-day period if a payee
withdraws more than $500 at one time, unless the payee
reserves an 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 cards. However, the certifications on the substitute
Form W-9 must clearly state (as shown on the official Form
W-9) that under penalties of perjury:
1. The payee's TIN is correct,
2. The payee is not subject to backup withholding due to
failure to report interest and dividend income,
3. The payee is a U.S. person, and
4. The payee is exempt from FATCA reporting.
Alternative rule. You may also elect to backup withhold
during this 60-day period, after a 7-day grace period, under
one of the two alternative rules discussed below.
Option 1. Backup withhold on any reportable payments if
the payee makes a withdrawal from the account after the
close of 7 business days after you receive the awaiting-TIN
certificate. Treat as reportable payments all cash withdrawals
in an amount up to the reportable payments made from the
day after you receive the awaiting-TIN certificate to the day of
withdrawal.
Option 2. Backup withhold on any reportable payments
made to the payee's account, regardless of whether the
payee makes any withdrawals, beginning no later than 7
business days after you receive the awaiting-TIN certificate.
You may not:
1. Use a substitute Form W-9 that requires the payee, by
signing, to agree to provisions unrelated to the required
certifications, or
2. Imply that a payee may be subject to backup
withholding unless the payee agrees to provisions on the
substitute form that are unrelated to the required
certifications.
The 60-day exemption from backup withholding
does not apply to any payment other than interest,
CAUTION
dividends, and certain payments relating to readily
tradable instruments. Any other reportable payment, such as
nonemployee compensation, is subject to backup
withholding immediately, even if the payee has applied for
and is awaiting a TIN.
!
A substitute Form W-9 that contains a separate signature
line just for the certifications satisfies the requirement that the
certifications be clearly stated.
Even if the payee gives you an awaiting-TIN certificate, you
must backup withhold on reportable interest and dividend
payments if the payee does not certify, under penalties of
perjury, that the payee is not subject to backup withholding.
If a single signature line is used for the required
certifications and other provisions, the certifications must be
highlighted, boxed, printed in bold-face type, or presented in
some other manner that causes the language to stand out
-2-
Instr. for Req. of Form W-9 (Rev. 5-2013)
Revenue Bulletin 2003-26 at www.irs.gov/pub/irs-irbs/
irb03-26.pdf.)
If you do not collect backup withholding from affected payees
as required, you may become liable for any uncollected
amount.
Payments made in settlement of payment card or third
party network transactions. Only payees listed in items 1
through 4 are exempt.
Payees Exempt From Backup
Withholding
Payments Exempt From Backup
Withholding
Even if the payee does not provide a TIN in the manner
required, you are generally not required to backup withhold
on any payments you make if the payee is:
1. An organization exempt from tax under
section 501(a), any IRA, or a custodial account under section
403(b)(7) if the account satisfies the requirements of section
401(f)(2);
2. The United States or any of its agencies or
instrumentalities;
3. A state, the District of Columbia, a possession of the
United States, or any of their political subdivisions, agencies,
or instrumentalities;
4. A foreign government or any of its political
subdivisions, agencies, or instrumentalities; or
5. A corporation;
6. A dealer in securities or commodities required to
register in the United States, the District of Columbia, or a
possession of the United States;
7. A futures commission merchant registered with the
Commodity Futures Trading Commission;
8. A real estate investment trust;
9. An entity registered at all times during the tax year
under the 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; or
13. A trust exempt from tax under section 664 or
described in section 4947.
Payments that are not subject to information reporting also
are not subject to backup withholding. For details, see
sections 6041, 6041A, 6042, 6044, 6045, 6049, 6050A,
6050N, and 6050W and their regulations. The following
payments are generally exempt from backup withholding.
Dividends and patronage dividends
Payments to nonresident aliens subject to withholding
under section 1441.
Payments to partnerships not engaged in a trade or
business in the United States and that have at least one
nonresident alien partner.
Payments of patronage dividends not paid in money.
Payments made by certain foreign organizations.
Section 404(k) distributions made by an ESOP.
Interest payments
Payments of interest on obligations issued by individuals.
However, if you pay $600 or more of interest in the course of
your trade or business to a payee, you must report the
payment. Backup withholding applies to the reportable
payment if the payee has not provided a TIN or has provided
an incorrect TIN.
Payments described in section 6049(b)(5) to nonresident
aliens.
Payments on tax-free covenant bonds under
section 1451.
Payments made by certain foreign organizations.
Mortgage or student loan interest paid to you.
Other types of payment
Wages.
Distributions from a pension, annuity, profit-sharing or
stock bonus plan, any IRA, an owner-employee plan, or other
deferred compensation plan.
Distributions from a medical or health savings account and
long-term care benefits.
Certain surrenders of life insurance contracts.
Distribution from qualified tuition programs or
Coverdell ESAs.
Gambling winnings if regular gambling winnings
withholding is required under section 3402(q). However, if
regular gambling winnings withholding is not required under
section 3402(q), backup withholding applies if the payee fails
to furnish a TIN.
Real estate transactions reportable under
section 6045(e).
Cancelled debts reportable under section 6050P.
Fish purchases for cash reportable under
section 6050R.
The following types of payments are exempt from backup
withholding as indicated for items 1 through 13 above.
Interest and dividend payments. All listed payees are
exempt except the payee in item 7.
Broker transactions. All payees listed in items 1 through 4
and 6 through 11 are exempt. Also, C corporations are
exempt. A person registered under the Investment Advisers
Act of 1940 who regularly acts as a broker is also exempt.
Barter exchange transactions and patronage dividends.
Only payees listed in items 1 through 4 are exempt.
Payments reportable under sections 6041 and 6041A.
Payees listed in items 1 through 5are generally exempt.
However, the following payments made to a corporation
(including gross proceeds paid to an attorney under section
6045(f), even if the attorney is a corporation) and reportable
on Form 1099-MISC, Miscellaneous Income, are not exempt
from backup withholding.
Payees and Account Holders Exempt
From FATCA Reporting
Medical and health care payments.
Attorneys' fees.
Gross proceeds paid to an attorney.
Payments for services paid by a federal executive agency.
(See Rev. Rul. 2003-66, which is on page 1115 of Intenal
Instr. for Req. of Form W-9 (Rev. 5-2013)
Reporting under chapter 4 (FATCA) with respect to U.S.
persons generally applies only to foreign financial institutions
(FFI) (including a branch of a U.S. financial institution that is
-3-
2. Any one of the joint payees who has not established
foreign status gives you a TIN.
treated as an FFI under an applicable intergovernmental
agreement (IGA)). Thus, for example, a U.S. financial
institution maintaining an account in the United States does
not need to collect an exemption code for FATCA reporting.
For details on the FATCA reporting requirements, including
specific information regarding which financial institutions are
required to report, see sections 1471 to 1474 and related
regulations. See Regulations section 1.1471-3(d)(2) for when
an FFI may rely on documentary evidence to treat a U.S.
person as other than a specified U.S. person and see
Regulations section 1.1471-3(f)(3) for when an FFI may
presume a U.S. person as other than a specified U.S.
person.
1. An organization exempt from tax under section 501(a),
or any individual retirement plan as defined in section
7701(a)(37);
2. The United States or any of its agencies or
instrumentalities;
3. A state, the District of Columbia, a possession of the
United States, or any of their political subdivisions, agencies,
or instrumentalities;
4. A corporation the stock of which is regularly traded on
one or more established securities markets, as described in
Reg, section 1.1472-1(c)(1)(i);
5. 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);
6. A dealer in securities, commodities, or derivative
financial instruments (including notional principal contracts,
futures, forwards, and options) that is registered as such
under the laws of the United States or any State;
7. A real estate investment trust;
8. A regulated investment company as defined in section
851 or an entity registered at all times during the tax year
under the Investment Company Act of 1940;
9. A common trust fund as defined in section 584(a);
10. A bank as defined in section 581;
11. A broker; or
12. A trust exempt from tax under section 664 or
described in section 4947.
13. A tax-exempt trust under a section 403(b) plan or
section 457(g) plan.
If any one of the joint payees who has not established
foreign status gives you a TIN, use that number for purposes
of backup withholding and information reporting.
For more information on foreign payees, see the
Instructions for the Requester of Forms W-8BEN, W-8ECI,
W-8EXP, and W-8IMY.
Names and TINs To Use
for Information Reporting
Show the full name and address as provided on Form W-9 on
the information return filed with the IRS and on the copy
furnished to the payee. If you made payments to more than
one payee or the account is in more than one name, enter on
the first name line of the information return only 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 below
the first name line on the information return.
TIP
For more information on the names and TINs to use
for information reporting, see section J of the
General Instructions for Certain Information Returns.
Notices From the IRS
The IRS will send you a notice if the payee's name and TIN
on the information return you filed do not match the IRS's
records. (See Taxpayer Identification Number (TIN)
Matching.) You may have to send a “B” notice to the payee to
solicit another TIN. Pub. 1281, Backup Withholding for
Missing and Incorrect Name/TIN(s), contains copies of the
two types of “B” notices.
Taxpayer Identification Number (TIN)
Matching
TIN Matching allows a payer or authorized agent who is
required to file Forms 1099-B, DIV, INT, K, MISC, OID,
and/or PATR to match TIN and name combinations with IRS
records before submitting the forms to the IRS. TIN Matching
is one of the e-services products that is offered and is
accessible through the 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 combinations before filing
information returns will receive fewer backup withholding
(CP2100) notices and penalty notices.
Joint Foreign Payees
Additional Information
If the first payee listed on an account gives you a
Form W-8 or a similar statement signed under penalties of
perjury, backup withholding applies unless:
1. Every joint payee provides the statement regarding
foreign status, or
For more information on backup withholding, see Pub. 1281.
-4-
Instr. for Req. of Form W-9 (Rev. 5-2013)
W-9
Form
(Rev. August 2013)
Department of the Treasury
Internal Revenue Service
Request for Taxpayer
Identification Number and Certification
Give Form to the
requester. Do not
send to the IRS.
Print or type
See Specific Instructions on page 2.
Name (as shown on your income tax return)
Business name/disregarded entity name, if different from above
Exemptions (see instructions):
Check appropriate box for federal tax classification:
Individual/sole proprietor
C Corporation
S Corporation
Partnership
Trust/estate
Exempt payee code (if any)
Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=partnership) ▶
Other (see instructions) ▶
Address (number, street, and apt. or suite no.)
Exemption from FATCA reporting
code (if any)
Requester’s name and address (optional)
City, state, and ZIP code
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 the “Name” line
to avoid backup withholding. For individuals, this is your social security number (SSN). However, for a
resident alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other
entities, it is your employer identification number (EIN). If you do not have a number, see How to get a
TIN on page 3.
Social security number
Note. If the account is in more than one name, see the chart on page 4 for guidelines on whose
number to enter.
Employer identification number
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 on page 3.
Sign
Here
Signature of
U.S. person ▶
Date ▶
General Instructions
withholding tax on foreign partners’ share of effectively connected income, and
Section references are to the Internal Revenue Code unless otherwise noted.
Future developments. The IRS has created a page on IRS.gov for information
about Form W-9, at www.irs.gov/w9. Information about any future developments
affecting Form W-9 (such as legislation enacted after we release it) will be posted
on that page.
Purpose of Form
A person who is required to file an information return with the IRS must obtain your
correct taxpayer identification number (TIN) to report, for example, income paid to
you, payments made to you in settlement of payment card and third party network
transactions, real estate transactions, mortgage interest you paid, acquisition or
abandonment of secured property, cancellation of debt, or contributions you made
to an IRA.
Use Form W-9 only if you are a U.S. person (including a resident alien), to
provide your correct TIN to the person requesting it (the requester) and, when
applicable, to:
1. Certify that the TIN you are giving is correct (or you are waiting for a number
to be issued),
2. Certify that you are not subject to backup withholding, or
3. Claim exemption from backup withholding if you are a U.S. exempt payee. If
applicable, you are also certifying that as a U.S. person, your allocable share of
any partnership income from a U.S. trade or business is not subject to the
4. Certify that FATCA code(s) entered on this form (if any) indicating that you are
exempt from the FATCA reporting, is correct.
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 it is substantially
similar to this Form W-9.
Definition of a U.S. person. For federal tax purposes, you are considered a U.S.
person if you are:
• An individual who is a U.S. citizen or U.S. resident alien,
• A partnership, corporation, company, or association created or organized in the
United States or under the laws of the United States,
• An estate (other than a foreign estate), or
• A domestic trust (as defined in Regulations section 301.7701-7).
Special rules for partnerships. Partnerships that conduct a trade or business in
the United States are generally required to pay a withholding tax under section
1446 on any foreign partners’ share of effectively connected taxable income from
such business. Further, in certain cases where a Form W-9 has not been received,
the rules under section 1446 require a partnership to presume that a partner is a
foreign person, and 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
United States, provide Form W-9 to the partnership to establish your U.S. status
and avoid section 1446 withholding on your share of partnership income.
Cat. No. 10231X
Form W-9 (Rev. 8-2013)
Page 2
Form W-9 (Rev. 8-2013)
In the cases below, the following person must give Form W-9 to the partnership
for purposes of establishing its U.S. status and avoiding withholding on its
allocable share of net income from the partnership conducting a trade or business
in the United States:
Updating Your Information
• In the case of a grantor trust with a U.S. grantor or other U.S. owner, generally,
the U.S. grantor or other U.S. owner of the grantor trust and not the trust, and
You must provide updated information to any person to whom you claimed to be
an exempt payee if you are no longer an exempt payee and anticipate receiving
reportable payments in the future from this person. For example, you may need to
provide updated information if you are a C corporation that elects to be an S
corporation, or if you no longer are tax exempt. In addition, you must furnish a new
Form W-9 if the name or TIN changes for the account, for example, if the grantor
of a grantor trust dies.
• 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.
Penalties
Foreign person. If you are a foreign person or the U.S. branch of a foreign bank
that has elected to be treated as a U.S. person, do not use Form W-9. Instead, use
the appropriate Form W-8 or Form 8233 (see Publication 515, Withholding of Tax
on Nonresident Aliens and Foreign Entities).
Failure to furnish TIN. If you fail to furnish your correct TIN to a requester, you are
subject to a penalty of $50 for each such failure unless your failure is due to
reasonable cause and not to willful neglect.
• In the case of a disregarded entity with a U.S. owner, the U.S. owner of the
disregarded entity and not the entity,
Nonresident alien who becomes a resident alien. Generally, only a 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 treaties contain a provision known as
a “saving clause.” Exceptions specified in the saving clause may permit an
exemption from tax to continue for certain types of income even after the payee
has otherwise become a U.S. resident alien for tax purposes.
If you are a U.S. resident alien who is relying on an exception contained in the
saving clause of a tax treaty to claim an exemption from U.S. tax on certain types
of income, you must attach a statement to Form W-9 that specifies the following
five items:
1. The treaty country. Generally, this must be the same treaty under which you
claimed exemption from tax as a nonresident alien.
2. The treaty article addressing the income.
3. The article number (or location) in the tax treaty that contains the saving
clause and its exceptions.
4. The type and amount of income that qualifies for the exemption from tax.
5. Sufficient facts to justify the exemption from tax under the terms of the treaty
article.
Example. Article 20 of the U.S.-China income tax treaty allows an exemption
from tax for scholarship income received by a Chinese 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 the United States exceeds 5 calendar years.
However, paragraph 2 of 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 student becomes a resident alien of the United States. A Chinese student
who qualifies for this exception (under paragraph 2 of the first protocol) and is
relying on this exception to claim an exemption from tax on his or her scholarship
or fellowship income would attach to Form W-9 a statement that includes the
information described above to support that exemption.
