Additional information.

For additional information and instructions for the withholding agent, see the Instructions for the Requester of Forms W-8BEN, W-8BEN-E, W-8ECI, W-8EXP, and W-8IMY.

Account holder.

An account holder is generally the person listed or identified as the holder or owner of a financial account. For example, if a partnership is listed as the holder or owner of a financial account, then the partnership is the account holder, rather than the partners of the partnership. However, an account that is held by a disregarded entity (other than a disregarded entity treated as an FFI for chapter 4 purposes) is treated as held by the entity's single owner.

Amount realized.

For purposes of section 1446(f), an amount realized on the transfer of an interest in a partnership other than a PTP is as determined under section 1001 (including Regulations sections 1.1001-1 through 1.1001-5) and section 752 (including Regulations sections 1.752-1 through 1.752-7). See Regulations section 1.1446(f)-2(c)(2). An amount realized on the transfer of a PTP interest is the amount of gross proceeds (as defined in Regulations section 1.6045-1(d)(5)) paid or credited to a partner or broker (as applicable) that is a transferor of the interest. The amount realized on a PTP distribution is the amount of the distribution reduced by the portion of the distribution that is attributable to the cumulative net income of the partnership (as determined under Regulations section 1.1446(f)-4(c)(2)(iii)).

Amounts subject to chapter 3 withholding.

Generally, an amount subject to chapter 3 withholding is an amount from sources within the United States that is fixed or determinable annual or periodical (FDAP) income (including such an amount on a PTP distribution unless indicated otherwise). FDAP income is all income included in gross income, including interest (as well as OID), dividends, rents, royalties, and compensation. Amounts subject to chapter 3 withholding do not include amounts that are not FDAP, such as most gains from the sale of property (including market discount and option premiums), as well as other specific items of income described in Regulations section 1.1441-2 (such as interest on bank deposits and short-term OID).

For purposes of section 1446(a), the amount subject to withholding is the foreign partner’s share of the partnership’s effectively connected taxable income. For purposes of section 1446(f), the amount subject to withholding is the amount realized on the transfer of a partnership interest.

Beneficial owner.

For payments other than those for which a reduced rate of, or exemption from, withholding is claimed under an income tax treaty, the beneficial owner of income is generally the person who is required under U.S. tax principles to include the payment in gross income on a tax return. A person is not a beneficial owner of income, however, to the extent that person is receiving the income as a nominee, agent, or custodian, or to the extent the person is a conduit whose participation in a transaction is disregarded. In the case of amounts paid that do not constitute income, beneficial ownership is determined as if the payment were income.

Foreign partnerships, foreign simple trusts, and foreign grantor trusts are not the beneficial owners of income paid to the partnership or trust. The beneficial owners of income paid to a foreign partnership are generally the partners in the partnership, provided that the partner is not itself a partnership, foreign simple or grantor trust, nominee or other agent. The beneficial owners of income paid to a foreign simple trust (that is, a foreign trust that is described in section 651(a)) are generally the beneficiaries of the trust, if the beneficiary is not a foreign partnership, foreign simple or grantor trust, nominee, or other agent. The beneficial owners of income paid to a foreign grantor trust (that is, a foreign trust to the extent that all or a portion of the income of the trust is treated as owned by the grantor or another person under sections 671 through 679) are the persons treated as the owners of the trust. The beneficial owners of income paid to a foreign complex trust (that is, a foreign trust that is not a foreign simple trust or foreign grantor trust) is the trust itself.

Generally, for purposes of section 1446(a) or (f), the same beneficial owner rules apply, except that under section 1446(a) or (f) a foreign simple trust is required to provide a Form W-8BEN-E on its own behalf, rather than on behalf of the beneficiary of such trust.

The beneficial owner of income paid to a foreign estate is the estate itself.

A payment to a U.S. partnership, U.S. trust, or U.S. estate is treated as a payment to a U.S. payee. A U.S. partnership, trust, or estate should provide the withholding agent with a Form W-9 pertaining to itself. However, for purposes of section 1446(a), a U.S. grantor trust or disregarded entity shall not provide the withholding agent a Form W-9. Instead, the entity must provide an applicable Form W-8 or Form W-9 pertaining to each grantor or owner, as appropriate, and, in the case of a trust, a statement identifying the portion of the trust treated as owned by each such person. For purposes of section 1446(f), the grantor or owner must provide an applicable Form W-8 or Form W-9 to certify its status and the amount realized allocable to the grantor or owner, which, alternatively, can be provided by the U.S. grantor trust on behalf of a grantor or owner.

Chapter 3.

Chapter 3 means chapter 3 of the Internal Revenue Code (Withholding of Tax on Nonresident Aliens and Foreign Corporations). Chapter 3 contains sections 1441 through 1464, excluding sections 1445 and 1446.

Chapter 4.

Chapter 4 means chapter 4 of the Internal Revenue Code (Taxes to Enforce Reporting on Certain Foreign Accounts). Chapter 4 contains sections 1471 through 1474.

Chapter 4 status.

The term chapter 4 status means a person’s status as a U.S. person, specified U.S. person, foreign individual, participating FFI, deemed-compliant FFI, restricted distributor, exempt beneficial owner, nonparticipating FFI, territory financial institution, excepted NFFE, or passive NFFE.

Deemed-compliant FFI.

Under section 1471(b)(2), certain FFIs are deemed to comply with the regulations under chapter 4 without the need to enter into an FFI agreement with the IRS. However, certain deemed-compliant FFIs are required to register with the IRS and obtain a GIIN. These FFIs are referred to as registered deemed-compliant FFIs. See Regulations section 1.1471-5(f)(1).

Disregarded entity.

A business entity that has a single owner and is not a corporation under Regulations section 301.7701-2(b) is disregarded as an entity separate from its owner. Generally, a disregarded entity does not submit this Form W-8BEN-E to a withholding agent. Instead, the owner of such entity provides the appropriate documentation (for example, a Form W-8BEN-E if the owner is a foreign entity). However, if a disregarded entity receiving a withholdable payment is an FFI outside the single owner’s country of organization or has its own GIIN, its foreign owner will be required to complete Part II of Form W-8BEN-E to document the chapter 4 status of the disregarded entity receiving the payment.

Certain entities that are disregarded for U.S. tax purposes may be treated as treaty residents for purposes of claiming treaty benefits under an applicable tax treaty or may be recognized as FFIs under an applicable IGA. A hybrid entity claiming treaty benefits on its own behalf is required to complete Form W-8BEN-E. See Hybrid Entity Making a Claim of Treaty Benefits under Special Instructions, later.

A disregarded entity with a U.S. owner or a disregarded entity with a foreign owner that is not otherwise able to fill out Part II (that is, because it is in the same country as its single owner and does not have a GIIN) may provide this form to an FFI solely for purposes of documenting itself for chapter 4 purposes. In such a case, the disregarded entity should complete Part I as if it were a beneficial owner and should not complete line 3.

Financial account.

A financial account includes:

For purposes of chapter 4, exceptions are provided for accounts such as certain tax-favored savings accounts, term life insurance contracts, accounts held by estates, escrow accounts, and certain annuity contracts. These exceptions are subject to certain conditions. See Regulations section 1.1471-5(b)(2). Accounts may also be excluded from the definition of financial account under an applicable IGA.

Financial institution.

A financial institution generally means an entity that is a depository institution, custodial institution, investment entity, or an insurance company (or holding company of an insurance company) that issues cash value insurance or annuity contracts. See Regulations section 1.1471-5(e).

An investment entity organized in a territory that is not also a depository institution, custodial institution, or specified insurance company is not treated as a financial institution. Instead, it is a territory NFFE. If such an entity cannot qualify as an excepted NFFE as described in Regulations section 1.1472-1(c)(1) (including an excepted territory NFFE), it must disclose its substantial U.S. owners using this definition (applying the 10 percent threshold) under Regulations section 1.1473-1(b)(1).

Foreign financial institution (FFI).

A foreign financial institution (FFI) means a foreign entity that is a financial institution.

Fiscally transparent entity.

An entity is treated as fiscally transparent with respect to an item of income for which treaty benefits are claimed to the extent that the interest holders in the entity must, on a current basis, take into account separately their shares of an item of income paid to the entity, whether or not distributed, and must determine the character of the items of income as if they were realized directly from the sources from which realized by the entity. For example, partnerships, common trust funds, and simple trusts or grantor trusts are generally considered to be fiscally transparent with respect to items of income received by them.