If you are a nonresident alien or a foreign entity, give the requester the
appropriate completed Form W-8 or Form 8233.
What is backup withholding? Persons making certain payments to you must
under certain conditions withhold and pay to the IRS a percentage of such
payments. This is called “backup withholding.” Payments that may be subject to
backup withholding include interest, tax-exempt interest, dividends, broker and
barter exchange transactions, rents, royalties, nonemployee pay, payments made
in settlement of payment card and third party network transactions, and certain
payments from fishing boat operators. Real estate transactions are not subject to
backup withholding.
You will not be subject to backup withholding on payments you receive if you
give the requester your correct TIN, make the proper certifications, and report all
your taxable interest and dividends on your tax return.
Payments you receive will be subject to backup
withholding if:
1. You do not furnish your TIN to the requester,
2. You do not certify your TIN when required (see the Part II instructions on page
3 for details),
3. The IRS tells the requester that you furnished an incorrect TIN,
4. The IRS tells you that you are subject to backup withholding because you did
not report all your interest and dividends on your tax return (for reportable interest
and dividends only), or
5. You do not certify to the requester that you are not subject to backup
withholding under 4 above (for reportable interest and dividend accounts opened
after 1983 only).
Certain payees and payments are exempt from backup withholding. See Exempt
payee code on page 3 and the separate Instructions for the Requester of Form
W-9 for more information.
Also see Special rules for partnerships on page 1.
What is FATCA reporting? The Foreign Account Tax Compliance Act (FATCA)
requires a participating foreign financial institution to report all United States
account holders that are specified United States persons. Certain payees are
exempt from FATCA reporting. See Exemption from FATCA reporting code on
page 3 and the Instructions for the Requester of Form W-9 for more information.
Civil penalty for false information with respect to withholding. If you make a
false statement with no reasonable basis that results in no backup withholding,
you are subject to a $500 penalty.
Criminal penalty for falsifying information. Willfully falsifying certifications or
affirmations may subject you to criminal penalties including fines and/or
imprisonment.
Misuse of TINs. If the requester discloses or uses TINs in violation of federal law,
the requester may be subject to civil and criminal penalties.
Specific Instructions
Name
If you are an individual, you must generally enter the name shown on your income
tax return. However, if you have changed your last name, for instance, due to
marriage without informing the Social Security Administration of the name change,
enter your first name, the last name shown on your social security card, and your
new last name.
If the account is in joint names, list first, and then circle, the name of the person
or entity whose number you entered in Part I of the form.
Sole proprietor. Enter your individual name as shown on your income tax return
on the “Name” line. You may enter your business, trade, or “doing business as
(DBA)” name on the “Business name/disregarded entity name” line.
Partnership, C Corporation, or S Corporation. Enter the entity's name on the
“Name” line and any business, trade, or “doing business as (DBA) name” on the
“Business name/disregarded entity name” line.
Disregarded entity. For U.S. federal tax purposes, an entity that is disregarded as
an entity separate from its owner is treated as a “disregarded entity.” See
Regulation section 301.7701-2(c)(2)(iii). Enter the owner's name on the “Name”
line. The name of the entity entered on the “Name” line should never be a
disregarded entity. The name on the “Name” line must be the name shown on the
income tax return on which the income should be reported. For example, if a
foreign LLC that is treated as a disregarded entity for U.S. federal tax purposes
has a single owner that is a U.S. person, the U.S. owner's name is required to be
provided on the “Name” line. If the direct owner of the entity is also a disregarded
entity, enter the first owner that is not disregarded for federal tax purposes. Enter
the disregarded entity's name on the “Business name/disregarded entity name”
line. If the owner of the disregarded entity is a foreign person, the owner must
complete an appropriate Form W-8 instead of a Form W-9. This is the case even if
the foreign person has a U.S. TIN.
Note. Check the appropriate box for the U.S. federal tax classification of the
person whose name is entered on the “Name” line (Individual/sole proprietor,
Partnership, C Corporation, S Corporation, Trust/estate).
Limited Liability Company (LLC). If the person identified on the “Name” line is an
LLC, check the “Limited liability company” box only and enter the appropriate
code for the U.S. federal tax classification in the space provided. If you are an LLC
that is treated as a partnership for U.S. federal tax purposes, enter “P” for
partnership. If you are an LLC that has filed a Form 8832 or a Form 2553 to be
taxed as a corporation, enter “C” for C corporation or “S” for S corporation, as
appropriate. If you are an LLC that is disregarded as an entity separate from its
owner under Regulation section 301.7701-3 (except for employment and excise
tax), do not check the LLC box unless the owner of the LLC (required to be
identified on the “Name” line) is another LLC that is not disregarded for U.S.
federal tax purposes. If the LLC is disregarded as an entity separate from its
owner, enter the appropriate tax classification of the owner identified on the
“Name” line.
Other entities. Enter your business name as shown on required U.S. federal tax
documents on the “Name” line. This name should match the name shown on the
charter or other legal document creating the entity. You may enter any business,
trade, or DBA name on the “Business name/disregarded entity name” line.
Exemptions
If you are exempt from backup withholding and/or FATCA reporting, enter in the
Exemptions box, any code(s) that may apply to you. See Exempt payee code and
Exemption from FATCA reporting code on page 3.
Page 3
Form W-9 (Rev. 8-2013)
Exempt payee code. Generally, individuals (including sole proprietors) are not
exempt from backup withholding. Corporations are exempt from backup
withholding for certain payments, such as interest and dividends. Corporations are
not exempt from backup withholding for payments made in settlement of payment
card or third party network transactions.
Note. If you are exempt from backup withholding, you should still complete this
form to avoid possible erroneous backup withholding.
The following codes identify payees that are exempt from backup withholding:
1—An organization exempt from tax under section 501(a), any IRA, or a
custodial account under section 403(b)(7) if the account satisfies the requirements
of section 401(f)(2)
2—The United States or any of its agencies or instrumentalities
3—A state, the District of Columbia, a possession of the United States, or any of
their political subdivisions or instrumentalities
4—A foreign government or any of its political subdivisions, agencies, or
instrumentalities
5—A corporation
6—A dealer in securities or commodities required to register in the United
States, the District of Columbia, or a possession of the United States
7—A futures commission merchant registered with the Commodity Futures
Trading Commission
8—A real estate investment trust
9—An entity registered at all times during the tax year under the 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
The following chart shows types of payments that may be exempt from backup
withholding. The chart applies to the exempt payees listed above, 1 through 13.
IF the payment is for . . .
THEN the payment is exempt for . . .
Interest and dividend payments
All exempt payees except
for 7
Broker transactions
Exempt payees 1 through 4 and 6
through 11 and all C corporations. S
corporations must not enter an exempt
payee code because they are exempt
only for sales of noncovered securities
acquired prior to 2012.
G—A real estate investment trust
H—A regulated investment company as defined in section 851 or an entity
registered at all times during the tax year under the Investment Company Act of
1940
I—A common trust fund as defined in section 584(a)
J—A bank as defined in section 581
K—A broker
L—A trust exempt from tax under section 664 or described in section 4947(a)(1)
M—A tax exempt trust under a section 403(b) plan or section 457(g) plan
Part I. Taxpayer Identification Number (TIN)
Enter your TIN in the appropriate box. If you are a resident alien and 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 below.
If you are a sole proprietor and you have an EIN, you may enter either your SSN
or EIN. However, the IRS prefers that you use your SSN.
If you are a single-member LLC that is disregarded as an entity separate from its
owner (see Limited Liability Company (LLC) on page 2), enter the owner’s SSN (or
EIN, if the owner has one). Do not enter the disregarded entity’s EIN. If the LLC is
classified as a corporation or partnership, enter the entity’s EIN.
Note. See the chart on page 4 for further clarification of name and TIN
combinations.
How to get a TIN. If you do not have a TIN, apply for one immediately. To apply
for an SSN, get Form SS-5, Application for a Social Security Card, from your local
Social Security Administration office or get this form online at www.ssa.gov. You
may also get this form by calling 1-800-772-1213. Use Form W-7, Application for
IRS Individual Taxpayer Identification Number, to apply for an ITIN, or Form SS-4,
Application for Employer Identification Number, to apply for an EIN. You can apply
for an EIN online by accessing the IRS website at www.irs.gov/businesses and
clicking on Employer Identification Number (EIN) under Starting a Business. You
can get Forms W-7 and SS-4 from the IRS by visiting IRS.gov or by calling 1-800TAX-FORM (1-800-829-3676).
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 the form, and give it
to the requester. For interest and dividend payments, and certain payments made
with respect to readily tradable instruments, generally you will have 60 days to get
a TIN and give it to the requester before you are subject to backup withholding on
payments. The 60-day rule does not apply to other types of payments. You will be
subject to backup withholding on all such payments until you provide your TIN to
the requester.
Note. Entering “Applied For” means that you have already applied for a TIN or that
you intend to apply for one soon.
Caution: A disregarded U.S. entity that has a foreign owner must use the
appropriate Form W-8.
Barter exchange transactions and
patronage dividends
Exempt payees 1 through 4
Payments over $600 required to be
1
reported and direct sales over $5,000
Generally, exempt payees
2
1 through 5
To establish to the withholding agent that you are a U.S. person, or resident alien,
sign Form W-9. You may be requested to sign by the withholding agent even if
items 1, 4, or 5 below indicate otherwise.
Payments made in settlement of
payment card or third party network
transactions
Exempt payees 1 through 4
For a joint account, only the person whose TIN is shown in Part I should sign
(when required). In the case of a disregarded entity, the person identified on the
“Name” line must sign. Exempt payees, see Exempt payee code earlier.
1
See Form 1099-MISC, Miscellaneous Income, and its instructions.
2
However, the following payments made to a corporation and reportable on Form
1099-MISC are not exempt from backup withholding: medical and health care
payments, attorneys' fees, gross proceeds paid to an attorney, and payments for
services paid by a federal executive agency.
Exemption from FATCA reporting code. The following codes identify payees
that are exempt from reporting under FATCA. These codes apply to persons
submitting this form for accounts maintained outside of the United States by
certain foreign financial institutions. Therefore, if you are only submitting this form
for an account you hold in the United States, you may leave this field blank.
Consult with the person requesting this form if you are uncertain if the financial
institution is subject to these requirements.
A—An organization exempt from tax under section 501(a) or any individual
retirement plan as defined in section 7701(a)(37)
B—The United States or any of its agencies or instrumentalities
C—A state, the District of Columbia, a possession of the United States, or any
of their political subdivisions or instrumentalities
D—A corporation the stock of which is regularly traded on one or more
established securities markets, as described in Reg. section 1.1472-1(c)(1)(i)
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)
F—A dealer in securities, commodities, or derivative financial instruments
(including notional principal contracts, futures, forwards, and options) that is
registered as such under the laws of the United States or any state
Part II. Certification
Signature requirements. Complete the certification as indicated in items 1
through 5 below.
1. Interest, dividend, and barter exchange accounts opened before 1984
and broker accounts considered active during 1983. You must give your
correct TIN, but you do not have to sign the certification.
2. Interest, dividend, broker, and barter exchange accounts opened after
1983 and broker accounts considered inactive during 1983. You must sign the
certification or backup withholding will apply. If 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 certification before signing the form.
3. Real estate transactions. You must sign the certification. You may cross out
item 2 of the certification.
4. Other payments. You must give your correct TIN, but you do not have to sign
the certification unless you have been notified that you have previously given an
incorrect TIN. “Other payments” include payments made in the course of the
requester’s trade or business for rents, royalties, goods (other than bills for
merchandise), medical and health care services (including payments to
corporations), payments to a nonemployee for services, payments made in
settlement of payment card and third party network transactions, payments to
certain fishing boat crew members and fishermen, and gross proceeds paid to
attorneys (including payments to corporations).
5. Mortgage interest paid by you, acquisition or abandonment of secured
property, cancellation of debt, qualified tuition program payments (under
section 529), IRA, Coverdell ESA, Archer MSA or HSA contributions or
distributions, and pension distributions. You must give your correct TIN, but you
do not have to sign the certification.
Page 4
Form W-9 (Rev. 8-2013)
What Name and Number To Give the Requester
For this type of account:
Give name and SSN of:
1. Individual
2. Two or more individuals (joint
account)
The individual
The actual owner of the account or,
if combined funds, the first
1
individual on the account
3. Custodian account of a minor
(Uniform Gift to Minors Act)
The minor
4. a. The usual revocable savings
trust (grantor is also trustee)
b. So-called trust account that is
not a legal or valid trust under
state law
5. Sole proprietorship or disregarded
entity owned by an individual
6. Grantor trust filing under Optional
Form 1099 Filing Method 1 (see
Regulation section 1.671-4(b)(2)(i)(A))
The actual owner
The owner
1
1
The grantor*
Give name and EIN of:
The owner
4
9. Corporation or LLC electing
corporate status on Form 8832 or
Form 2553
10. Association, club, religious,
charitable, educational, or other
tax-exempt organization
The corporation
11. Partnership or multi-member LLC
12. A broker or registered nominee
The partnership
The broker or nominee
13. Account with the Department of
Agriculture in the name of a public
entity (such as a state or local
government, school district, or
prison) that receives agricultural
program payments
The public entity
14. Grantor trust filing under the Form
1041 Filing Method or the Optional
Form 1099 Filing Method 2 (see
Regulation section 1.671-4(b)(2)(i)(B))
The trust
1
2
3
Identity theft occurs when someone uses your personal information such as your
name, social security number (SSN), or other identifying information, without your
permission, to commit fraud or other crimes. An identity thief may use your SSN to
get a job or may file a tax return using your SSN to receive a refund.
• Protect your SSN,
• Ensure your employer is protecting your SSN, and
• Be careful when choosing a tax preparer.
If your tax records are affected by identity theft and you receive a notice from
the IRS, respond right away to the name and phone number printed on the IRS
notice or letter.
3
Legal entity
Secure Your Tax Records from Identity Theft
To reduce your risk:
The grantor-trustee
For this type of account:
7. Disregarded entity not owned by an
individual
8. A valid trust, estate, or pension trust
2
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.
The organization
If your tax records are not currently affected by identity theft but you 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 at 1-800-908-4490 or submit
Form 14039.
For more information, see Publication 4535, Identity Theft Prevention and Victim
Assistance.
Victims of identity theft who are experiencing economic harm or a system
problem, or are seeking help in resolving tax problems that have not been resolved
through normal channels, may be eligible for 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 1-800-829-4059.
Protect yourself from suspicious emails or phishing schemes. Phishing is the
creation and use of email and websites designed to mimic legitimate business
emails and websites. The most common act is sending an email to a user falsely
claiming to be an established legitimate enterprise in an attempt to scam the user
into surrendering private information that will be used for identity theft.
The IRS does not initiate contacts with taxpayers via emails. Also, the IRS does
not request personal detailed information through email or ask taxpayers for the
PIN numbers, passwords, or similar secret access information for their credit card,
bank, or other financial accounts.
If you receive an unsolicited email claiming to be from the IRS, forward this
message to [email protected] You may also report misuse of the IRS name, logo,
or other IRS property to the Treasury Inspector General for Tax Administration at
1-800-366-4484. You can forward suspicious emails to the Federal Trade
Commission at: [email protected] or contact them at www.ftc.gov/idtheft or 1-877IDTHEFT (1-877-438-4338).
Visit IRS.gov to learn more about identity theft and how to reduce your risk.
List first and circle the name of the person whose number you furnish. If only one person on a
joint account has an SSN, that person’s number must be furnished.
Circle the minor’s name and furnish the minor’s SSN.