Flow-through entity.

A flow-through entity is a foreign partnership (other than a withholding foreign partnership), a foreign simple or foreign grantor trust (other than a withholding foreign trust), or, for payments for which a reduced rate of, or exemption from, withholding is claimed under an income tax treaty, any entity to the extent the entity is considered to be fiscally transparent with respect to the payment by an interest holder’s jurisdiction.

Foreign person.

A foreign person includes a foreign corporation, a foreign partnership, a foreign trust, a foreign estate, and any other person that is not a U.S. person. It also includes a foreign branch or office of a U.S. financial institution or U.S. clearing organization if the foreign branch is a qualified intermediary. Generally, a payment to a U.S. branch of a foreign person is a payment to a foreign person.

GIIN.

The term GIIN means a global intermediary identification number. A GIIN is the identification number assigned to an entity that has registered with the IRS for chapter 4 purposes.

Hybrid entity.

A hybrid entity is any person (other than an individual) that is treated as fiscally transparent for purposes of 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. Hybrid entity status is relevant for claiming treaty benefits. A hybrid entity is required to provide its chapter 4 status if it is receiving a withholdable payment.

Intergovernmental agreement (IGA).

An intergovernmental agreement (IGA) means a Model 1 IGA or a Model 2 IGA. For a list of jurisdictions treated as having in effect a Model 1 or Model 2 IGA, see www.treasury.gov/resource-center/tax-policy/treaties/Pages/FATCA-Archive.aspx.

A Model 1 IGA means an agreement between the United States or the Treasury Department and a foreign government or one or more agencies to implement FATCA through reporting by FFIs to such foreign government or agency, followed by automatic exchange of the reported information with the IRS. An FFI in a Model 1 IGA jurisdiction that performs account reporting to the jurisdiction’s government is referred to as a reporting Model 1 FFI.

A Model 2 IGA means an agreement or arrangement between the United States or the Treasury Department and a foreign government or one or more agencies to implement FATCA through reporting by FFIs directly to the IRS in accordance with the requirements of an FFI agreement, supplemented by the exchange of information between such foreign government or agency and the IRS. An FFI in a Model 2 IGA jurisdiction that has entered into an FFI agreement with respect to a branch is a participating FFI but may be referred to as a reporting Model 2 FFI.

The term reporting IGA FFI refers to both reporting Model 1 FFIs and reporting Model 2 FFIs.

Nonparticipating FFI.

A nonparticipating FFI means an FFI that is not a participating FFI, deemed-compliant FFI, or exempt beneficial owner.

Nonreporting IGA FFI.

A nonreporting IGA FFI is an FFI that is a resident of, or located or established in, a Model 1 or Model 2 IGA jurisdiction that meets the requirements of:

Participating FFI.

A participating FFI is an FFI that has agreed to comply with the terms of an FFI agreement with respect to all branches of the FFI, other than a branch that is a reporting Model 1 FFI or a U.S. branch. The term participating FFI also includes a reporting Model 2 FFI and a QI branch of a U.S. financial institution unless such branch is a reporting Model 1 FFI.

Participating payee.

A participating payee means any person that accepts a payment card as payment or accepts payment from a third party settlement organization in settlement of a third party network transaction for purposes of section 6050W.

Payee.

A payee is generally a person to whom a payment is made regardless of whether such person is the beneficial owner. For a payment made to a financial account, the payee is generally the holder of the financial account. See Regulations sections 1.1441-1(b)(2) and 1.1471-3(a)(3).

Payment settlement entity (PSE).

A payment settlement entity is a merchant acquiring entity or third party settlement organization. Under section 6050W, a PSE is generally required to report payments made in settlement of payment card transactions or third party network transactions. However, a PSE is not required to report payments made to a beneficial owner that is documented as foreign with an applicable Form W-8.

Publicly Traded Partnership (PTP).

A PTP is an entity that has the same meaning as in section 7704 and Regulations section 1.7704-4 but does not include a PTP treated as a corporation under that section.

PTP interest.

A PTP interest is an interest in a PTP if the interest is publicly traded on an established securities market or is readily tradable on a secondary market (or the substantial equivalent thereof).

Qualified intermediary (QI).

A qualified intermediary (QI) is a person that is a party to an agreement with the IRS that is described in Regulations section 1.1441-1(e)(5)(iii). A qualified derivatives dealer (QDD) is a QI that has agreed to certain reporting and withholding requirements pursuant to Regulations section 1.1441-1(e)(6).

Recalcitrant account holder.

A recalcitrant account holder includes an entity (other than an entity required to be treated as a nonparticipating FFI) that fails to comply with a request by an FFI maintaining the account for documentation and information for determining whether the account is a U.S. account. See Regulations section 1.1471-5(g).

Reverse hybrid entity.

A reverse hybrid entity is any person (other than an individual) that is not fiscally transparent under U.S. tax law principles but that is fiscally transparent under the laws of a jurisdiction with which the United States has an income tax treaty. See Form W-8IMY and the accompanying instructions for information on a reverse hybrid entity making a claim of treaty benefits on behalf of its owners.

Specified U.S. person.

A specified U.S. person is any U.S. person other than a person identified in Regulations section 1.1473-1(c).

Substantial U.S. owner.

A substantial U.S. owner (as defined in Regulations section 1.1473-1(b)) means any specified U.S. person that:

Transfer.

A transfer is a sale, exchange, or other disposition of a partnership interest, and includes a distribution from a partnership to a partner, as well as a transfer treated as a sale or exchange under section 707(a)(2)(B).

Transferee.

A transferee is any person, foreign or domestic, that acquires a partnership interest through a transfer and includes a partnership that makes a distribution.

Transferor.

A transferor is any person, foreign or domestic, that transfers a partnership interest. In the case of a trust, to the extent all or a portion of the income of the trust is treated as owned by the grantor or another person under sections 671 through 679 (such trust, a grantor trust), the term transferor means the grantor or other person.

U.S. person.

A U.S. person is defined in section 7701(a)(30) and includes domestic partnerships, corporations, and trusts.

.Certain foreign insurance companies issuing annuities or cash value insurance contracts that elect to be treated as a U.S. person for federal tax purposes but are not licensed to do business in the United States are treated as FFIs for purposes of chapter 4. For purposes of providing a withholding agent with documentation for both chapter 3 and chapter 4 purposes, however, such an insurance company is permitted to use Form W-9 to certify its status as a U.S. person. Likewise, a foreign branch of a U.S. financial institution (other than a branch that operates as a qualified intermediary) that is treated as an FFI under an applicable IGA is permitted to use Form W-9 to certify its status as a U.S. person for chapter 3 and chapter 4 purposes..

Withholdable payment.

A withholdable payment is defined in Regulations section 1.1473-1(a). For exceptions applicable to the definition of a withholdable payment, see Regulations section 1.1473-1(a)(4) (for example, certain nonfinancial payments).

Withholding agent.

Any person, U.S. or foreign, that has control, receipt, custody, disposal, or payment of U.S. source FDAP income subject to chapter 3 or 4 withholding 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, and U.S. branches of certain foreign banks and insurance companies.

For purposes of section 1446(a), the withholding agent is the partnership conducting the trade or business in the United States. For a partnership distribution made by a PTP, the withholding agent for purposes of section 1446(a) may be the PTP, a nominee holding an interest on behalf of a foreign person, or both. See Regulations sections 1.1446-1 through 1.1446-6.

Line 1.

Enter your name. If you are a disregarded entity or branch, do not enter your business name. Instead, enter the legal name of your owner (or, if you are a branch, the entity that you form a part of) (looking through multiple disregarded entities if applicable). If you are a disregarded entity that is a hybrid entity filing a treaty claim, however, see Hybrid Entity Making a Claim of Treaty Benefits under Special Instructions, later.

.If you are an account holder providing this form to an FFI solely for purposes of documenting yourself as an account holder and you are not receiving a withholdable payment or reportable amount (as defined in Regulations section 1.1441-1(e)(3)(vi)), you should complete Part I by substituting the references to "beneficial owner" with "account holder." .