You must show your individual name and you may also enter your business or “DBA” name on
the “Business name/disregarded entity” name line. You may use either your SSN or EIN (if you
have one), but the IRS encourages you to use your SSN.
4
List first and circle the name of the trust, estate, or pension trust. (Do not furnish the TIN of the
personal representative or trustee unless the legal entity itself is not designated in the account
title.) Also see Special rules for partnerships on page 1.
*Note. Grantor also must provide a Form W-9 to trustee of trust.
Privacy Act Notice
Section 6109 of the Internal Revenue Code requires you to provide your correct TIN to persons (including federal agencies) who are required to file information returns with
the IRS to report interest, dividends, or certain other income paid to you; mortgage interest you paid; the acquisition or abandonment of secured property; the cancellation
of debt; or contributions you made to an IRA, Archer MSA, or HSA. The person collecting this form uses the information on the form to file information returns with the IRS,
reporting the above information. Routine uses of this information include giving it to the Department of Justice for civil and criminal litigation and to cities, states, the District
of Columbia, and U.S. commonwealths and possessions for use in administering their laws. The information also may be disclosed to other countries under a treaty, to
federal and state agencies to enforce civil 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.
Instructions for
the Requester of
Forms W–8BEN,
W–8BEN–E, W–8ECI,
W–8EXP, and W–8IMY
Department of the Treasury
Internal Revenue Service
(Rev. July 2014)
Section references are to the Internal Revenue Code
unless otherwise noted.
Future developments. For the latest information about
developments related to the Forms W-8 and their
instructions for requesters, such as legislation enacted
after they were published, go to Form-W-8,-Certificate-ofForeign-Status.
What's New
In 2010, Congress passed the Hiring Incentives to
Restore Employment Act of 2010, P.L. 111-147 (the HIRE
Act), which added chapter 4 of Subtitle A to the Code,
consisting of sections 1471 through 1474 of the Code and
commonly referred to as “FATCA” or “chapter 4.” Under
chapter 4 and the regulations thereunder, a withholding
agent that makes withholdable payments on or after July
1, 2014, to a payee that is a foreign financial institution
(FFI) generally must withhold 30% on the payment unless
the withholding agent is able to treat the FFI as a
participating FFI, deemed-compliant FFI, or an exempt
beneficial owner. Additionally, a participating FFI or
registered deemed-compliant FFI is generally required to
perform due diligence procedures to identify its account
holders for purposes of chapter 4 and to report or
withhold, as appropriate, on such account holders that are
U.S. account holders, recalcitrant account holders, or
nonparticipating FFIs. A withholding agent is also required
to withhold on withholdable payments made on or after
July 1, 2014, to a nonfinancial foreign entity (NFFE),
unless it is able to treat the NFFE as other than a passive
NFFE that fails to identify its substantial U.S. owners (or
certify that it does not have any substantial U.S. owners).
In January 2013, final regulations were published that
provide due diligence, withholding, and reporting rules for
both U.S. withholding agents and FFIs under chapter 4
(T.D. 9610, available at www.irs.gov/irb/2013-15_IRB/
ar16.html). Additionally, temporary and proposed
regulations were released in February 2014, providing
updated regulations under chapter 4 (T.D. 9657, available
at www.irs.gov/irb/2014-13_IRB/ar06.html) as well as
guidance amending certain of the regulations under
chapters 3 and 61 of the Code to coordinate with the
requirements of chapter 4 (T.D. 9658, available at
www.irs.gov/irb/2014-13_IRB/ar07.html). Additional
guidance was provided in Notice 2014-33, 2014-21 I.R.B.
1033, available at www.irs.gov/irb/2014-13_IRB/
ar04.html.
Jul 16, 2014
In order to document an account holder or other payee, a
withholding agent or an FFI may need to obtain a
withholding certificate (i.e., Form W-8 series) to establish
the chapter 4 status of a payee or an account holder or
the payee's chapter 3 status, or to validate a payee’s or an
account holder’s claim of foreign status when there are
U.S. indicia associated with the payee or the account. See
Due Diligence Requirements, later outlined in these
instructions. Forms W-8ECI, W-8EXP, and W-8IMY have
been updated to reflect the documentation requirements
of chapter 4. Additionally, Form W-8BEN has been
divided into two versions — Form W-8BEN for use by
individuals and Form W-8BEN-E for use by entities. Form
W-8BEN will continue to be used to document
nonresident alien individuals, while Form W-8BEN-E will
be used to document foreign entities, for purposes of
chapters 3 and 4, and under certain other sections of the
Code in order to establish their status for withholding or
reporting purposes. If you are a withholding agent making
a payment of U.S. source fixed or determinable, annual or
periodical (FDAP) income, you should continue to fulfill
your chapter 3 reporting and withholding obligations (as
required) using these forms in addition to using these
forms to satisfy any withholding or reporting obligations
you may have under chapter 4. These updated forms
replace prior versions of Forms W-8.
Purpose of Instructions
These instructions supplement the instructions for the
following forms and provide, for each form, notes to assist
withholding agents and FFIs in validating the forms for
chapter 3 and 4 purposes in addition to outlining the due
diligence requirements applicable to withholding agents
for establishing a beneficial owner’s foreign status and
claim for reduced withholding under an income tax treaty.
These notes for chapters 3 and 4 are not inclusive of all
requirements that may apply to a withholding agent for
validating Forms W-8. A withholding agent should also
reference the instructions for each Form W-8 and
applicable regulations under chapter 3 and chapter 4
describing the requirements for withholding certificates.
Form W-8BEN, Certificate of Foreign Status of
Beneficial Owner for United States Tax Withholding and
Reporting (Individuals).
Form W-BEN-E, Certificate of Status of Beneficial
Owner for United States Tax Withholding and Reporting
(Entities).
Cat. No. 26698G
Form W-8ECI, Certificate of Foreign Person's Claim
That Income Is 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 and Reporting.
Form W-8IMY, Certificate of Foreign Intermediary,
Foreign Flow-Through Entity, or Certain U.S. Branches for
United States Tax Withholding and Reporting.
For general information and the purpose of each of the
forms described in these instructions, see those forms
and their accompanying instructions. For definitions of
terms used and not defined in these instructions, see the
Forms W-8 and their accompanying instructions for
definitions that also apply for purposes of these
instructions.
TIP
Throughout these instructions, a reference to or
mention of “Form W-8” includes Forms W-8BEN,
W-8BEN-E, W-8ECI, W-8EXP, and W-8IMY.
Requirements to Withhold
For purposes of sections 1441 and 1442, a withholding
agent must withhold 30% of any payment of an amount
subject to chapter 3 withholding made to a payee that is a
foreign person unless it can associate the payment with
documentation (for example, Form W-8 or Form W-9,
Request for Taxpayer Identification Number and
Certification) upon which it is permitted to 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 person entitled to a
reduced rate of or exemption from withholding. See,
however, Regulations section 1.1441-1(c)(17), allowing a
payment to be associated with documentary evidence
rather than a Form W-8 for a payment made outside the
United States with respect to an offshore obligation under
Regulations section 1.6049-5(c)(1). A withholding agent
must also withhold under section 1443 on certain
payments to foreign tax-exempt organizations that
constitute unrelated business taxable income or are
subject to the 4% excise tax imposed by section 4948.
However, a withholding agent making a payment to a
foreign person need not withhold if the foreign person
assumes responsibility for withholding on the payment as
a qualified intermediary, a withholding foreign partnership,
or a withholding foreign trust and has provided a valid
Form W-8IMY certifying to such status. Withholding is
also not required if the payment is made to a U.S. branch
of a foreign insurance company or foreign bank or a
territory financial institution that agrees to be treated as a
U.S. person under the requirements of Regulations
section 1.1441-1(b)(2)(iv)(A) and provides a valid Form
W-8IMY certifying to such status.
Generally, an amount is subject to withholding for
purposes of chapter 3 if it is an amount from sources
within the United States that is FDAP income. FDAP
income is all income included in gross income, including
interest (and original issue discount), dividends, rents,
royalties, and compensation. FDAP income does not
include most gains from the sale of property (including
market discount and option premiums). FDAP income
also does not include items of income excluded from
gross income without regard to the U.S. or foreign status
of the owner of the income, such as interest under section
103(a).
Generally, under section 1446, a partnership that
allocates effectively connected taxable income (ECTI) to a
foreign person must withhold at the highest tax rate
applicable to that person for the type of income allocated
(for example, ordinary income or capital gains). Unless
the partnership is a publicly traded partnership, the
partnership must withhold in the year the ECTI is allocable
to the foreign partner, rather than the year in which the
distribution is made. The partnership may rely on
documentation (for example, Form W-8BEN, Form
W-8BEN-E, or Form W-9) to determine if the partner is
foreign or domestic and the type of partner (for example,
individual or corporate). A partnership that does not
receive valid documentation or knows or has reason to
know that the documentation is incorrect or unreliable
must presume the partner is foreign.
For purposes of chapter 4, a withholding agent must
withhold 30% of any payment of U.S. source FDAP
income that is a withholdable payment (defined in
Regulations section 1.1473-1(a)) made to a
nonparticipating FFI under Regulations section
1.1471-2(a), an NFFE that is not an excepted NFFE
(defined in Regulations section 1.1472-1(c)(1)) and does
not disclose its substantial U.S. owners (or certify that it
has no substantial U.S. owners) under Regulations
section 1.1472-1(b), or an exempt beneficial owner under
Regulations section 1.1471-6. In addition, a withholding
agent that is a participating FFI must withhold to the extent
required under Regulations section 1.1471-4(b) and its
FFI agreement, which, in addition to the requirements
mentioned in the previous sentence, requires withholding
on withholdable payments made to recalcitrant account
holders of the FFI. A similar requirement applies in certain
cases to certain classes of registered deemed-compliant
FFIs. See Regulations section 1.1471-5(f)(1). A
participating FFI (or registered deemed-compliant FFI)
may use a Form W-8 to document and establish the
foreign status of an account holder. See Regulations
section 1.1471-5(g) for when a participating FFI or
registered deemed-compliant FFI must treat an account
holder as a recalcitrant account holder. An FFI that is
considered a reporting FFI under a Model 1 or Model 2
intergovernmental agreement (IGA) may apply the
requirements of the applicable IGA to document its
account holders for purposes of FATCA.
Who Is a Withholding Agent?
Any person, U.S. or foreign, in whatever capacity acting,
that has control, receipt, custody, disposal, or payment of
an amount subject to withholding for chapter 3 purposes
or a withholdable payment for chapter 4 purposes is a
withholding agent. The withholding agent may be an
individual, corporation, partnership, trust, association, or
any other entity, including (but not limited to) any foreign
intermediary, foreign partnership, or U.S. branch of certain
foreign banks and insurance companies. If several
persons qualify as withholding agents for a single
payment, the tax required to be withheld must only be
withheld once. Generally, the person who pays (or causes
to be paid) an amount subject to withholding under
-2- Instructions for the Requester of Forms W-8 (Rev. 7-2014)
chapter 3 or a withholdable payment to the foreign person
(or to its agent) must withhold. See the Instructions for
Form 1042, Annual Withholding Tax Return for U.S.
Source Income of Foreign Persons, and Form 1042-S,
Foreign Person's U.S. Source Income Subject to
Withholding, for return filing and information reporting
obligations with respect to payments made to foreign
persons.
Generally, a foreign person that is a partner in a
partnership that submits a Form W-8 for purposes of
section 1441 or 1442 will satisfy the documentation
requirements under section 1446. However, in some
cases the documentation requirements for sections 1441
and 1442 do not match the documentation requirements
of section 1446. For example, a partner may generally
submit Form W-8BEN-E to establish itself as a foreign
person for purposes of section 1446, but a foreign
partnership or foreign grantor trust must submit Form
W-8IMY and accompanying documentation as provided
by Regulations sections 1.1446-1 through 1.1446-6. Also,
the owner of a disregarded entity, rather than the entity
itself, must submit the appropriate Form W-8 for purposes
of section 1446.
Responsibilities of a
Withholding Agent
Failure to Obtain Form W-8 or
Form W-9 — Presumption Rules
For ECTI allocable to a foreign partner, the partnership
is generally the withholding agent and must file Form
8804, Annual Return for Partnership Withholding Tax
(Section 1446), Form 8805, Foreign Partner's Information
Statement of Section 1446 Withholding Tax, and Form
8813, Partnership Withholding Tax Payment Voucher
(Section 1446).
Chapter 3 and Form 1099 Responsibilities
If you are a withholding agent making a payment of U.S.
source interest, dividends, rents, royalties, commissions,
nonemployee compensation, other FDAP gains, profits, or
income, and certain other amounts (including broker and
barter exchange transactions, and certain payments
made by fishing boat operators), you are generally
required to obtain from the payee either a Form W-9 or a
Form W-8. These forms are also used to establish a
person's status for purposes of domestic information
reporting (for example, on a Form 1099) and backup
withholding, including to determine, for purposes of
section 6050W, whether a participating payee is a foreign
person. If you receive a Form W-9, you must generally
make an information return on a Form 1099 (unless the
payee has provided a valid code on the form to indicate it
is an exempt recipient). If you receive a Form W-8, you
are exempt from reporting on Form 1099, but you may
have to file Form 1042-S and withhold under the rules
applicable to payments made to foreign persons. See the
Instructions for Form 1042-S for more information. See,
however, Regulations section 1.1441-1(c)(17), allowing a
payment to be associated with documentation other than
a Form W-8 for a payment made outside the United
States with respect to an offshore obligation under
Regulations section 1.6049-5(c)(1).
Generally, for purposes of chapter 3, you must withhold
30% from the gross amount of FDAP income paid to a
foreign person that is an amount subject to chapter 3
withholding under Regulations section 1.1441-2(a) unless
you can reliably associate the payment with a Form W-8
or other permitted documentation. You can reliably
associate a payment with a Form W-8 if you hold a valid
form, you can reliably determine how much of the
payment relates to the form, and you have no actual
knowledge or reason to know that any of the information
or certifications on the form are unreliable or incorrect. In
addition, a partnership that has ECTI allocable to a foreign
partner is a withholding agent with respect to that income
and must withhold in accordance with the provisions of
Regulations sections 1.1446-1 through 1.1446-6. See the
Instructions for Forms 8804, 8805, and 8813.
Instructions for the Requester of Forms W-8 (Rev. 7-2014) -3-
If you do not receive a Form W-8 or Form W-9 that you
may rely upon, or cannot otherwise determine whether a
payment should be treated as made to a U.S. person or to
a foreign person, use the presumption rules provided in
the Regulations under sections 1441, 1446, 1471, 6045,
and 6049. However, you may not withhold at a reduced
rate by applying the presumption rules if you have actual
knowledge that a higher withholding rate is applicable.
Chapter 4 Responsibilities
For purposes of chapter 4, if you are a withholding agent
making a withholdable payment to an entity payee, you
must establish the chapter 4 status of the entity payee (as
required for chapter 4 purposes) to determine if
withholding applies by generally obtaining a Form W-8
that you can reliably associate with the payment. If you
are not making a withholdable payment, a valid chapter 4
status is generally not required on the form for the payee,
but see the additional requirements for providing a
chapter 4 status by an entity providing a Form W-8IMY.
You can reliably associate a payment with a Form W-8 for
purposes of establishing a payee’s chapter 4 status if,
prior to the payment, you obtain a valid form that contains
the information required for chapter 4 purposes, you can
reliably determine how much of the payment relates to the
documentation, and you have no actual knowledge or
reason to know that any of the information, certifications,
or statements in, or associated with, the documentation
are unreliable or incorrect for chapter 4 purposes. See
Regulations section 1.1471-3(e)(4) for “reason to know”
standards for purposes of chapter 4.