.The named holder on the account is not necessarily the account holder for purposes of chapter 4. See Definitions, earlier, or, for an account maintained by an FFI covered by a Model 1 or Model 2 IGA with respect to the account, the definition of account holder in an applicable IGA to determine if you are the account holder. If you hold an account with an FFI and are unsure whether the definition of "account holder" under an IGA is applicable to your account, consult with the FFI requesting this form..

Line 2.

If you are a corporation, enter your country of incorporation. If you are another type of entity, enter the country under whose laws you are created, organized, or governed.

Line 3.

If you are a disregarded entity receiving a withholdable payment, enter your name on line 3 if you: 1) have registered with the IRS and been assigned a GIIN associated with the legal name of the disregarded entity; 2) are a reporting Model 1 FFI or reporting Model 2 FFI; and 3) are not a hybrid entity using this form to claim treaty benefits.

Line 4.

Check the one box that applies. By checking a box, you are representing that you qualify for the classification indicated. You must check the box that represents your classification (for example, corporation, partnership, trust, estate, etc.) under U.S. tax principles (not under the law of a treaty country). To determine whether you are an integral part of a foreign government or an entity that is controlled by a foreign government, see Temporary Regulations section 1.892-2T. If you are providing Form W-8BEN-E to an FFI solely for purposes of documenting yourself for chapter 4 purposes as an account holder of an account maintained by an FFI, you do not need to complete line 4.

If you are a partnership, disregarded entity, simple trust, or grantor trust receiving a payment for which treaty benefits are being claimed by such entity, you must check the "Partnership," "Disregarded entity," "Simple trust," or "Grantor trust" box. For such a case, you must also check the "yes" box to indicate that you are a hybrid entity making a treaty claim. You may only check the "no" box if (1) you are a disregarded entity, partnership, simple trust, or grantor trust and are using the form solely for purposes of documenting yourself as an account holder of an FFI and the form is not associated with a withholdable payment or a reportable amount or (2) you are using this form solely for purposes of documenting your status as a participating payee for purposes of section 6050W. In such cases, you are not required to complete line 4, but you may check the "no" box if you choose to complete line 4. You may also use Form W-8IMY to document yourself as an account holder of an FFI.

.Only entities that are tax-exempt under section 501(c) should check the "Tax-exempt organization" box for purposes of line 4. Such organizations should use Form W-8BEN-E only if they are claiming a reduced rate of withholding under an income tax treaty or a Code exception other than section 501(c) or if they are using this form solely for purposes of documenting themselves as an account holder with an FFI. However, if you are a private foundation you should check “Private Foundation” instead of "Tax-exempt organization." .

Line 5.

Check the one box that applies to your chapter 4 status. You are only required to provide a chapter 4 status on this form if you are the payee of a withholdable payment or are documenting the status of a financial account you hold with an FFI requesting this form. By checking a box on this line, you are representing that you qualify for this classification in your country of residence.

.For most of the chapter 4 statuses, you are required to complete an additional part of this form certifying that you meet the conditions of the status indicated on line 5. Complete the required portion of this form before signing and providing it to the withholding agent. See Entities Providing Certifications Under an Applicable IGA under Special Instructions, later..

Line 11.

Check the one box that applies. If no box applies to the disregarded entity, you do not need to complete this part. If you check reporting Model 1 FFI, reporting Model 2 FFI, or participating FFI, you must complete line 13, later. If your branch is a branch of a reporting IGA FFI that cannot comply with the requirements of an applicable IGA or the regulations under chapter 4 (a related entity), you must check "Branch treated as nonparticipating FFI."

Line 12.

Enter the address of the branch or disregarded entity.

Line 13.

If you are a reporting Model 1 FFI, reporting Model 2 FFI, or participating FFI, you must enter the GIIN on line 13 of your branch that receives the payment. If you are a disregarded entity that completed Part I, line 3 of this form and are receiving payments associated with this form, enter your GIIN. Do not enter your GIIN on line 9. If you are a U.S. branch, enter a GIIN applicable to any other branch of the FFI (including in its residence country).

Line 14a.

If you are claiming a reduced rate of, or exemption from, withholding under an income tax treaty you must enter the country where you are a resident for income tax treaty purposes and check the box to certify that you are a resident of that country.

Line 14b.

If you are claiming a reduced rate of, or exemption from, withholding under an income tax treaty you must check the box to certify that you:

An item of income may be derived by either the entity receiving the item of income or by the interest holders in the entity or, in certain circumstances, both. An item of income paid to an entity is considered to be derived by the entity only if the entity is not fiscally transparent under the laws of the entity’s jurisdiction with respect to the item of income. An item of income paid to an entity shall be considered to be derived by the interest holder in the entity only if:

Line 14c.

If you are a foreign corporation claiming treaty benefits under an income tax treaty that entered into force before January 1, 1987 (and has not been renegotiated) on (1) U.S. source dividends paid to you by another foreign corporation or (2) U.S. source interest paid to you by a U.S. trade or business of another foreign corporation, you must generally be a "qualified resident" of a treaty country. See section 884 for the definition of interest paid by a U.S. trade or business of a foreign corporation ("branch interest") and other applicable rules.

In general, a foreign corporation is a qualified resident of a country if any of the following apply:

.If you are claiming treaty benefits under an income tax treaty entered into force after December 31, 1986, do not check the line on box 14c. Instead, check the boxes for line 14b. .

Line 15.

Line 15 must be used only if you are claiming treaty benefits that require that you meet conditions not covered by the representations you make on line 14 (or other certifications on the form). This line is generally not applicable to claiming treaty benefits under an interest or dividends (other than dividends subject to a preferential rate based on ownership) article of a treaty or other income article, unless such article requires additional representations. For example, certain treaties allow for a zero rate on dividends for certain qualified residents provided that additional requirements are met, such as ownership percentage, ownership period, and that the resident meet a combination of tests under an applicable LOB article. You should indicate the specific treaty article and paragraph or subparagraph, as applicable. You should also use this space to set out the requirements you meet under the identified treaty article.

The following are examples of persons who should complete this line:

IGA.

In lieu of the certifications contained in Parts IV through XXVIII of Form W-8BEN-E, in certain cases you may provide an alternate certification to a withholding agent. See Entities Providing Certifications Under an Applicable IGA under Special Instructions, later.
 

Line 16.

If you are a sponsored FFI described in Regulations section 1.1471-5(f)(1)(i)(F), enter the name of the sponsoring entity that has agreed to fulfill the due diligence, reporting, and withholding obligations (as applicable) on behalf of the sponsored FFI identified on line 1. You must provide your GIIN on line 9.

Line 17.

You must check the applicable box to certify that you are either a sponsored investment entity or sponsored controlled foreign corporation (within the meaning of section 957(a)) and that you satisfy the other relevant requirements for this status.

Line 18.

If you are a certified deemed-compliant nonregistering local bank, you must check the box to certify that you meet all of the requirements for this certified deemed-compliant status.

Line 19.

If you are a certified deemed-compliant FFI with only low-value accounts, you must check the box to certify that you meet all of the requirements for this certified deemed-compliant classification.

Line 20.

Enter the name of your sponsoring entity that has agreed to fulfill the due diligence, reporting, and withholding obligations of the entity identified on line 1 as if the entity on line 1 were a participating FFI. You must also enter the GIIN of your sponsoring entity on line 9a.

Line 21.

If you are a sponsored, closely held investment vehicle, you must check the box to certify that you meet all of the requirements for this certified deemed-compliant status.

Line 22.

If you are a limited life debt investment entity, you must check the box to certify that you meet all of the requirements for this certified deemed-compliant status.

Line 23.

If you are an FFI that is a financial institution solely because you are described in Regulations section 1.1471-5(e)(4)(i)(A) and you do not maintain financial accounts, you must check the box to certify that you meet all of the requirements for this certified deemed-compliant status.

Line 24a.

If you are an owner-documented FFI, you must check the box to certify that you meet all of the requirements for this status and are providing this form to a U.S. financial institution, participating FFI, reporting Model 1 FFI, or reporting Model 2 FFI that agrees to act as a designated withholding agent with respect to you. See Regulations section 1.1471-5(f)(3) for more information about an owner-documented FFI, including with respect to a designated withholding agent.

Line 24b.

Check the box to certify that you have provided or will provide the documentation set forth in the certifications, including the FFI owner reporting statement and the valid documentation for each person identified on the FFI owner reporting statement described on line 24b.

Line 24c.