Thus, a withholding agent must also determine if a
payment is a withholdable payment without regard to
exceptions from withholding applicable under chapter 3
and, for each such withholdable payment, must obtain a
Form W-8 upon which it is permitted to rely under
chapter 4 to determine the chapter 4 status of a payee
that is a foreign person for purposes of whether
withholding applies under chapter 4. See, however,
Regulations section 1.1471-3(d) for cases in which a
withholding agent may obtain other documentation to
determine an entity payee’s chapter 4 status. For a
participating FFI or registered deemed-compliant FFI, see
the requirements under Regulations section 1.1471-4 or
the requirements of an applicable IGA for the
documentation permitted to be used to document an
account holder for purposes of FATCA.
If you determine that you are making a withholdable
payment to an entity and cannot reliably associate the
payment with a Form W-8 or other permitted
documentation that is valid for chapter 4 purposes, you
are required to treat the entity payee as a nonparticipating
FFI such that withholding applies under Regulations
section 1.1471-2(a). If you are making a withholdable
payment to an NFFE, you must withhold under
Regulations section 1.1472-1 unless the NFFE (or other
entity that is the beneficial owner of the payment) certifies
on Form W-8 that it does not have any substantial U.S.
owners or identifies its substantial U.S. owners or is a
class of NFFE that certifies its status on Form W-8 to
obtain an exemption from these requirements. See also
Regulations sections 1.1471-2(a)(4)(ii) and 1.1472-1(b)(2)
for transition rules for withholdable payments made to
entities prior to July 1, 2016, for which withholding (and
establishing a payee's chapter 4 status) is not generally
required before that date. If you are a withholding agent
that is a participating FFI, you are required to withhold on
withholdable payments made to accounts held by
recalcitrant account holders as well as to nonparticipating
FFIs (including entities treated as nonparticipating FFIs
under the chapter 4 presumption rules) under Regulations
section 1.1471-4(b). See Regulations section 1.1471-4(c)
for the standards of knowledge applicable to participating
FFIs when documenting their account holders. A
participating FFI acting as a withholding agent with
respect to a withholdable payment made to an NFFE that
is not an account holder of the participating FFI must also
withhold to the extent required under Regulations section
1.1472-1 and, as applicable, based on the chapter 4
presumption rules. If you make a withholdable payment to
a payee (including a payee that is not an account holder),
you may be required to report the payment on Form
1042-S or on Form 8966, FATCA Report, or both, to the
extent required in the instructions for those forms. See the
Instructions for Form 1042-S and Form 8966 for more
information.
You may use the Form W-8 received from a payee or
an account holder documenting the payee or account
holder in connection with your withholding and reporting
obligations under chapter 4 (in addition to those under
chapter 3).
Do not send Forms W-8 to the IRS. Instead, keep the
forms in your records for as long as they may be relevant
to the determination of your tax liability under section 1461
(for payments subject to withholding under chapter 3),
section 1474 (for withholdable payments under
chapter 4), or Regulations section 1.1471-4(c)(2)(iv) (for
an FFI documenting account holders).
Requesting Form W-8
Request a Form W-8 described in these instructions from
any person to whom you are making a payment that you
presume or otherwise believe to be a foreign person. You
should request the form before making a payment so that
you have the form when you make the payment. A
withholding agent or payer that fails to obtain a Form W-8
or Form W-9 and fails to withhold as required under the
presumption rules may be assessed tax at the 30% rate or
backup withholding rate of 28%, as well as interest and
penalties for lack of compliance. See later in the
discussion of Form W-8IMY as to the extent that form is
required to be collected by a withholding agent making a
payment to a qualified securities lender.
A partnership should request a Form W-8 or W-9 from
any partner that is allocated income that is effectively
connected with the conduct of the partnership's U.S. trade
or business. A partnership that fails to withhold as
required under section 1446 is liable for the tax required to
be withheld. In addition, the partnership may be liable for
interest, penalties, and additions to the tax even if there is
no underlying tax liability due from a foreign partner on its
allocable share of partnership ECTI.
When you receive a completed Form W-8, you must
review it for completeness and accuracy with respect to
the claims made on the form. This responsibility extends
to the information attached to Form W-8, including for
Form W-8IMY, withholding statements, beneficial owner
withholding certificates, or other documentation and
information to the extent such documentation is required
to be associated with the Form W-8IMY. See below for
specific requirements for each type of Form W-8. You may
accept a valid Form W-8 for chapter 3 or 61 (for Form
1099 reporting) purposes that does not contain a valid
chapter 4 status for an entity payee with respect to
payments that you determine are not withholdable
payments. Otherwise, you must request a chapter 4 status
be provided in accordance with these instructions. See
Notes for Validating Form W-8IMY, later in these
instructions, for when a chapter 4 status is required on
Form W-8IMY.
If you are a withholding agent making a withholdable
payment or a payment subject to chapter 3 withholding
and you make the payment to an intermediary, you must
obtain documentation (for example, Form W-8IMY) from
such intermediary (including the intermediary’s chapter 4
status if the payment is also a withholdable payment), as
well as any required documentation from the beneficial
owner or owners of the payment.
Requesting Prior Form W-8 Versions
For purposes of chapter 3, a withholding agent can
request the prior version of Form W-8 if the form is
executed before the end of the six month period beginning
with the month after the revision date shown on the form,
and may rely on the form until the form’s period of validity
expires. See Regulations sections 1.1441-1(e)(4)(ii) and
(viii)(C). For purposes of chapter 4, a withholding agent
may request the prior version of Form W-8 but may rely on
the prior version of the form only to the extent permitted
under the allowance for reliance on a pre-FATCA Form
W-8. See Regulations section 1.1471-3(d)(1) regarding
reliance on a pre-FATCA Form W-8 for chapter 4
purposes and the period of validity for a form used for this
purpose. Notwithstanding the above, for purposes of both
chapters 3 and 4, a withholding agent making a payment
to, or documenting, an entity payee or account holder can
request the prior version of a Form W-8BEN-E, W-8IMY,
W-8EXP, or W-8ECI prior to January 1, 2015, and with
respect to chapter 3 may rely on the form to the extent
-4- Instructions for the Requester of Forms W-8 (Rev. 7-2014)
otherwise permitted until the form’s period of validity
expires (subject to a change in circumstances), but with
respect to chapter 4 may rely on the form only to the
extent permitted under the allowance for reliance on a
pre-FATCA Form W-8. A withholding agent may rely on a
prior version of a Form W-8 described in the preceding
sentence only if it is provided to the withholding agent
prior to January 1, 2015. Also see Notice 2014-33,
2014-21 I.R.B. 1033, available at www.irs.gov/irb/
2014-13_IRB/ar07.html for when a withholding agent may
treat an obligation open before January 1, 2015, as a
preexisting obligation for purposes of applying the due
diligence procedures under chapter 4.
FFI’s Requirement To Request Form
W-8 To Document Account Holders
If you are an FFI maintaining an account for an account
holder, you may be required to perform due diligence
procedures to identify and document a U.S. account
holder or entity account holder even if you are not making
a payment that is a withholdable payment (or an amount
subject to chapter 3 withholding) to the account holder.
You may also use Forms W-8 to document the chapter 4
status of a foreign account holder regardless of whether
you make a payment that is a withholdable payment or an
amount subject to chapter 3 withholding to the account
holder, and to validate a claim of foreign status made by
the account holder when the account has certain U.S.
indicia. For example, an FFI may treat an individual
account holder that has U.S. indicia (as described in
Regulations section 1.1471-4(c)(5)(iv)(B)) as a foreign
person for purposes of its U.S. account reporting
requirements when the individual provides a withholding
certificate (Form W-8BEN) and certain documentary
evidence establishing foreign status. Similar
documentation rules apply to a registered
deemed-compliant FFI for chapter 4 purposes. See
Regulations section 1.1471-5(f)(1).
In the case of an FFI documenting an account holder of
an account that the FFI determines is excepted as a
financial account under Regulations section 1.1471-5(b)
(2), a Form W-8 (or other permitted documentation for
chapter 4 purposes) need not be provided unless the form
is associated with amounts subject to withholding under
chapter 3. In such a case, a valid chapter 4 status need
not be provided on the form (only the information needed
for chapter 3 purposes with respect to the account
holder).
Requirements for Payment
Settlement Entities (PSEs)
Under section 6050W, a PSE is required to report certain
payments on Form 1099-K made to a participating payee
if the PSE does not establish the foreign status of the
payee. A Form W-8BEN, W-8BEN-E, or W-8ECI (as
applicable) may be used for this purpose. See the
requirements of section 6050W for when other
documentation may be used for this purpose.
Instructions for the Requester of Forms W-8 (Rev. 7-2014) -5-
Special Rules for Requesting
Specific Types of Forms W–8
Form W–8BEN
Request Form W-8BEN from any foreign individual to
whom you are making a payment subject to chapter 3
withholding or a withholdable payment if he or she is the
beneficial owner of the income, whether or not he or she is
claiming a reduced rate of, or exemption from, withholding
(including under an applicable income tax treaty). In
addition, if you are a partnership, request Form W-8BEN
for purposes of section 1446 from any foreign partner that
is an individual who is allocated ECTI. A beneficial owner
is required to enter a U.S. taxpayer identification number
(TIN) on line 5 if he or she is submitting the form to a
partnership that conducts a trade or business in the
United States.
Also request Form W-8BEN when an individual payee
may claim an exception from domestic information
reporting on Form 1099 (including section 6050W) and
backup withholding under section 3406 as a foreign
person for certain types of income, including broker
proceeds, short-term original issue discount, bank deposit
interest, foreign source interest, dividends, rents, or
royalties.
Finally, request Form W-8BEN if you are a participating
FFI or registered deemed-compliant FFI required to
establish the foreign status of an individual account holder
for chapter 4 purposes or under the requirements of an
applicable IGA, absent obtaining other applicable
documentation that may be used for this purpose under
chapter 4 or the IGA.
TIN requirements for Forms W-8BEN. You should
request the individual payee’s foreign TIN to be
completed on line 6 of the Form W-8BEN if the payee is
providing the Form W-8BEN with respect to an obligation
held at your U.S. office and you are a financial institution.
If a foreign TIN is not provided for the payee in this case,
you may not treat the Form W-8BEN as valid if you know
that the payee has a foreign TIN that it has not provided,
unless you have a record of the TIN in your account files
that you are able to report on Form 1042-S. In any other
case in which the foreign TIN is not provided, you must
obtain the individual payee’s date of birth on line 8 in order
to treat the Form W-8BEN as valid unless you otherwise
have the individual payee’s date of birth in your account
files for the payee that you are able to report on a Form
1042-S. Note that a future revision to Form W-8BEN may
require you to obtain both a foreign TIN and date of birth
for a payee described in this paragraph.
Form W–8BEN–E
Request Form W-8BEN-E from any foreign entity to which
you are making a payment of an amount subject to
chapter 3 withholding or a withholdable payment if the
entity is the beneficial owner of the income, whether or not
it is claiming a reduced rate of, or exemption from,
withholding (including under an applicable income tax
treaty). A foreign reverse hybrid entity claiming treaty
benefits on its own behalf should submit to you a Form
W-8BEN-E with respect to the income for which treaty
benefits are being claimed even though it is not the
beneficial owner of the income under U.S. tax principles.
See Special Requirements for Hybrid and Reverse Hybrid
Entities, later in these instructions, for further
requirements for chapter 4 purposes. In addition, if you
are a partnership, request Form W-8BEN-E for purposes
of section 1446 from any foreign partner that is an entity
that is allocated ECTI (other than a foreign partner that is
a partnership, grantor trust, or person or organization that
qualifies to file Form W-8EXP). A beneficial owner is
required to enter a U.S. TIN for section 1446 purposes on
line 8 if it is submitting the form to a partnership that
conducts a trade or business in the United States. Also
request Form W-8BEN-E when an entity payee may claim
an exception from domestic information reporting as a
foreign person (including for section 6050W purposes) or
to establish that certain income from notional principal
contracts is not effectively connected with the conduct of
a U.S. trade or business for purposes of the reporting
requirements on Form 1042-S for such payments. See
Regulations section 1.1441-4.
For a Form W-8BEN-E that is associated with a
withholdable payment to a foreign entity, you must obtain
a valid chapter 4 status for the entity to the extent required
for chapter 4 purposes to determine if withholding applies
under chapter 4, and must obtain an applicable
certification in Parts IV through XXVIII unless provided
otherwise in the instructions for Form W-8BEN-E (see
Alternative Certifications Under an Applicable IGA,
below). Also, see Regulations section 1.1471-1(b)(19)
(defines chapter 4 status). A valid chapter 4 status is not
required to be provided when the form is associated with
a payment subject to chapter 3 withholding that is not a
withholdable payment, when the payment is made with
respect to a preexisting obligation before January 1, 2016,
to the extent provided in Regulations section 1.1471-2(a)
(4)(ii) or 1.1472-1(b)(2), or the payment is made to an
account that is excepted as a financial account under
Regulations section 1.1471-5(b)(2).
If you are a participating FFI or registered
deemed-compliant FFI, request Form W-8BEN-E (or other
permitted documentation) to document the chapter 4
status of an entity account holder, regardless of whether
you make a withholdable payment or an amount subject to
chapter 3 withholding to such entity when you are required
to do so under your chapter 4 due diligence requirements
or under the requirements of an applicable IGA.
Alternative Certifications Under an Applicable IGA
If you are an FFI covered under a Model 1 IGA or Model 2
IGA using Form W-8BEN-E to document account holders
pursuant to the due diligence requirements of Annex I of
an applicable IGA, you may be permitted to request
alternative certifications from your account holders in
accordance with the requirements of and definitions
applicable to the IGA to which you are subject instead of
the certifications in Parts IV through XXVIII of the Form
W-8BEN-E (which are based on the regulations under
chapter 4). You should provide those certifications to
account holders that provide you with a Form W-8BEN-E,
and the account holder should attach the completed
certification to the Form W-8BEN-E in lieu of completing a
certification otherwise required in Parts IV through XXVIII
of the form. In such a case, you must provide a written
statement to the account holder stating that you have
provided the alternative certification to meet your due
diligence requirements under an applicable IGA and must
associate the certification with the Form W-8BEN-E.
If you are a withholding agent (including an FFI), you
may also request and rely upon an alternative certification
from an entity account holder to establish that the account
holder is an NFFE (rather than a financial institution)
under an applicable IGA. An entity providing such a
certification will still be required, however, to provide its
chapter 4 status (i.e., the type of NFFE) in Part I, line 5, as
determined under the regulations or IGA, whichever is
applicable to the withholding agent. For example, if you
are a U.S. withholding agent that receives a Form
W-8BEN-E from an entity account holder certifying to its
status as a publicly traded NFFE, you may request a
written certification that the entity is not a financial
institution as defined under the IGA applicable to the entity
and document it under the regulations by obtaining the
NFFE's certification of its chapter 4 status in Part I, line 5.
However, a nonprofit organization treated as an active
NFFE under Annex I of an applicable IGA may provide an
alternative certification that it is an NFFE that qualifies as
a nonprofit organization under an applicable IGA. In such
a case, the nonprofit organization will not be required to
check a box in Part I, line 5, and the withholding agent
may treat the entity as an excepted NFFE.
If you receive an alternative certification under an
applicable IGA described in the preceding paragraphs,
you may rely on such certification unless you know or
have reason to know the certification is incorrect.
Requirements for Obtaining and Verifying a
Global Intermediary Identification Number (GIIN)
If you receive a Form W-8BEN-E from an entity payee that
is identified in Part I, line 1, that is claiming chapter 4
status as a participating FFI (including a reporting Model 2
FFI) or registered deemed-compliant FFI (including a
reporting Model 1 FFI), or a nonreporting IGA FFI under a
Model 2 IGA, provided that the nonreporting IGA FFI is
treated as a registered deemed-compliant FFI under the
Model 2 IGA, you must obtain and verify the entity’s GIIN
against the published IRS FFI list. See Regulations
sections 1.1471-3(d)(4)(i) and 1.1471-3(e)(3).
If you make a withholdable payment to a direct
reporting NFFE, you must obtain and verify the direct
reporting NFFE’s GIIN against the published IRS FFI list.
For payments made prior to January 1, 2016, a
registered deemed-compliant FFI that is a sponsored FFI,
or a direct reporting NFFE that is a sponsored direct
reporting NFFE, must provide the GIIN of its sponsoring
entity to you if it has not obtained its own GIIN. See
Regulations section 1.1471-3(e)(3)(iv) for the
requirements to verify the GIIN against the published IRS
FFI list for withholdable payments made to direct reporting
NFFEs and sponsored direct reporting NFFEs.
-6- Instructions for the Requester of Forms W-8 (Rev. 7-2014)
If you make a withholdable payment to a branch of an
FFI identified in a box shown on Part II of the form that
provides you a GIIN, you must verify against the FFI list
the GIIN (if applicable) provided in Part II, line 13, rather
than the GIIN for the entity provided in Part I, line 9a.
You may only accept a Form W-8BEN-E with Part II
completed if the entity shown in Part II is an FFI that is a
branch of the entity identified in line 1 and the branch is
receiving a withholdable payment or if the entity shown in
Part II is a disregarded entity that is identified in Part I,
line 3, as receiving the payment. If you receive such a
Form W-8BEN-E from a branch or disregarded entity
described in the preceding sentence that is receiving such
a payment associated with the form, you must verify the
GIIN of the branch or disregarded entity against the
published IRS FFI list and not that of the entity identified in
Part I, line 1.
For a withholdable payment made to a certified
deemed-compliant FFI that is a sponsored, closely held
investment vehicle, you must obtain a GIIN for the
sponsoring entity and verify it against the published IRS
FFI list.
If you receive a Form W-8BEN-E from an entity payee
that is claiming chapter 4 status as a participating FFI,
reporting Model 1 FFI, reporting Model 2 FFI, registered
deemed-compliant FFI, direct reporting NFFE, sponsored
direct reporting NFFE, or sponsoring entity of an NFFE
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-8BEN-E from such a payee that does
not include a GIIN, or includes a GIIN that does not
appear on the published IRS FFI list, will be invalid for
purposes of chapter 4 beginning on the date that is 90
days after the date the form is provided. See Regulations
section 1.1471-3(e)(3)(iii) and (iv).
Prior to January 1, 2015, if you receive a Form
W-8BEN-E from an entity payee that is claiming chapter 4
status as a reporting Model 1 FFI, you are not required to
obtain the entity payee’s GIIN. A form from such an entity
without the GIIN is valid for payments made prior to
January 1, 2015.
You may accept a GIIN that is indicated and clearly
identified on the form rather than provided as required in
box 9a or another box permitted in the Instructions for
Form W-8BEN-E if the GIIN is clearly identified as being
furnished with respect to the box.
If you receive a Form W-8 from a payee or an account
holder that contains a TIN or GIIN, you may not rely on the
TIN or GIIN if the number provided is incomplete or
truncated.
Further Notes for Validating Form W-8BEN-E
Part I, Line 4 (Chapter 3 Status). If you receive a Form
W-8BEN-E from an entity that indicates in Part I, line 4,
that the entity is a disregarded entity, partnership, simple
trust, or grantor trust, and the entity has checked “No” in
Part I, line 4, of the Form W-8BEN-E, then you should not
accept the Form W-8BEN-E if the form is used with
Instructions for the Requester of Forms W-8 (Rev. 7-2014) -7-
respect to payments that are subject to chapter 3
withholding. In such a case, you should request the entity
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
based on the owner’s characteristics if the entity is a
disregarded entity. An FFI documenting an account holder
under its chapter 4 requirements or under an applicable
IGA may, however, accept the Form W-8BEN-E when the
entity account holder does not receive payments subject
to chapter 3 withholding or withholdable payments
associated with the form.
Part I, Line 5 (Chapter 4 Status). If you receive a Form
W-8BEN-E from an entity that is a certified
deemed-compliant FFI under Regulations section
1.1471-5(f)(2), a deemed-compliant FFI under an
applicable IGA, or an exempt beneficial owner, the entity
should not check the box in Part I, line 5, of Form
W-8BEN-E for Nonparticipating FFI (including a limited
FFI or an FFI related to a Reporting IGA FFI other than a
registered deemed-compliant FFI or participating FFI).
Instead, it should check the appropriate box for its status
as a certified deemed-compliant FFI, nonreporting IGA
FFI, or exempt beneficial owner. See the Instructions for
Part I, line 5, of Form W-8BEN-E.
Part I, Line 9 (Foreign TIN). You should request the
entity payee’s foreign TIN to be completed on line 9b of
the Form W-8BEN-E if you are a financial institution
maintaining the payee’s obligation at your U.S. office. If
the foreign TIN is not provided, you may not treat the
Form W-8BEN-E as valid if you know that the entity payee
has a foreign TIN that it has not provided, unless you have
record of the TIN in your account files that you are able to
report on Form 1042-S.
Part X, Line 24 (Owner-Documented FFI). You may
accept a Form W-8BEN-E from an entity claiming status
as an owner-documented FFI that you agree to treat as an
owner-documented FFI that does not check box 24d in
Part X regardless of whether you know that the entity is a
trust that has one or more contingent beneficiaries. You
may accept this certificate (and may otherwise treat an
entity as an owner-documented FFI) only if you are a
designated withholding agent under the chapter 4
regulations.
Form W–8ECI
Request Form W-8ECI from any foreign person or
organization to which you are making a payment if it is the
beneficial owner of the income and it claims that the
income is effectively connected with the conduct of a
trade or business in the United States. However, request
a Form W-8BEN or W-8BEN-E (as applicable) from a
foreign partner that is allocated income that is effectively
connected with the conduct of the partnership's trade or
business in the United States, unless the foreign partner
has made an election under section 871(d) or section
882(d).
Notes for Form W-8ECI
If you are an FFI maintaining accounts for account holders
and you receive a Form W-8ECI from an account holder,
you may also need to obtain other documentation for
determining the account holder’s chapter 4 status to meet
your documentation requirements as a participating FFI or
registered deemed-compliant FFI.
If you receive a Form W-8ECI without a U.S. TIN
entered on line 7, you may not treat the income as
effectively connected with a U.S. trade or business and
you must apply the appropriate presumption rules.
Your receipt of Form W-8ECI serves as a
representation by the payee or beneficial owner that the
items of income identified on line 11 are effectively
connected with the conduct of a trade or business within
the United States. Therefore, if a beneficial owner
provides you with a Form W-8ECI, you may treat all of the
U.S. source income identified on line 11 paid to that
beneficial owner as effectively connected with the conduct
of a trade or business within the United States and not as
a withholdable payment for purposes of chapter 4 (see
Regulations section 1.1473-1(a)(4)(ii)). Therefore, a
chapter 4 status is not required for a payee who provides
a valid Form W-8ECI, except in the circumstances
described above (for an FFI documenting an account
holder under its chapter 4 requirements or the
requirements of an applicable IGA).
If you pay items of income that are not identified on
line 11 by the beneficial owner as effectively connected
with the conduct of a trade or business within the United
States, you are generally required to obtain from the
beneficial owner another type of Form W-8.
You may not treat an amount as income effectively
connected with the conduct of a trade or business within
the United States unless the beneficial owner gives you a
valid Form W-8ECI. However, there are exceptions for
income paid on notional principal contracts and payments
made to certain U.S. branches.
Notional principal contracts reportable on Form
1042-S. Withholding at a 30% rate is not required on
amounts paid under the terms of a notional principal
contract whether or not a Form W-8ECI is provided
(except when a payment made under such contract is
U.S. source income, such as a dividend equivalent
amount under section 871(m)). However, if the income is
effectively connected with the conduct of a U.S. trade or
business, it is reportable by the withholding agent on Form
1042-S (regardless of whether the payment is U.S. source
income). A withholding agent must treat income as
effectively connected with the conduct of a U.S. trade or
business, even if a Form W-8ECI has not been received, if
the income is paid to a qualified business unit of a foreign
person located in the United States or if the income is paid
to a qualified business unit of a foreign person located
outside the United States and the withholding agent
knows, or has reason to know, the payment is effectively
connected with the conduct of a U.S. trade or business.
However, a payment is not treated as effectively
connected with the conduct of a U.S. trade or business if
the payee provides a Form W-8BEN-E representing that
the income is not effectively connected with a U.S. trade
or business or makes a representation in a master
agreement that governs the transactions in notional
principal contracts between the parties (for example, an
International Swaps and Derivatives Association
agreement), or in the confirmation on the particular
notional principal contract transaction, that the payment is
not effectively connected with the conduct of a U.S. trade
or business. See Regulations section 1.1441-4(a)(3)(ii)
and the instructions for Form W-8BEN-E described
earlier.
Payments to certain U.S. branches treated as effectively connected income. Payments to U.S. branches
of certain foreign persons that have not agreed to be
treated as U.S. persons under Regulations section
1.1441-1(b)(2)(iv)(A) and that have provided a U.S. TIN
are presumed to be effectively connected with the
conduct of a trade or business within the United States
even if the foreign person (or its U.S. branch) does not
give you a Form W-8ECI or withholding certificates with
respect to other persons receiving the payment for which
a Form W-8IMY is provided by the U.S. branch.
If Form W-8IMY or the branch’s EIN is not provided, the
income paid cannot be treated as effectively connected
income, and the withholding agent must withhold when
the payment is collected by the branch on behalf of other
persons.
Form W–8EXP
Request Form W-8EXP from any foreign government,
international organization, foreign central bank of issue,
foreign tax-exempt organization, foreign private
foundation, or government of a U.S. possession to which
you are making a payment subject to chapter 3
withholding if such person is claiming an exemption from
withholding under sections 1441, 1442, and 1443
pursuant to section 115(2), 501(c), 892, or 895, or
claiming a reduced rate of withholding under section
1443(b).
A withholding agent making a withholdable payment
will also be required to determine the chapter 4 status of
the person submitting Form W-8EXP to determine an
exemption from withholding under chapter 4. In some
instances, for example, a payee that is claiming an
exemption from withholding under sections 1441, 1442,
and 1443 will also be an exempt beneficial owner that is
not subject to withholding for purposes of chapter 4. See
Regulations section 1.1471-6. You should also request
Form W-8EXP when the government, organization, or
other entity referred to in the first sentence of this
paragraph is claiming an exemption from withholding
under chapter 4 as an exempt beneficial owner under
Regulations section 1.1471-6, as a tax-exempt
organization under section 501(c), or as an entity with
another chapter 4 status to which withholding under
chapter 4 does not apply (among the chapter 4 statuses
shown on Form W-8EXP). See line 4 of Form W-8EXP for
the chapter 4 statuses that may be claimed on this form.
If you are an FFI documenting an account holder that is
a tax-exempt organization or exempt beneficial owner
under Regulations section 1.1471-6 to which you do not
pay amounts subject to withholding under chapter 3, you
may instead require that the account holder complete
Form W-8BEN-E to establish its status for chapter 4
purposes. For purposes other than documenting a payee
-8- Instructions for the Requester of Forms W-8 (Rev. 7-2014)
or account holder claiming a reduced rate of withholding
pursuant to section 115(2), 501(c), 892, 895, or 1443, you
may request Form W-8BEN-E (such as to establish only
the entity’s foreign status) or W-8ECI (to establish that the
income is effectively connected with a U.S. trade or
business).
A Form W-8EXP submitted by a foreign person for
purposes of withholding under sections 1441 through
1443 will also establish that partner's foreign status for
purposes of section 1446. However, except as provided in
Regulations section 1.1446-3(c)(3) (regarding certain
tax-exempt organizations described in section 501(c)), the
submission of Form W-8EXP will have no effect on
whether the partner is subject to withholding under section
1446.
A withholding agent may treat a payee as an
international organization without requiring a Form
W-8EXP if the name of the payee is one designated as an
international organization by Executive Order (pursuant to
22 U.S.C. 288 through 288(f)) and other facts surrounding
the payment reasonably indicate that the beneficial owner
of the payment is an international organization. With
regard to amounts derived from bankers' acceptances for
chapter 3 purposes, a withholding agent may treat a
payee as a foreign central bank of issue without requiring
a Form W-8EXP if the name of the payee and other facts
surrounding the payment reasonably indicate that the
beneficial owner of the payment is a foreign central bank
of issue.
A U.S. TIN is required if the beneficial owner is claiming
an exemption based solely on a claim of tax-exempt
status as a foreign private foundation (or other foreign
organization described under section 501(c)). However, a
U.S. TIN is not required from a foreign private foundation
that is subject to the 4% excise tax on gross investment
income (under section 4948(a)) on income that would be
exempt from withholding except for section 4948(a) (for
example, portfolio income).
Form W–8IMY
Request Form W-8IMY from any person that is an
intermediary (whether a qualified intermediary (QI) or a
nonqualified intermediary, including certain U.S. branches
or territory financial institutions), a withholding foreign
partnership (WP), a withholding foreign trust (WT), or a
flow-through entity to which you make a withholdable
payment or payment that is a reportable amount (as
described in Regulations section 1.1441-1(e)(3)(vi)). A
flow-through entity includes a foreign partnership (other
than a WP), a foreign simple or grantor trust (other than a
WT), and, for any payments for which a treaty benefit is
claimed, any entity to the extent it is treated as fiscally
transparent under section 894. See the Instructions for
Form W-8IMY for when a Form W-8IMY is required to be
provided by a U.S. branch. Form W-8IMY should also be
provided by an entity to claim status as a qualified
securities lender (QSL) with respect to payments of U.S.
source substitute dividends and may be relied upon
regardless of whether the QSL acts as an intermediary
with respect to substitute dividends associated with the
form. In a case in which an entity certifies on Form
W-8IMY its status as a QSL, you may make payments of
Instructions for the Requester of Forms W-8 (Rev. 7-2014) -9-
substitute dividends to this entity without requiring a
withholding statement when the QSL provides a written
statement that it is not acting as an intermediary with
respect to such payments associated with the form or
certifies its status as a QI. Additionally, you may rely on
documentation that does not include a chapter 4 status for
an account holder or an intermediary or flow-through
entity when the withholding statement provided by such
entity indicates that the payment is made to an account
excluded as a financial account under Regulations section
1.1471-5(b)(2).
The chapter 4 status of an intermediary or flow-through
entity is also required on the form if the form is associated
with a withholdable payment and you are required to
determine the entity's status for chapter 4 purposes.
Except to the extent provided otherwise in applicable
regulations, appropriate withholding certificates,
documentary evidence, and withholding statements must
be associated with Form W-8IMY for both chapter 3 and 4
purposes or you must apply the presumption rules. See
the Instructions for Form W-8IMY for details on these
requirements, including the requirements for chapter 3
withholding rate pools permitted to be provided to
withholding agents by QIs, and when chapter 4
withholding rate pools may be included in withholding
statements provided by intermediaries and flow-through
entities. A participating FFI or registered
deemed-compliant FFI may also request Form W-8IMY
from an intermediary or flow-through entity that is an
account holder of the participating FFI or registered
deemed-compliant FFI to establish its chapter 4 status
(when required for chapter 4 purposes) or status under an
applicable IGA even when no payments subject to
chapter 3 withholding or withholdable payments are made
to the account. In such a case, a withholding statement is
not required.
Notes for Validating Form W-8IMY
TIN, Chapter 4 Status, and Withholding Statement. A
QI, WP, or WT must provide the EIN that was issued to
the entity in such capacity (its QI-EIN, WP-EIN, or
WT-EIN) as well as its GIIN if it is an FFI (other than a QI
that is a limited FFI), a direct reporting NFFE, or a
sponsoring entity as required for chapter 4 purposes when
it is receiving a withholdable payment associated with the
Form W-8IMY unless an exception for providing a
chapter 4 status applies (for example, a Form W-8IMY
provided with respect to a preexisting account (see
Regulations section 1.1471-2(a)(4)(ii)). See the
Instructions for Form W-8BEN-E and the discussion of
Form W-8BEN-E earlier in these instructions for the
requirements with respect to obtaining and validating a
GIIN that also apply with respect to an entity providing a
Form W-8IMY, including when a branch of an FFI receives
a withholdable payment and when a GIIN is not required
on Form W-8IMY and when a chapter 4 status is not
required on this form. Because status as a QI, WP, or WT
for a financial institution is limited to certain classes of
FFIs, for Forms W-8IMY associated with withholdable
payments, a withholding agent must validate that the QI,
WP, or WT certifies its status when required for chapter 4
purposes described in Regulations sections 1.1441-1(e)
(5)(ii) (for a QI), 1.1441-5(c)(2) (for a WP), or 1.1441-5(e)
(5)(v) (for a WT). However, for certain QIs that are not
financial institutions, you may request the written
statement described later in these instructions to establish
its chapter 4 status. Also see the Instructions for Form
W-8IMY and the section 1441 regulations for the
permitted chapter 4 statuses of these entities.
A U.S. TIN is also required for an entity certifying its
status as a QSL with respect to U.S. source substitute
dividend payments and for a U.S. branch or territory
financial institution providing a Form W-8IMY to evidence
its agreement to be treated as a U.S. person. In a case in
which you make a payment of a substitute dividend to a
QSL for which you are required to determine the QSL's
chapter 4 status, you must collect Form W-8IMY. In a
case in which a QSL's chapter 4 status is not required,
you may continue to rely on the written certification of its
compliance with the requirements of QSL status as
required in Section III.C of Notice 2010-46, 2010-24 I.R.B.
757, available at www.irs.gov/irb/2010-24_IRB/ar09.html,
until such certification expires.
A chapter 4 status is also required on a Form W-8IMY
when the intermediary or flow-through entity providing the
form is a participating FFI or registered deemed-compliant
FFI that is using the form to provide a withholding
statement allocating a payment to a chapter 4 withholding
rate pool of U.S. payees (in addition to when a chapter 4
status is otherwise required for withholdable payments).
Additionally, for a Form W-8IMY provided by an
intermediary allocating a payment to such a pool, the
intermediary must provide the certification required on the
form in Part IV with respect to its compliance with the
requirements of Regulations section 1.6049-4(c)(4) (or
similar requirement under chapter 61 for a payment other
than interest). In the case of a QI providing a withholding
statement allocating a payment to this pool, the QI must
check the applicable certification(s) in Part III, line 14e(i)
and/or 14e(ii). If the QI provides the certification in
line 14e(i), the QI must certify to its chapter 4 status as a
participating FFI (including a reporting Model 2 FFI) or
registered deemed-compliant FFI (including a reporting
Model 1 FFI.)
If a participating FFI or registered deemed-compliant
FFI that is an intermediary or flow-through entity provides
you with a withholding statement and documentation for
its account holders and payees, you are not required to
verify the information on the account holders and payees
provided in the documentation for chapter 4 purposes
unless it is facially incorrect, and you are not required to
obtain supporting documentation for the payee in addition
to the information provided on the withholding statement
unless you are obtaining the documentation for purposes
of chapter 3 or 61, or unless you know that the
documentation review conducted by the participating FFI
or registered deemed-compliant FFI was not adequate for
purposes of chapter 4. See Regulations section
1.1471-3(e)(4)(vi)(B) for standards that apply in such a
case to determine that chapter 4 withholding does not
apply (such that you may then determine the rate of
withholding applicable for chapter 3 purposes).
A QI that is a limited FFI may provide a Form W-8IMY
associated with a withholding statement allocating a
payment to a pool of exempt beneficial owners for which
the QI is receiving the payment.
For a QI providing this form that is not an FFI, the entity
is not required to provide a chapter 4 status on Form
W-8IMY and need not check a box in Part I, line 5. You
may request that the entity certify, on a statement
associated with the form, that the entity is a QI that is an
NFFE to clarify its chapter 4 status as other than an FFI.
An intermediary or flow-through entity may provide a
status for chapter 4 purposes found under the
requirements of (and documentation permitted under) an
applicable IGA for an account holder, and a withholding
agent may rely upon such status and documentation.
Additionally, see the earlier instructions for Form
W-8BEN-E and Form W-8IMY for further details on
alternative certifications that may be requested by
withholding agents for such cases.
1446 requirements. Request Form W-8IMY for
purposes of section 1446 only from a foreign upper-tier
partnership or foreign grantor trust. Generally, for
purposes of section 1446, the Form W-8IMY submitted by
these entities is used to transmit the forms of the owners
of these entities. When such other forms are provided, a
partnership may look through these entities to the
beneficial owners when determining its section 1446 tax
obligation.
Special Requirements for Hybrid
and Reverse Hybrid Entities
A hybrid entity is any person (other than an individual) that
is treated as fiscally transparent (rather than as a
beneficial owner) for purposes of declaring its status
under the Code but is not treated as fiscally transparent
by a country with which the United States has an income
tax treaty. A hybrid entity, however, may be considered a
payee for chapter 4 purposes when receiving a
withholdable payment when it is a flow-through entity (i.e.,
not a disregarded entity) in addition to its partners,
beneficiaries, or owners as applicable. See Regulations
section 1.1471-3(a) (defining who is a payee of a
withholdable payment) and Regulations section
1.1471-3(d) for entities required to be documented for
chapter 4 purposes.
If you are making a payment to a hybrid entity that is
making a claim for treaty benefits as a qualified resident
under an applicable tax treaty on its own behalf, the hybrid
entity should provide a Form W-8BEN-E to claim treaty
benefits. If the hybrid entity is receiving a payment that is a
withholdable payment, it should also provide to you a
Form W-8IMY along with a withholding statement (if
required) establishing the chapter 4 status of each of its
partners, beneficiaries, or owners as a condition for
providing the rate of withholding under the treaty on the
entire payment. If the hybrid entity is a disregarded entity,
the single owner should provide a Form W-8BEN-E or
W-8BEN (as applicable) along with the Form W-8BEN-E
for the hybrid entity. Line 10 of the Form W-8BEN-E may
be used by the hybrid entity to associate the Forms W-8.
For an entity that is a reverse hybrid entity receiving a
withholdable payment, you should obtain a Form
-10- Instructions for the Requester of Forms W-8 (Rev. 7-2014)
W-8BEN-E from the entity to establish its chapter 4 status.
Additionally, with respect to a payment for which the entity
is claiming a reduced rate of withholding for its partners,
beneficiaries, or owners, as applicable, you have obtained
from the entity a Form W-8IMY with applicable
documentation with respect to claims of treaty benefits for
reduced withholding made by partners, beneficiaries, or
owners in the entity. Otherwise, withholding will apply
under chapter 4 based on the presumptions under
Regulations section 1.1473-1(f) regardless of whether
otherwise valid treaty claims are made by such persons.
Due Diligence Requirements
You are responsible for ensuring that all information
relating to the type of income for which Form W-8 is
submitted is complete and appears to be accurate and,
for an entity providing the form, includes a chapter 4
status (if required as described above). In general, you
may rely on the information and certifications provided on
the form (including the status of the beneficial owner as an
individual, corporation, etc.) unless you have actual
knowledge or reason to know that the information is
unreliable or incorrect. You have reason to know that the
information is unreliable or incorrect if you have
knowledge of relevant facts or statements contained in the
withholding certificate or other documentation that would
cause a reasonably prudent person in your position to
question the claims made. For example, if you have
information in your records that contradicts information
provided on the form, you may not rely on the form. If you
know or have reason to know that any information is
unreliable or incorrect, you must obtain a new Form W-8
or other appropriate documentation.
Reason to know. You have reason to know that a Form
W-8 is unreliable or incorrect if the Form W-8 is
incomplete with respect to any item that is relevant to the
claims made, the form contains any information that is
inconsistent with the claims made, the form lacks
information necessary to establish that the beneficial
owner is entitled to a reduced rate of withholding, or the
withholding agent has other account information that is
inconsistent with the claims made. See, however, the
allowance to use other documentation to validate a Form
W-8 for an inconsequential error on a Form W-8
described below in these instructions.
If you are a withholding agent that is a financial
institution (as defined in Regulations section 1.1471-5(e)),
insurance company, or a broker or dealer in securities that
maintains an account for a direct account holder
(beneficial owner) making a payment of U.S. source
FDAP income to a direct account holder, you have reason
to know that a Form W-8BEN or W-8BEN-E provided by
the direct account holder is unreliable or incorrect for such
payments if one or more of the following circumstances
exist with respect to a claim of foreign status for chapter 3
or 4 purposes or a claim of treaty benefits. In that case,
you must either request a new form or the additional
documentation to substantiate the claims on the form. See
Regulations section 1.1441-7(b)(3) for the limits on reason
to know for the entities referenced in this paragraph for
purposes of chapter 3. See Regulations section
1.1471-3(e)(4)(v) for when a withholding agent may rely
on a code or classification under Regulations section
1.1471-3(c)(5)(ii)(B) to treat an entity as a foreign person
for chapter 4 purposes (including the U.S. indicia relevant
for such purposes). For participating FFIs documenting
the status of account holders for purposes of the FFI’s
chapter 4 requirements, see Regulations section
1.1471-4(c).
A withholding agent described above may not rely on a
Form W-8BEN or Form W-8BEN-E if:
1. The withholding agent has classified the account
holder as a U.S. person in its account information, the
Form W-8 has a current permanent residence address or
a current mailing address in the United States, the
withholding agent has a current residence or current
mailing address in the United States as part of its account
information, the account holder notifies the withholding
agent of a new residence or mailing address in the United
States, or, only to the extent described in Regulations
section 1.1441-7(b)(5), the withholding agent has a U.S.
telephone number as the sole telephone number for the
account holder. However:
a. An individual who has provided a Form W-8BEN
may be treated as a foreign person if:
The withholding agent has in its possession or obtains
documentary evidence (as described in Regulations
section 1.1471-3(c)(5)(i)) (which does not contain a U.S.
address) supporting the claim of foreign status, and the
individual provides the withholding agent with a
reasonable explanation, in writing, supporting his or her
claim of foreign status,
For a payment made outside the U.S. with respect to an
offshore obligation (as defined in Regulations section
1.6049-5(c)(1)), the withholding agent has in its
possession or obtains documentary evidence establishing
foreign status (as described in Regulations section
1.1471-3(c)(5)(i)) that does not contain a U.S. address,
With respect to an offshore obligation (as defined in
Regulations section 1.6049-5(c)(1)), the withholding agent
classifies the individual as a resident of the country where
the obligation is maintained and is required to report
payments to the individual annually to the tax authority of
the country in which the obligation is maintained and that
country has an income tax treaty or information exchange
agreement in effect with the United States, or
The withholding agent has classified the account holder
as a U.S. person in its account information, and the
withholding agent has in its possession or obtains
documentary evidence (as described in Regulations
section 1.1471-3(c)(5)(i)(B)) evidencing citizenship in a
country other than the United States.
b. An entity that has provided a Form W-8BEN-E may
be treated as a foreign person if the withholding agent
does not know or have reason to know that it is a
flow-through entity and:
The withholding agent has in its possession or obtains
documentation establishing foreign status (as described
in Regulations section 1.1471-3(c)(5)(i) and as applicable
to entities) that substantiates that the entity is actually
organized or created under the laws of a foreign country,
or
For a payment made with respect to an offshore
obligation (as defined in Regulations section 1.6049-5(c)
(1)), the withholding agent classifies the entity as a
Instructions for the Requester of Forms W-8 (Rev. 7-2014) -11-
resident of the country in which the account is maintained,
the withholding agent is required to report a payment
made to the entity annually to the tax authority of the
country in which the account is maintained and that
country has an income tax treaty or tax information
exchange agreement in effect with the United States.
2. The form is provided with respect to an offshore
obligation and the account holder has provided standing
instructions directing the withholding agent to pay
amounts from its account to an address in, or an account
maintained in, the United States, unless the account
holder provides a reasonable explanation in writing that
supports its foreign status or provides documentary
evidence (as described in Regulations section
1.1471-3(c)(5)(i)) supporting its foreign status.
3. The Form W-8BEN is provided by an individual and
is used to establish foreign status and the withholding
agent has, either on accompanying documentation or as
part of its account information, an unambiguous indication
of a place of birth for the individual in the United States,
unless the withholding agent has in its possession or
obtains documentary evidence (described in Regulations
section 1.1471-3(c)(5)(i)(B)) evidencing citizenship in a
country other than the United States and either:
A copy of the individual’s Certificate of Loss of
Nationality of the United States, or
A reasonable written explanation of the account
holder’s renunciation of U.S. citizenship or the reason the
account holder did not obtain U.S. citizenship at birth.
4. The Form W-8 is used to establish residence in a
treaty country and:
a. The permanent residence address is not in the
treaty country or the withholding agent is notified of a new
permanent residence address that is not in the treaty
country. However, the beneficial owner may be treated as
a resident of the treaty country if it provides a reasonable
explanation for the permanent residence address outside
the treaty country or the withholding agent has in its
possession, or obtains, documentary evidence described
in Regulations section 1.1471-3(c)(5)(i) that establishes
residency in the treaty country.
b. The mailing address is not in the treaty country or
the withholding agent has a mailing address that is not in
the treaty country as part of its account information.
However, the beneficial owner may be treated as a
resident of the treaty country if:
The withholding agent has in its possession, or obtains,
documentary evidence supporting the claim of residence
in the treaty country and the additional documentation
does not contain an address outside the treaty country,
The withholding agent has in its possession, or obtains,
documentation that establishes that the beneficial owner
is an entity organized in a treaty country (or an entity
managed and controlled in a treaty country, if required by
the applicable treaty),
The withholding agent knows that the address outside
the treaty country (other than a P.O. box or in-care-of
address) is a branch of the account holder that is a
resident of the treaty country, or
The beneficial owner provides a written statement that
reasonably establishes entitlement to treaty benefits.
c. The account holder has standing instructions for the
withholding agent to pay amounts from its account to an
address outside, or an account maintained outside, the
treaty country unless the account holder provides (or has
provided) a reasonable explanation, in writing,
establishing the account holder's residency in the
applicable treaty country or the withholding agent has in
its possession or obtains documentary evidence
(described in Regulations section 1.1471-3(c)(5)(i))
establishing the account holder’s residence in the
applicable treaty country.
For additional information on the standards of
knowledge for chapter 3 purposes applicable to
withholding agents for relying on a claim of foreign status
or a claim of residency in a treaty country, see
Regulations section 1.1441-7(b) (including special rules
for accounts documented before July 1, 2014, including
when a withholding agent is required to identify whether
an individual has a U.S. place of birth for such an
account).
For additional information on the standards of
knowledge applicable to withholding agents for Forms
W-8 provided for chapter 4 purposes, see Regulations
section 1.1471-3(e).
Where required, a reasonable explanation supporting
an individual’s claim of foreign status means a written
statement prepared by the individual, or, in the alternative,
a checklist provided by the withholding agent and
completed by the individual stating that the individual
meets one of the requirements listed in Regulations
section 1.1441-7(b)(12)(i) through (iv). See Regulations
section 1.1441-7(b)(12) for purposes of chapter 3 and
Regulations section 1.1471-3(e)(4)(viii) for purposes of
chapter 4.
Dual claims. If you are making payments to a foreign
entity that is simultaneously claiming a reduced rate of tax
on its own behalf and on behalf of persons in their
capacity as interest holders in that entity, you may, at your
option, accept the dual claims even though you hold
different withholding certificates that require you to treat
the entity inconsistently for different payments or for
different portions of the same payment, or you may
choose to apply only the claim made by the entity,
provided the entity may be treated as the beneficial owner
of the income. If, however, inconsistent claims are made
for the same portion of a payment, you may either reject
both claims and request consistent claims or you may
choose which reduction to apply. For partnerships that
allocate effectively connected taxable income to partners
that are foreign partnerships, the rules under section
1.1446-5 apply.
Requesting a New Form W-8
Request a new Form W-8:
Before the expiration of the validity period of an existing
Form W-8 (see Period of Validity below for more
information);
If the existing form does not support a claim of reduced
rate for a type of income that the submitter of the form has
not previously received or is incomplete with respect to
any claim made on the form; or
-12- Instructions for the Requester of Forms W-8 (Rev. 7-2014)
If you know or have reason to know of a change in
circumstances that makes any information on the current
form unreliable or incorrect for purposes of chapter 3 or 4
(to the extent applicable based on the claims made on the
form). For limits on reason to know if you are a financial
institution, insurance company, or broker or dealer in
securities, see Regulations sections 1.1441-7(b)(3) (if you
are a withholding agent with respect to a payment subject
to chapter 3 withholding) and 1.1471-3(d)(4)(v) (if you are
a withholding agent with respect to a withholdable
payment).
Example. A foreign individual investor opens an
account with a broker to purchase U.S. Treasury bonds
and provides Form W-8BEN to obtain the portfolio interest
exemption. The investor does not complete Part II of Form
W-8BEN (because he is not claiming treaty benefits).
Later, the investor purchases U.S. stock and claims treaty
benefits on dividend income. The investor at that time
completes a new Form W-8BEN providing the information
required in Part II.
Period of Validity
Generally, a Form W-8 is valid from the date signed until
the last day of the third succeeding calendar year. For
example, a Form W-8BEN signed on September 30,
2015, remains valid through December 31, 2018.
However, under certain conditions a Form W-8 will have
an indefinite validity period, unless there has been a
change in circumstances. For example, a Form
W-8BEN-E provided by an entity to support its foreign
status along with documentary evidence to support a
claim made on the form. To determine the period of
validity for a Form W-8 for purposes of chapter 3, see
Regulations section 1.1441-1(e)(4)(ii). To determine the
period of validity for a Form W-8 for purposes of
chapter 4, see Regulations section 1.1471-3(c)(6)(ii). For
the validity period of a pre-FATCA Form W-8 that may be
relied upon by a withholding agent for chapter 4 purposes,
see Regulations section 1.1471-3(d)(1).
Forms Received That Are Not Dated or That
Contain Inconsequential Errors or Omissions
If a Form W-8 is valid except that the person providing the
form has not dated the form, the withholding agent may
date the form from the day it is received and measure the
validity period from that date. A withholding agent
generally may treat a withholding certificate as valid if it
contains an error or omission that is inconsequential and
the withholding agent has sufficient documentation on file
to supplement the missing information. However, a failure
to establish an entity type or make a required certification
is not inconsequential. For example, if an entity beneficial
owner receiving a withholdable payment selects a
certified deemed-compliant FFI status on line 5 of Form
W-8BEN-E but does not complete the corresponding
required certifications in Part V, the form is invalid for
chapter 4 purposes. On the other hand, for a Form W-8 for
which the person signing the form does not also print a
name before the signature when required on the form, the
withholding agent need not treat the form as incomplete if
the withholding agent has documentation or information
supporting the identity of the person signing the form. See
Regulations sections 1.1441-1(b)(7)(iv) for chapter 3
purposes and 1.1471-3(c)(7)(i) for chapter 4 purposes for
further information about the rules for withholding
certificates that contain inconsequential errors.
Substitute Forms W–8
You may develop and use your own Form W-8BEN,
W-8BEN-E, W-8ECI, W-8EXP, or W-8IMY (a substitute
form) if its content is substantially similar to the IRS's
official Form W-8BEN, W-8BEN-E, W-8ECI, W-8EXP, or
W-8IMY (to the extent required by these instructions) and
it satisfies certain certification requirements. You may
develop and use a substitute form that is in a foreign
language, provided that you make an English translation
of the form and its contents available to the IRS upon
request. You may combine Forms W-8BEN, W-8BEN-E,
W-8ECI, W-8EXP, and W-8IMY into a single substitute
form. A form that satisfies these substitute forms
requirements may be treated as a similar agreed form for
purposes of an applicable Model 1 IGA, if the partner
jurisdiction does not decline such treatment.
You may omit the chapter 4 certifications on your
substitute form if such certifications are not required
based on the payments made to the payees or account
holders. You may not, however, omit the chapter 4
certifications if you are an FFI documenting the chapter 4
status of your account holders under your chapter 4
requirements or under an applicable IGA. You may
choose to provide a substitute form that does not include
all of the chapter 4 statuses provided on the Form W-8,
but the substitute form must include any chapter 4 status
for which withholding may apply, such as the categories
for a nonparticipating FFI or passive NFFE.
You are also required to furnish instructions for the
substitute form to the extent and manner provided in the
official instructions for the official form.
You may incorporate a substitute Form W-8 into other
business forms you customarily use, such as account
signature cards, provided the required certifications are
clearly set forth. However, you may not:
1. Use a substitute form that requires the payee, by
signing, to agree to provisions unrelated to the required
certifications, or
2. Imply that a person may be subject to 30%
withholding or backup withholding unless that person
agrees to provisions on the substitute form that are
unrelated to the required certifications.
A substitute Form W-8 is valid only if it contains the
same penalties of perjury statement and certifications as
the official forms and the required signature. However, if
the substitute form is contained in some other business
form, the words “information on this form” may be
modified to refer to that portion of the business form
containing the substitute form information. The design of
the substitute form must be such that the information and
certifications that are being attested to by the penalties of
perjury statement clearly stand out from any other
information contained in the form.
Instructions for the Requester of Forms W-8 (Rev. 7-2014) -13-
Content of Substitute Form
Form W-8BEN. The substitute Form W-8BEN must
contain all of the information required in Part I, lines 1
through 7, and line 8. The certifications in Part II must be
included in a substitute form only if treaty benefits are
claimed, and then only to the extent that the certifications
are required. For example, Form W-8BEN, line 10, special
rates and conditions (applicable to a claim for treaty
benefits), is not required if this form is being requested
from an individual receiving a payment of U.S. source
dividends from stocks that are actively traded on an
established securities market.
Penalties of perjury statement. The design of the
substitute Form W-8BEN must be such that the
information and certifications that are being attested to by
the penalties of perjury statement clearly stand out from
any other information contained on the form. Additionally,
the following statement must be presented in the same
manner as in the preceding sentence and must appear
immediately above the single signature line: “The Internal
Revenue Service does not require your consent to any
provisions of this document other than the certifications
required to establish your status as a non-U.S. individual
and, if applicable, obtain a reduced rate of withholding.”
Non-IRS Form for Individuals
A withholding agent may also substitute its own form for
an official Form W-8BEN, regardless of whether the
substitute form is titled as a Form W-8. The form must
include the name and address of the individual that is the
payee or beneficial owner, all countries in which the
individual is resident for tax purposes, the individual’s city
and country of birth, and a tax identification number, if
any, for each country of residence. The form may also
request other information required for purposes of tax or
anti-money laundering (AML) due diligence in the United
States or in other countries.
Penalties of perjury statement. A non-IRS form for
individuals must contain a signed and dated certification
made under penalties of perjury that the information
provided on the form is accurate and will be updated by
the individual within 30 days of a change in circumstances
that causes the form to become incorrect. However, the
signed certification provided on a form need not be signed
under penalties of perjury if the form is accompanied by
documentary evidence that supports the individual’s claim
of foreign status. Such documentary evidence may be the
same documentary evidence that is used to support
foreign status in the case of a payee whose account has
U.S. indicia as described in Regulations sections
1.1471-3(e) and 1.1471-4(c)(4)(i)(A).
Form W-8BEN-E. The substitute Form W-8BEN-E must
contain all of the information required in Part I, lines 1
through 6, and lines 8 and 9 if a U.S. or foreign TIN (or a
GIIN) is required. The certifications in Part II must be
included in a substitute form if you are making a
withholdable payment to a branch or disregarded entity
owned by the payee that is a class of FFI identified in Part
II operating in a jurisdiction other than the jurisdiction of
residency of the entity named in Part I of the form. See
discussion regarding payments to branches or
disregarded entities in Further Notes for Validating Form
W-8BEN-E, earlier in these instructions. The certifications
in Part III must be included only if treaty benefits are
claimed, and then only to the extent that the certifications
are required. See Alternative Certifications Under an
Applicable IGA, earlier in these instructions, for
circumstances in which the chapter 4 certifications may
be replaced with alternative certifications.
Penalties of perjury statement. The design of the
substitute Form W-8BEN-E must be such that the
information and certifications that are being attested to by
the penalties of perjury statement clearly stand out from
any other information contained on the form. Additionally,
the following statement must be presented in the same
manner as in the preceding sentence and must appear
immediately above the single signature line: “The Internal
Revenue Service does not require your consent to any
provisions of this document other than the certifications
required to establish your status as a non-U.S. person,
establish your chapter 4 status (if required), and, if
applicable, obtain a reduced rate of withholding. ”
Form W-8ECI. The substitute Form W-8ECI must contain
all of the information required in Part I other than line 9.
The certifications in Part II of Form W-8ECI must be
included in a substitute form.
Penalties of perjury statement. The design of the
substitute Form W-8ECI must be such that the information
and certifications that are being attested to by the
penalties of perjury statement clearly stand out from any
other information contained on the form. Additionally, the
following statement must be presented in the same
manner as in the preceding sentence and must appear
immediately above the single signature line: “The Internal
Revenue Service does not require your consent to any
provisions of this document other than the certifications
required to establish your status as a non-U.S. person and
that the income for which this form is provided is
effectively connected with the conduct of a trade or
business within the United States.”
Form W-8EXP. The substitute Form W-8EXP must
contain all of the information required in Part I, lines 1
through 5, line 7, if a U.S. TIN is required, and line 8. The
substitute Form W-8EXP must also contain all of the
statements and certifications contained in Parts II and III
as applicable with respect to the purpose for which the
form is provided, but a specific statement needs to be
included (in its entirety) only if it is relevant to the type of
entity providing the form. For example, if the only
beneficial owners a U.S. withholding agent has as
account holders are foreign governments for purposes of
both chapters 3 and 4, the withholding agent may use a
substitute Form W-8EXP that contains the required
information in Part I, plus the required statements and
certifications from Parts II and III that are related to foreign
governments, as opposed to the certifications for other
types of entities that would otherwise be providing the
Form W-8EXP.
Penalties of perjury statement. The design of the
substitute Form W-8EXP must be such that the
information and certifications that are being attested to by
the penalties of perjury statement clearly stand out from
any other information contained on the form. Additionally,
the following statement must be presented in the same
-14- Instructions for the Requester of Forms W-8 (Rev. 7-2014)
manner as in the preceding sentence and must appear
immediately above the single signature line: “The Internal
Revenue Service does not require your consent to any
provisions of this document other than the certifications
required to establish your status as a foreign government,
international organization, foreign central bank of issue,
foreign tax-exempt organization, foreign private
foundation, or government of a U.S. possession.”
Form W-8IMY. The substitute Form W-8IMY must
contain all of the information required in Part I, lines 1
through 6, line 8 if a U.S. TIN is required, and line 9, if a
GIIN is required. The information required in Part II must
be included in a substitute form if you are making a
withholdable payment to a branch or disregarded entity
provided by the payee that is a class of FFI identified in
Part II operating in a jurisdiction other than the jurisdiction
of residence of the entity named in Part I of the form. See
discussion regarding payments to branches or
disregarded entities in Further Notes for Validating Form
W-8BEN-E, earlier in these instructions. The substitute
Form W-8IMY must also contain all of the statements and
certifications relevant to chapter 3 contained in Parts III
through VIII if you are making a payment subject to
withholding under chapter 3 and, except as otherwise
indicated in the form’s instructions, the statements and
certifications relevant to the chapter 4 status contained in
Parts IX through XXVI for the intermediary or flow-through
entity providing the form if you are making a withholdable
payment or if you are an FFI documenting your account
holders for purposes of chapter 4 or the applicable IGA.
However, a specific part needs to be included (in its
entirety) only if it is relevant. For example, if the only
intermediaries to which a U.S. withholding agent makes
payments are qualified intermediaries that are
participating FFIs, the withholding agent may use a
substitute Form W-8IMY that contains only the required
information from Part I (including line 9 to collect the
intermediaries’ GIINs), plus the statements and
certifications from Part III. A substitute Form W-8IMY must
also incorporate the same attachments as the official form
(such as a withholding statement and beneficial owner
documentation, to the extent otherwise required). A
withholding agent may also include any information in a
substitute Form W-8IMY, or require any information to be
associated with the form, that is reasonably related to his
obligation to withhold and correctly report payments.
Penalties of perjury statement. The design of the
substitute Form W-8IMY must be such that the information
and certifications that are being attested to by the
penalties of perjury statement clearly stand out from any
other information contained on the form. Additionally, the
following statement must be presented in the same
manner as in the preceding sentence and must appear
immediately above the single signature line: “The Internal
Revenue Service does not require your consent to any
provisions of this document other than the certifications
required to establish:1) your status as a qualified
intermediary, a nonqualified intermediary, a specific type
of U.S. branch, a withholding foreign partnership, a
withholding foreign trust, a nonwithholding foreign
partnership, a nonwithholding foreign simple trust, or a
nonwithholding foreign grantor trust; 2) your chapter 4
status; and/or 3) your status as a qualified securities
lender.”
Instructions for the Requester of Forms W-8 (Rev. 7-2014) -15-
This page is blank (do not print)
Form
W-8BEN
Certificate of Foreign Status of Beneficial Owner for United
States Tax Withholding and Reporting (Individuals)
(Rev. February 2014)
▶
Department of the Treasury
Internal Revenue Service
OMB No. 1545-1621
▶ For use by individuals. Entities must use Form W-8BEN-E.
Information about Form W-8BEN and its separate instructions is at www.irs.gov/formw8ben.
▶ Give this form to the withholding agent or payer. Do not send to the IRS.
Do NOT use this form if:
• You are NOT an individual
Instead, use Form:
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• 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) . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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. W-8ECI
• You are a U.S. citizen or other U.S. person, including a resident alien individual
• You are a beneficial owner who is receiving compensation for personal services performed in the United States .
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• A person acting as an intermediary
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Part I
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Name of individual who is the beneficial owner
3
Permanent residence address (street, apt. or suite no., or rural route). Do not use a P.O. box or in-care-of address.
2
Country
Mailing address (if different from above)
City or town, state or province. Include postal code where appropriate.
5
U.S. taxpayer identification number (SSN or ITIN), if required (see instructions)
7
Reference number(s) (see instructions)
Part II
10
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Country of citizenship
City or town, state or province. Include postal code where appropriate.
9
8233 or W-4
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Identification of Beneficial Owner (see instructions)
1
4
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Country
6
Foreign tax identifying number (see instructions)
Date of birth (MM-DD-YYYY) (see instructions)
Claim of Tax Treaty Benefits (for chapter 3 purposes only) (see instructions)
within the meaning of the income tax treaty
I certify that the beneficial owner is a resident of
between the United States and that country.
Special rates and conditions (if applicable—see instructions): The beneficial owner is claiming the provisions of Article
of the treaty identified on line 9 above to claim a
% rate of withholding on (specify type of income):
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Explain the reasons the beneficial owner meets the terms of the treaty article:
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 as an individual that is an owner or account holder of a foreign financial institution,
•
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.
▲
Sign Here
Signature of beneficial owner (or individual authorized to sign for beneficial owner)
Print name of signer
For Paperwork Reduction Act Notice, see separate instructions.
Date (MM-DD-YYYY)
Capacity in which acting (if form is not signed by beneficial owner)
Cat. No. 25047Z
Form
W-8BEN
(Rev. 2-2014)
This page is blank (do not print)
Form
W-8ECI
Certificate of Foreign Person's Claim That Income Is
Effectively Connected With the Conduct of a Trade or
Business in the United States
(Rev. February 2014)
OMB No. 1545-1621
▶ Section
Department of the Treasury
Internal Revenue Service
references are to the Internal Revenue Code.
▶ Information about Form W-8ECI and its separate instructions is at www.irs.gov/formw8eci.
▶ 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) . . . . . . . . . . . . . . . . . . . . .
• A person acting as an intermediary . . . .
Note. See instructions for additional exceptions.
Part I
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Name of individual or organization that is the beneficial owner
3
Name of disregarded entity receiving the payments (if applicable)
4
Type of entity (check the appropriate box):
Partnership
Government
Private foundation
.
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.
.
.
.
.
W-8IMY
Simple trust
Grantor trust
International organization
2 Country of incorporation or organization
Individual
Corporation
Complex trust
Central bank of issue
Estate
Tax-exempt organization
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.
6
.
Identification of Beneficial Owner (see instructions.)
1
5
.
W-8BEN-E
or W-8IMY
Country
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
9
Reference number(s) (see instructions)
11
8 Foreign tax identifying number
10 Date of birth (MM-DD-YYYY)
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
Sign
Here
• The beneficial owner is not a U.S. person.
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.
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. 2-2014)
This page is blank (do not print)
Form
W-8EXP
(Rev. April 2014)
Certificate of Foreign Government or Other Foreign
Organization for United States Tax
Withholding and Reporting
OMB No. 1545-1621
(For use by foreign governments, international organizations, foreign central banks of issue, foreign
tax-exempt organizations, foreign private foundations, and governments of U.S. possessions.)
Department of the Treasury
Internal Revenue Service
▶ Information about Form W-8EXP and its separate instructions is at www.irs.gov/formw8exp.
▶ Section references are to the Internal Revenue Code.
▶ 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
3 Type of
entity
2 Country of incorporation or organization
Foreign government
International organization
Foreign central bank of issue (not wholly
owned by the foreign sovereign)
4 Chapter 4 Status (FATCA status):
Participating FFI.
Reporting Model 1 FFI.
Reporting Model 2 FFI.
Registered deemed-compliant FFI
(other than a Reporting Model 1 FFI).
Nonreporting IGA FFI. Complete Part III.
Territory financial institution. Complete Part III.
International organization.
Foreign tax-exempt organization
Foreign private foundation
Government of a U.S. possession
Foreign government (including a political subdivision),
government of a U.S. possession, or foreign central bank of
issue. Complete Part III.
Exempt retirement plan of foreign government. Complete Part III.
501(c) organization. Complete Part III.
Passive NFFE. Complete Part III.
Direct reporting NFFE.
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).
Country
City or town, state or province. Include postal code where appropriate.
6 Mailing address (if different from above).
City or town, state or province. Include postal or ZIP code where appropriate.
7 U.S. TIN, if required (see instructions)
8a
Country
b
GIIN
Foreign TIN (see instructions)
9 Reference number(s) (see instructions)
Part II
Qualification Statement for Chapter 3 Status
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:
The entity identified in Part I is an integral part of the government of
.
b
.
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.
10
For Paperwork Reduction Act Notice, see separate instructions.
Cat. No. 25401F
Form
W-8EXP
(Rev. 4-2014)
Form W-8EXP (Rev. 4-2014)
Part II
Page
2
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:
I certify that the entity identified in Part I has been issued a determination letter by the IRS dated
a
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
15
Qualification Statement for Chapter 4 Status (if required)
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:
▶
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)).
For an exempt retirement plan of a foreign government:
I certify that the entity identified in Part I:
18
• 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. 4-2014)
Form W-8EXP (Rev. 4-2014)
Part IV
Page
3
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
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. 4-2014)
Form
W-8IMY
(Rev. April 2014)
Certificate of Foreign Intermediary, Foreign Flow-Through Entity, or Certain
U.S. Branches for United States Tax Withholding and Reporting
▶ Section
Department of the Treasury
Internal Revenue Service
references are to the Internal Revenue Code.
about Form W-8IMY and its separate instructions is at www.irs.gov/formw8imy.
▶ Give this form to the withholding agent or payer. Do not send to the IRS.
OMB No. 1545-1621
▶ Information
Do not use this form for:
• A beneficial owner solely claiming foreign status or treaty benefits .
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• A hybrid entity claiming treaty benefits on its own behalf
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Instead, use Form:
W-8BEN or W-8BEN-E
. . . . 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-8BEN, W-8ECI, or W-8BEN-E
.
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.
. W-8ECI
• A disregarded entity with a single foreign owner that is the beneficial owner of the income to which this form relates. Instead,
the single foreign owner should use
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• 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)
. .
.
• U.S. entity or U.S. citizen or resident
.
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• A foreign person documenting themselves for purposes of section 6050W .
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Part I
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. W-8EXP
. W-9
W-8BEN, W-8BEN-E, or W-8ECI
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Identification of Entity
1
Name of individual or organization that is acting as intermediary
3
Name of disregarded entity (if applicable)
2
4 Chapter 3 Status:
Qualified intermediary. Complete Part III.
Nonqualified intermediary. Complete Part IV.
Country of incorporation or organization
Withholding foreign trust. Complete Part VII.
Nonwithholding foreign partnership. Complete Part VIII.
Nonwithholding foreign simple trust. Complete Part VIII.
Territory financial institution. Complete Part V.
U.S. branch. Complete Part VI.
Withholding foreign partnership. Complete Part VII.
Nonwithholding foreign grantor trust. Complete Part VIII.
5 Chapter 4 Status:
Nonparticipating FFI (including a limited FFI or limited branch).
Complete Part IX (if applicable).
Owner-documented FFI. Complete Part XI.
Restricted distributor. Complete Part XVI.
Participating FFI.
Reporting Model 1 FFI.
Reporting Model 2 FFI.
Foreign central bank of issue. Complete Part XVII.
Nonreporting IGA FFI. Complete Part XVIII.
Registered deemed-compliant FFI (other than a reporting Model 1 FFI
or sponsored FFI that has not obtained a GIIN).
Excepted nonfinancial group entity. Complete Part XX.
Excepted nonfinancial start-up company. Complete Part XXI.
Territory financial institution. Complete Part V.
Excepted nonfinancial entity in liquidation or bankruptcy.
Complete Part XXII.
Exempt retirement plans. Complete Part XIX.
Sponsored FFI that has not obtained a GIIN (other than a certified
deemed-compliant sponsored, closely held investment vehicle).
Complete Part X.
Publicly traded NFFE or NFFE affiliate of a publicly traded
corporation. Complete Part XXIII.
Certified deemed-compliant FFI with only low-value accounts. Complete Part XIII.
Excepted territory NFFE. Complete Part XXIV.
Active NFFE. Complete Part XXV.
Passive NFFE. Complete Part XXVI.
Certified deemed-compliant sponsored, closely held investment
vehicle. Complete Part XIV.
Direct reporting NFFE.
Sponsored direct reporting NFFE. Complete Part XXVII.
Certified deemed-compliant nonregistering local bank. Complete Part
XII.
Certified deemed-compliant limited life debt investment entity.
Complete Part XV.
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.
8 U.S. taxpayer identification number, if required
QI-EIN
9 GIIN (if applicable)
Country
▶
WP-EIN
WT-EIN
EIN
SSN or ITIN
10 Reference number(s) (see instructions)
For Paperwork Reduction Act Notice, see separate instructions.
Cat. No. 25402Q
Form
W-8IMY
(Rev. 4-2014)
Form W-8IMY (Rev. 4-2014)
Part II
11
12
Page
Chapter 4 Status (FATCA status) of disregarded entity or branch receiving payment.
Limited branch.
Reporting Model 1 FFI.
U.S. Branch.
Participating FFI.
Reporting Model 2 FFI.
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.
13
2
Disregarded Entity or Branch Receiving Payment. (Complete only if disregarded entity or branch of an
FFI in a country other than the FFI's country of residence.)
GIIN (if any)
Country
▶
Chapter 3 Status Certifications
Part III
14a
Qualified Intermediary
(All qualified intermediaries check here) I certify that the entity identified in Part I (or branch, if relevant):
• Is a qualified intermediary and is not acting for its own account with respect to the account(s) identified on line 10 or in a withholding
statement associated with this form; 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
Check all that apply:
I certify that the entity identified in Part I of this form is not providing a withholding statement associated with this form because it assumes
primary withholding responsibility for purposes of chapters 3 and 4, and either:
• 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 and 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.
c
I certify that the entity identified in Part I of this form assumes primary withholding responsibility under chapters 3 and 4 with respect to
payments made to each account identified on this line 14c (or on an attachment to this form) ▶
d
I certify that the entity identified in Part I of this form assumes primary Form 1099 reporting and backup withholding responsibility with
respect to payments made to each account identified on this line 14d or on an attachment to this form or reporting responsibility as a
participating FFI or registered deemed-compliant FFI with respect to accounts that it maintains and 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 ▶
e
I certify that the entity identified in Part I of this form does NOT assume primary Form 1099 reporting and backup withholding responsibility
and is using this form to transmit Forms W-9 with respect to each account(s) held by a U.S. non-exempt recipient identified on this line 14e
or in a withholding statement associated with this form ▶
If the entity identified on 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 (check all that apply):
f
(i)
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 a withholding rate pool of U.S. payees provided on a withholding statement associated
with this form.
(ii)
To the extent the entity is providing a withholding statement that includes a chapter 4 withholding rate pool of U.S. payees that
are accountholders of an intermediary or flow-through entity receiving a payment from the entity identified on line 1, I certify
that the entity on line 1 has obtained or will obtain documentation sufficient to establish each such intermediary or flowthrough entity's status as a participating FFI, registered deemed-compliant FFI, or FFI that is a qualified intermediary.
I certify that the entity identified in Part I of this form is acting as Qualified Securities Lender with respect to payments associated with this
form that are U.S. source substitute dividends received from the withholding agent.
Part IV
Nonqualified Intermediary
Check all that apply:
15a
(All nonqualified intermediaries and qualified intermediaries 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.
Form
W-8IMY
(Rev. 4-2014)
Form W-8IMY (Rev. 4-2014)
Part V
16 a
Page
3
Territory Financial Institution
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 whichever box 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
17 a
Certain U.S. Branches
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 whichever box 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 a participating FFI (including a reporting Model 2 FFI), registered deemed-compliant FFI (including a
reporting Model 1 FFI), or NFFE 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; and
Part VII
• Has provided or will provide a withholding statement, as required.
Withholding Foreign Partnership (WP) or Withholding Foreign Trust (WT)
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.
18
Part VIII
19
Nonwithholding Foreign Partnership, Simple Trust, or Grantor Trust
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 that the
payments to which this certificate relates 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.
Chapter 4 Status Certifications
Part IX
20
Nonparticipating FFI with Exempt Beneficial Owners
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
21 a
b
c
Sponsored FFI That Has Not Obtained a GIIN
Name of sponsoring entity: ▶
Check whichever box applies.
I certify that the entity identified in Part I:
• Is an FFI solely because it is an investment entity;
• Is not a QI, WP, 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-8IMY
(Rev. 4-2014)
Form W-8IMY (Rev. 4-2014)
Part XI
Page
4
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.
22a
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 whichever box 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
c
(iii) Any additional information the withholding agent requests in order to fulfill its obligations with respect to the entity.
I certify that the FFI identified in Part I:
• Has provided, or will provide, an auditor's letter, signed no more than four 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).
Part XII
23
Certified Deemed-Compliant Nonregistering Local Bank
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 five percent 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 XII.
Part XIII
24
Certified Deemed-Compliant FFI with Only Low-Value Accounts
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, have more than $50 million in assets on its consolidated or
combined balance sheet as of the end of its most recent accounting year.
Form
W-8IMY
(Rev. 4-2014)
Form W-8IMY (Rev. 4-2014)
Part XIV
25a
b
Page
5
Certified Deemed-Compliant Sponsored, Closely Held Investment Vehicle
Name of sponsoring entity: ▶
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 in line 25a; and
• Twenty 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 percent 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
I certify that the FFI identified in Part I:
• Was in existence as of January 17, 2013;
26
• 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 1.1471-4(f)(2)(iv)).
Part XVI
27a
Restricted Distributor
(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.
Check whichever box 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 XVII
28
Foreign Central Bank of Issue
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).
Form
W-8IMY
(Rev. 4-2014)
Form W-8IMY (Rev. 4-2014)
Part XVIII
29
Page
6
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 IGA between the United States and
;
• Is entitled to the provisions of the IGA because the entity (or relevant branch) is considered a
under the provisions of the applicable IGA; and
• If you are an FFI treated as a registered deemed-compliant FFI under an applicable Model 2 IGA, provide your GIIN:
▶
Part XIX
Exempt Retirement Plans
Check whichever box applies.
30a
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
c
(iv) Limits contributions by employees to the fund by reference to earned income of the employee or may not exceed $50,000 annually.
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 percent 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.
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.
Form
W-8IMY
(Rev. 4-2014)
Form W-8IMY (Rev. 4-2014)
Part XX
Page
7
Excepted Nonfinancial Group Entity
31
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 XXI
Excepted Nonfinancial Start-Up Company
32
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 XXII
33
Excepted Nonfinancial Entity in Liquidation or Bankruptcy
I certify that the entity identified in Part I:
• Filed a plan of liquidation, filed a plan or 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 three years.
Part XXIII
Publicly Traded NFFE or NFFE Affiliate of a Publicly Traded Corporation
Check whichever box applies:
34a
b
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
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;
; and
• The name of the entity, the stock of which is regularly traded on an established securities market, is
• The name of the securities market on which the stock is regularly traded is ▶
Part XXIV
35
Excepted Territory NFFE
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, 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; and
Part XXV
36
• 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.
Active NFFE
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.
Form
W-8IMY
(Rev. 4-2014)
Page 8
Form W-8IMY (Rev. 4-2014)
Part XXVI Passive NFFE
37
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 XXVII
38
39
Sponsored Direct Reporting NFFE
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 38.
Part XXVIII 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.
▲
Sign Here
Signature of authorized official
Date (MM-DD-YYYY)
Form
W-8IMY
(Rev. 4-2014)

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