Check the box to certify that you have provided or will provide the auditor’s letter (in lieu of the information required by line 24b) that satisfies the requirements reflected on this line.

Line 24d.

Check the box if you do not have any contingent beneficiaries or designated classes with unidentified beneficiaries. While this certification is not required, an owner reporting statement provided by an owner-documented FFI will remain valid indefinitely for chapter 4 purposes absent a change in circumstances with respect to offshore obligations (as defined in Regulations section 1.6049-5(c)(1)) only if this certification is provided and the account balance of all accounts held by the owner-documented FFI with the withholding agent does not exceed $1,000,000 on the later of June 30, 2014, or the last day of the calendar year in which the account was opened, and the last day of each subsequent calendar year preceding the payment, applying the account aggregation rules of Regulations section 1.1471-5(b)(4)(iii).

Line 25a.

If you are a restricted distributor you must check the box to certify that you meet all of the requirements for this status.

Lines 25b and 25c.

Check the appropriate box to certify your status. Do not check both boxes.

.A restricted distributor may certify only with respect to an account it maintains in connection with a distribution agreement with a restricted fund. A restricted distributor that, in connection with such a distribution agreement, receives a payment subject to chapter 3 withholding or a withholdable payment should complete Form W-8IMY and not this form except to the extent it holds interests in connection with such an agreement as a beneficial owner..

Line 26.

Check the box to indicate that you are treated as a nonreporting IGA FFI. You must identify the IGA by entering the name of the jurisdiction that has the IGA treated as in effect with the United States, and indicate whether it is a Model 1 or Model 2 IGA. You must also provide the withholding agent with the specific category of FFI described in Annex II of the IGA. In providing the specific category of FFI described in Annex II, you should use the language from Annex II that best and most specifically describes your status. For example, indicate "investment entity wholly owned by exempt beneficial owners" rather than "exempt beneficial owner." If you are a nonreporting IGA FFI claiming a deemed-compliant status under the regulations, you must instead indicate on this line which section of the regulations you qualify under.

If you are a nonreporting financial institution under an applicable IGA because you qualify as an owner-documented FFI under the regulations, do not check "Nonreporting IGA FFI." Instead, you must check "Owner-documented FFI" and complete Part X rather than this Part XII.

See instructions for Line 9a for when a GIIN is required for a nonreporting IGA FFI (including a trustee of a trustee-documented trust that is a foreign person).

Line 27.

If you are a foreign government or political subdivision of a foreign government (including wholly owned agencies and instrumentalities thereof), government of a U.S. possession, or foreign central bank of issue (each as defined in Regulations section 1.1471-6) you must check the box and certify that you meet all of the requirements for this status (including that you do not engage in the type of commercial financial activities described on this line except to the extent permitted under Regulations section 1.1471-6(h)(2)).

.If you are a foreign government or political subdivision of a foreign government (including wholly owned agencies and instrumentalities thereof), government of a U.S. possession, or foreign central bank of issue, you should only complete Form W-8BEN-E for payments for which you are not claiming the applicability of section(s) 115(2), 892, or 895; otherwise you should use Form W-8EXP..

Line 28a.

Check this box to certify that you are an international organization described in section 7701(a)(18).

Line 28b.

If you are an international organization other than an international organization described on line 28a, you must check the box to certify that you satisfy all of the requirements for this status.

Lines 29a, b, c, d, e, and f.

,

If you are an exempt retirement plan you must check the appropriate box to certify that you meet all of the requirements for this status.

Line 30.

If you are an entity wholly owned by exempt beneficial owners you must check the box to certify that you meet all of the requirements for this status. You must also provide the owner documentation described in this line establishing that each of your direct owners or debt holders is an exempt beneficial owner described in Regulations section 1.1471-6(b).

Line 31.

If you are a territory financial institution you must check the box to certify that you meet all of the requirements for this status.

Line 32.

If you are an excepted nonfinancial group entity you must check the box to certify that you meet all of the requirements for this status.

Line 33.

If you are an excepted nonfinancial start-up company you must check the box to certify that you meet all of the requirements for this status. You must also provide the date you were formed or your board passed a resolution (or equivalent measure) approving a new line of business (which cannot be that of a financial institution or passive NFFE).

Line 34.

If you are an excepted nonfinancial group entity in liquidation or bankruptcy you must check the box to certify that you meet all of the requirements for this status. You must also provide the date that you filed a plan of liquidation, plan of reorganization, or bankruptcy petition.

Line 35.

If you are an entity claiming chapter 4 status as a section 501(c) organization pursuant to Regulations section 1.1471-5(e)(5)(v) you must check the box and provide the date that the IRS issued you a determination letter or provide a copy of an opinion from U.S. counsel certifying that you qualify as a section 501(c) organization (without regard to whether you are a foreign private foundation).

.If you are a section 501(c) organization claiming an exemption from withholding for purposes of chapter 3, however, use Form W-8EXP..

Line 36.

If you are a nonprofit organization (other than an entity claiming chapter 4 status as a section 501(c) organization pursuant to Regulations section 1.1471-5(e)(5)(v)) you must check the box to certify that you meet all of the requirements for this status.

Nonprofit organization under an IGA. If you are an entity that is established and maintained in a jurisdiction that is treated as having in effect an IGA and you are described in Annex I as a nonprofit organization that is an Active NFFE, see Entities Providing Certifications Under an Applicable IGA under Special Instructions, later.

Line 37a.

If you are a publicly-traded NFFE you must check the box to certify that you are not a financial institution and provide the name of a securities exchange on which your stock is publicly traded.

Line 37b.

If you are an NFFE that is a member of the same expanded affiliated group as a publicly-traded U.S. or foreign entity you must check this box, provide the name of the publicly-traded entity, and identify the securities market on which the stock of the publicly- traded entity is traded. See Regulations section 1.1472-1(c)(1)(i) to determine if the stock of an entity is regularly traded on an established securities market (substituting the term "U.S. entity" for "NFFE," as appropriate, for purposes of testing whether an entity is publicly traded).

Line 38.

If you are an excepted territory NFFE you must check the box to certify that you meet all of the requirements for this classification. See Regulations section 1.1472-1(c)(1)(iii) for the definition of an excepted territory NFFE.

Line 39.

If you are an active NFFE you must check the box to certify that you meet all of the requirements for this status, including the assets and passive income test described in the certification for this part. For purposes of applying this test, passive income includes dividends, interest, rents, royalties, annuities, and certain other forms of passive income. See Regulations section 1.1472-1(c)(1)(iv)(A) for additional detail for the definition of passive income. Also see Regulations section 1.1472-1(c)(1)(iv)(B) for exceptions from the definition of passive income for certain types of income.

Line 40a.

If you are a passive NFFE you must check the box to certify that you are not a financial institution and are not certifying your status as a publicly-traded NFFE, NFFE affiliate of a publicly-traded company, excepted territory NFFE, active NFFE, direct reporting NFFE, or sponsored direct reporting NFFE.

.If you are an NFFE that may qualify as an active NFFE (or other NFFE described in another part of this form), you may still check line 40a and disclose your substantial U.S. owners or certify that you have no substantial U.S. owners..

Line 40b.

Check this box to certify that you have no substantial U.S. owners.

Line 40c.

If you do not check the box and make the certification on line 40b, you must check this box 40c and complete Part XXIX to identify and provide the name, address, and TIN of each of your substantial U.S. owners.

Line 41.

If you are an excepted inter-affiliate FFI you must check the box to certify that you meet all of the requirements of this classification. This classification will only apply for an excepted inter-affiliate FFI that holds deposit accounts described in the certification for this part and that is documenting itself to the financial institution that maintains the deposit account. You are not eligible for this classification if you receive or make withholdable payments to or from any person other than a member of your expanded affiliated group, other than the depository institution described in the previous sentence. See Regulations section 1.1471-5(e)(5)(iv) for all the requirements of this status.

Lines 42 and 43.

If you are a sponsored direct reporting NFFE you must enter the name of the sponsoring entity on line 42 and check the box to certify that you meet all of the requirements for this classification. You must also provide your GIIN on line 9a.

Broker transactions or barter exchanges.

Income from transactions with a broker or a barter exchange is subject to reporting rules and backup withholding unless Form W-8BEN-E or a substitute form is filed to notify the broker or barter exchange that you are an exempt foreign person.

You are an exempt foreign person for a calendar year in which: