Instructions for Department of the Treasury

Internal Revenue Service

Form W-8BEN-E
(Rev. April 2016)
Certificate of Status of Beneficial Owner for
United States Tax Withholding and Reporting (Entities)
Section references are to the Internal Revenue Code
unless otherwise noted. General Instructions
For definitions of terms used throughout these
Future Developments instructions, see Definitions, later.
For the latest information about developments related to Purpose of Form
Form W-8BEN-E and its instructions, such as legislation
enacted after they were published, go to www.irs.gov/ This form is used by foreign entities to document their
formw8bene. status for purposes of chapter 3 and chapter 4, as well as
for certain other Code provisions as described later in
these instructions.
What's New
Foreign persons are subject to U.S. tax at a 30% rate
Limitation on benefits (LOB) for treaty claims. In (the foreign-person withholding rate) on income they
order to claim treaty benefits, an entity must not only be a receive from U.S. sources that consists of:
resident of the treaty country but also derive and Interest (including certain original issue discount (OID));
beneficially own the item of income as well as satisfy the Dividends;
limitation on benefits (LOB) article of that treaty, if any. Rents;
New checkboxes have been added to Part III (Claim of Royalties;
Tax Treaty Benefits) for each of the main tests that can be
Premiums;
met to satisfy an LOB provision. A taxpayer is required to
Annuities;
check the relevant box associated with the LOB test it
meets with respect to the treaty benefits associated with Compensation for, or in expectation of, services
this form, or to check a box that it has obtained a performed;
favorable discretionary determination from the U.S. Substitute payments in a securities lending transaction;
competent authority that it qualifies for the treaty benefits or
associated with this form. Other fixed or determinable annual or periodical gains,
profits, or income.
Accounts that are not financial accounts. A new
checkbox has been added to the chapter 4 statuses in This tax is imposed on the gross amount paid and is
line 5 for payments made to payees for accounts they generally collected by withholding under section 1441 or
hold that are not financial accounts under Regulations 1442 on that amount. A payment is considered to have
section 1.1471-5(b)(2). been made whether it is made directly to the beneficial
owner or to another person, such as an intermediary,
Nonreporting IGA FFIs. The instructions for how agent, or partnership, for the benefit of the beneficial
nonreporting IGA FFIs should properly document owner.
themselves on this form and certify to their status have
been revised to coordinate qualification for such status In addition, section 1446 requires a partnership
under the IGA with the chapter 4 regulations. An FFI that conducting a trade or business in the United States to
meets the requirements of both a nonreporting IGA FFI withhold tax on a foreign partner’s distributive share of the
under the IGA and a deemed-compliant FFI status under partnership’s effectively connected taxable income.
the regulations should certify as a nonreporting IGA FFI, Generally, a foreign person that is a partner in a
unless such entity meets the requirements for partnership that submits a Form W-8 for purposes of
owner-documented FFI status for payments associated section 1441 or 1442 will satisfy the documentation
with this form, in which case it should certify to that status requirements under section 1446 as well. However, in
under the regulations only by completing Part X of the some cases the documentation requirements of sections
form. 1441 and 1442 do not match the documentation
requirements of section 1446. See Regulations sections
1.1446-1 through 1.1446-6. Further, the owner of a
Reminder disregarded entity, rather than the disregarded entity
Note. If you are a resident in a FATCA partner jurisdiction itself, submits the appropriate Form W-8 for purposes of
(i.e., a Model 1 IGA jurisdiction with reciprocity), certain section 1446.
tax account information may be provided to your A withholding agent or payer of the income may rely on
jurisdiction of residence. a properly completed Form W-8BEN-E to treat a payment
associated with the Form W-8BEN-E as a payment to a
foreign person who beneficially owns the amounts paid. If

Apr 13, 2016 Cat. No. 59691Z

applicable, the withholding agent may rely on the Form that you provide this Form W-8BEN-E in order to
W-8BEN-E to apply a reduced rate of, or exemption from, document your chapter 4 status.
withholding. If you receive certain types of income, you
Additional information. For additional information and
must provide Form W-8BEN-E to: instructions for the withholding agent, see the Instructions
Claim that you are the beneficial owner of the income for the Requester of Forms W-8BEN, W-8BEN-E,
for which Form W-8BEN-E is being provided or a partner W-8ECI, W-8EXP, and W-8IMY.
in a partnership subject to section 1446; and
If applicable, claim a reduced rate of, or exemption Who Must Provide Form W-8BEN-E
from, withholding as a resident of a foreign country with You must give Form W-8BEN-E to the withholding agent
which the United States has an income tax treaty that is or payer if you are a foreign entity receiving a withholdable
eligible for treaty benefits. payment from a withholding agent, receiving a payment
You may also use Form W-8BEN-E to identify income subject to chapter 3 withholding, or if you are such an
from a notional principal contract that is not effectively entity maintaining an account with an FFI requesting this
connected with the conduct of a trade or business in the form.
United States to establish the exception to reporting such Do not use Form W-8BEN-E if you are described
income on Form 1042-S. See Regulations section below.
1.1461-1(c)(2)(ii)(F). You are U.S. person (including U.S. citizens, resident
Form W-8BEN-E may also be used to claim exemption aliens, and entities treated as U.S. persons, such as a
from withholding for portfolio interest pursuant to section corporation organized under the law of a state). Instead,
881(c). The portfolio interest exemption does not apply to use Form W-9, Request for Taxpayer Identification
payments of interest for which the recipient is a 10 percent Number and Certification.
shareholder of the payer or to payments of interest You are a foreign insurance company that has made an
received by a controlled foreign corporation from a related election under section 953(d) to be treated as a U.S.
person. See sections 881(c)(3) and 881(c)(5). A future person. Instead, provide a withholding agent with Form
version of this form may require that persons receiving W-9 to certify to your U.S. status even if you are
interest payments to which this form relates identify any considered an FFI for purposes of chapter 4.
obligation with respect to which they have one of these You are a nonresident alien individual. Instead, use
prohibited relationships. Form W-8BEN, Certificate of Foreign Status of Beneficial
Owner for United States Tax Withholding and Reporting
You may also be required to submit Form W-8BEN-E to (Individuals), or Form 8233, Exemption From Withholding
claim an exception from domestic information reporting on on Compensation for Independent (and Certain
Form 1099 and backup withholding (at the backup Dependent) Personal Services of a Nonresident Alien
withholding rate under section 3406) for certain types of Individual, as applicable.
income. Such income includes: You are a disregarded entity, branch, or flow-through
Broker proceeds. entity for U.S. tax purposes. However, you may use this
Short-term (183 days or less) original issue discount form if you are a disregarded entity or flow-through entity
(short-term OID). using this form only either solely to document your
Bank deposit interest. chapter 4 status (because you hold an account with an
Foreign source interest, dividends, rents, or royalties. FFI requesting this form) or, if you are a disregarded entity
Provide Form W-8BEN-E to the withholding agent or or a partnership, to claim treaty benefits because you are
payer before income is paid or credited to you. Failure to a hybrid entity liable to tax as a resident for treaty
provide a Form W-8BEN-E when requested may lead to purposes. See Special Instructions for Hybrid Entities,
withholding at a 30% rate (foreign-person withholding later. A flow-through entity may also use this form solely
rate) or the backup withholding rate in certain cases when for purposes of documenting itself as a participating
you receive a payment to which backup withholding payee for purposes of section 6050W. If you are a
applies. disregarded entity with a single owner or branch of an FFI,
the single owner, if such owner is a foreign person, should
In addition to the requirements of chapter 3, chapter 4 provide Form W-8BEN or Form W-8BEN-E (as
requires withholding agents to identify the chapter 4 status appropriate). Note, however, that the single entity owner
of entities that are payees receiving withholdable may be required to identify the branch (including a
payments (see the instructions for Part I, line 5, of this disregarded entity) in Part II of the owner’s Form
form, later). A withholding agent may request this Form W-8BEN-E and, in some cases, provide the legal name of
W-8BEN-E to establish your chapter 4 status and avoid the disregarded entity in Part I, line 3 (see the specific
withholding at a 30% rate (the chapter 4 rate) on such instructions for line 3, later). If the single owner is a U.S.
payments. Withholding on withholdable payments under person, a Form W-9 should be provided. If you are a
chapter 4 generally began on July 1, 2014. partnership, you should provide a Form W-8IMY.
You are acting as an intermediary (that is, acting not for
Chapter 4 also requires participating FFIs and certain
your own account, but for the account of others as an
registered deemed-compliant FFIs to document their
agent, nominee, or custodian), a qualified intermediary
entity account holders in order to determine their
(including a qualified intermediary acting as a qualified
chapter 4 status regardless of whether withholding applies
derivatives dealer), or a qualified securities lender (QSL)
to any payments made to the entities. If you are an entity
with regard to a payment of U.S. source substitute
maintaining an account with an FFI, the FFI may request

-2- Instructions for Form W-8BEN-E (Rev. 4-2016)

dividends. Instead, provide Form W-8IMY, Certificate of identifying yourself to withholding agents, you may submit
Foreign Intermediary, Foreign Flow-Through Entity, or Form W-9 to certify to your U.S. status.
Certain U.S. Branches for United States Tax Withholding
Giving Form W-8BEN-E to the withholding agent. Do
and Reporting. not send Form W-8BEN-E to the IRS. Instead, give it to
You are receiving income that is effectively connected the person who is requesting it from you. Generally, this
with the conduct of a trade or business in the United will be the person from whom you receive the payment,
States, unless it is allocable to you through a partnership. who credits your account, or a partnership that allocates
Instead, provide Form W-8ECI, Certificate of Foreign income to you. An FFI may also request this form from you
Person’s Claim That Income Is Effectively Connected to document the status of your account.
With the Conduct of a Trade or Business in the United
States. If any of the income for which you have provided a When to provide Form W-8BEN-E to the withholding
Form W-8BEN-E becomes effectively connected, this is a agent. Give Form W-8BEN-E to the person requesting it
change in circumstances and the Form W-8BEN-E is no before the payment is made to you, credited to your
longer valid. You must provide Form W-8ECI. See account, or allocated. If you do not provide this form, the
Change in circumstances, later. withholding agent may have to withhold at the 30% rate
You are filing for a foreign government, international (as applicable under chapters 3 or 4), backup withholding
organization, foreign central bank of issue, foreign rate, or the rate applicable under section 1446. If you
tax-exempt organization, foreign private foundation, or receive more than one type of income from a single
government of a U.S. possession claiming the withholding agent for which you claim different benefits,
applicability of section 115(2), 501(c), 892, 895, or the withholding agent may, at its option, require you to
1443(b). Instead, provide Form W-8EXP, Certificate of submit a Form W-8BEN-E for each different type of
Foreign Government or Other Foreign Organization for income. Generally, a separate Form W-8BEN-E must be
United States Tax Withholding and Reporting, to certify as given to each withholding agent.
to your exemption and identify your applicable chapter 4 Note. If you own the income with one or more other
status. However, provide Form W-8BEN-E if you are persons, the income will be treated by the withholding
claiming treaty benefits, providing this form only to claim agent as owned by a foreign person that is a beneficial
you are a foreign person exempt from backup withholding, owner of a payment only if Form W-8BEN or W-8BEN-E
or providing this form solely to document your chapter 4 (or other applicable document) is provided by each of the
status. For example, a foreign tax-exempt organization owners. An account will be treated as a U.S. account for
under section 501(c) receiving royalty income that is not chapter 4 purposes by an FFI requesting this form if any of
exempt because it is taxable as unrelated business the account holders is a specified U.S. person or a
income but is eligible for a reduced rate of withholding U.S.-owned foreign entity (unless the account is otherwise
under a royalty article of a tax treaty should provide Form excepted from U.S. account status for chapter 4
W-8BEN-E. You should use Form W-8ECI if you are purposes).
receiving effectively connected income (for example, Change in circumstances. If a change in
income from commercial activities that is not exempt circumstances makes any information on the Form
under an applicable section of the Code). W-8BEN-E you have submitted incorrect for purposes of
You are a foreign reverse hybrid entity transmitting either chapter 3 or chapter 4, you must notify the
documentation provided by your interest holders to claim withholding agent or financial institution maintaining your
treaty benefits on their behalf. Instead, provide Form account within 30 days of the change in circumstances by
W-8IMY. A foreign reverse hybrid entity also may not use providing the documentation required in Regulations
this form to attempt to claim treaty benefits on its own section 1.1471-3(c)(6)(ii)(E)(2). See Regulations sections
behalf. See Foreign Reverse Hybrid Entities, later. 1.1441-1(e)(4)(ii)(D) for the definition of a change in
You are a withholding foreign partnership or a circumstances for purposes of chapter 3. See Regulations
withholding foreign trust within the meaning of sections section 1.1471-3(c)(6)(ii)(E) for the definition of a change
1441 and 1442 and the accompanying regulations. A in circumstances for purposes of chapter 4.
withholding foreign partnership or a withholding foreign
trust is a foreign partnership or trust that has entered into With respect to an FFI claiming a chapter 4 status
a withholding agreement with the IRS under which it ! under an applicable IGA, a change in
agrees to assume primary withholding responsibility for CAUTION circumstances includes when the jurisdiction
each partner’s, beneficiary’s, or owner’s distributive share where the FFI is organized or resident (or the jurisdiction
of income subject to withholding under chapters 3 and 4 identified in Part II of the form) was included on the list of
that is paid to the partnership or trust. Instead, provide jurisdictions treated as having an intergovernmental
Form W-8IMY. agreement in effect and is removed from that list or when
You are a foreign partnership or foreign grantor trust the FATCA status of the jurisdiction changes (e.g., from
providing documentation for purposes of section 1446. Model 2 to Model 1). The list of agreements is maintained
Instead, provide Form W-8IMY and accompanying at www.treasury.gov/resource-center/tax-policy/treaties/
documentation. See Regulations sections 1.1446-1 Pages/FATCA-Archive.aspx.
through 1.1446-6.
Expiration of Form W-8BEN-E. Generally, a Form
You are a foreign branch of a U.S. financial institution
W-8BEN-E will remain valid for purposes of both chapters
that is an FFI (other than a qualified intermediary branch)
3 and 4 for a period starting on the date the form is signed
under an applicable Model 1 IGA. For purposes of
and ending on the last day of the third succeeding
calendar year, unless a change in circumstances makes

Instructions for Form W-8BEN-E (Rev. 4-2016) -3-

any information on the form incorrect. For example, a foreign grantor trust (that is, a foreign trust to the extent
Form W-8BEN signed on September 30, 2014 remains that all or a portion of the income of the trust is treated as
valid through December 31, 2017. owned by the grantor or another person under sections
However, under certain conditions a Form W-8BEN-E 671 through 679) are the persons treated as the owners of
will remain in effect indefinitely until a change of the trust. The beneficial owners of income paid to a
circumstances occurs. To determine the period of validity foreign complex trust (that is, a foreign trust that is not a
for Form W-8BEN-E for purposes of chapter 4, see foreign simple trust or foreign grantor trust) is the trust
Regulations section 1.1471-3(c)(6)(ii). To determine the itself.
period of validity for Form W-8BEN-E for purposes of For purposes of section 1446, the same beneficial
chapter 3, see Regulations section 1.1441-1(e)(4)(ii). owner rules apply, except that under section 1446 a
foreign simple trust rather than the beneficiary provides
Definitions the form to the partnership.
Account holder. An account holder is generally the The beneficial owner of income paid to a foreign estate
person listed or identified as the holder or owner of a is the estate itself.
financial account. For example, if a partnership is listed as Note. A payment to a U.S. partnership, U.S. trust, or
the holder or owner of a financial account, then the U.S. estate is treated as a payment to a U.S. payee that is
partnership is the account holder, rather than the partners not subject to 30% withholding for purposes of chapter 3
of the partnership. However, an account that is held by a and chapter 4. A U.S. partnership, trust, or estate should
disregarded entity (other than a disregarded entity treated provide the withholding agent with a Form W-9. For
as an FFI for chapter 4 purposes) is treated as held by the purposes of section 1446, a U.S. grantor trust or
person owning the entity. disregarded entity shall not provide the withholding agent
Amounts subject to withholding under chapter 3. a Form W-9 in its own right. Rather, the grantor or other
Generally, an amount subject to chapter 3 withholding is owner shall provide the withholding agent the appropriate
an amount from sources within the United States that is form.
fixed or determinable annual or periodical (FDAP) income. Chapter 3. Chapter 3 means chapter 3 of the Internal
FDAP income is all income included in gross income, Revenue Code (Withholding of Tax on Nonresident Aliens
including interest (as well as OID), dividends, rents, and Foreign Corporations). Chapter 3 contains sections
royalties, and compensation. Amounts subject to 1441 through 1464.
chapter 3 withholding do not include amounts that are not
Chapter 4. Chapter 4 means chapter 4 of the Internal
FDAP, such as most gains from the sale of property
Revenue Code (Taxes to Enforce Reporting on Certain
(including market discount and option premiums), as well
Foreign Accounts). Chapter 4 contains sections 1471
as other specific items of income described in Regulations
through 1474.
section 1.1441-2 (such as interest on bank deposits and
short-term OID). Chapter 4 status. The term chapter 4 status means a
For purposes of section 1446, the amount subject to person’s status as a U.S. person, specified U.S. person,
withholding is the foreign partner’s share of the foreign individual, participating FFI, deemed-compliant
partnership’s effectively connected taxable income. FFI, restricted distributor, exempt beneficial owner,
nonparticipating FFI, territory financial institution,
Beneficial owner. For payments other than those for excepted NFFE, or passive NFFE. See Regulations
which a reduced rate of, or exemption from, withholding is section 1.1471-1(b) for the definitions of these terms.
claimed under an income tax treaty, the beneficial owner
of income is generally the person who is required under Deemed-compliant FFI. Under section 1471(b)(2),
U.S. tax principles to include the payment in gross income certain FFIs are deemed to comply with the regulations
on a tax return. A person is not a beneficial owner of under chapter 4 without the need to enter into an FFI
income, however, to the extent that person is receiving the agreement with the IRS. However, certain
income as a nominee, agent, or custodian, or to the extent deemed-compliant FFIs are required to register with the
the person is a conduit whose participation in a IRS and obtain a GIIN. These FFIs are referred to as
transaction is disregarded. In the case of amounts paid registered deemed-compliant FFIs. See Regulations
that do not constitute income, beneficial ownership is section 1.1471-5(f)(1).
determined as if the payment were income. Disregarded entity. A business entity that has a single
Foreign partnerships, foreign simple trusts, and foreign owner and is not a corporation under Regulations section
grantor trusts are not the beneficial owners of income paid 301.7701-2(b) is disregarded as an entity separate from
to the partnership or trust. The beneficial owners of its owner. Generally, a disregarded entity does not submit
income paid to a foreign partnership are generally the this Form W-8BEN-E to a withholding agent or FFI.
partners in the partnership, provided that the partner is not Instead, the owner of such entity provides the appropriate
itself a partnership, foreign simple or grantor trust, documentation (for example, a Form W-8BEN-E if the
nominee or other agent. The beneficial owners of income owner is a foreign entity). See Regulations section
paid to a foreign simple trust (that is, a foreign trust that is 1.1446-1 and section 1.1471-3(a)(3)(v), respectively.
described in section 651(a)) are generally the However, if a disregarded entity receiving a withholdable
beneficiaries of the trust, if the beneficiary is not a foreign payment is an FFI outside the single owner’s country of
partnership, foreign simple or grantor trust, nominee, or organization or has its own GIIN, its foreign owner will be
other agent. The beneficial owners of income paid to a required to complete Part II of Form W-8BEN-E to

-4- Instructions for Form W-8BEN-E (Rev. 4-2016)

document the chapter 4 status of the disregarded entity a foreign simple or foreign grantor trust (other than a
receiving the payment. withholding foreign trust), or, for payments for which a
Certain entities that are disregarded for U.S. tax reduced rate of, or exemption from, withholding is claimed
purposes may be treated as a treaty resident for purposes under an income tax treaty, any entity to the extent the
of claiming treaty benefits under an applicable tax treaty entity is considered to be fiscally transparent (see above)
(see the definition of hybrid entity, later) or may be with respect to the payment by an interest holder’s
recognized as an FFI under an applicable IGA (see jurisdiction.
instructions for line 3, later, for when this applies). A For purposes of section 1446, a foreign partnership or
hybrid entity claiming treaty benefits on its own behalf is foreign grantor trust must submit Form W-8IMY to
required to complete this Form W-8BEN-E. See Hybrid establish the partnership or grantor trust as a look-through
Entities under Special Instructions, later. entity. The Form W-8IMY may be accompanied by this
A disregarded entity with a U.S. owner or a disregarded form or another version of Form W-8 or Form W-9 to
entity with a foreign owner that is not otherwise able to fill establish the foreign or domestic status of a partner or
out Part II (i.e., because it is in the same country as its grantor or other owner. See Regulations section 1.1446-1.
single owner and does not have a GIIN) may provide this Foreign person. A foreign person includes a foreign
form to an FFI solely for purposes of documenting itself for corporation, a foreign partnership, a foreign trust, a foreign
chapter 4 purposes. In such a case, the disregarded entity estate, and any other person that is not a U.S. person. It
should complete Part I as if it were a beneficial owner and also includes a foreign branch or office of a U.S. financial
should not complete line 3. institution or U.S. clearing organization if the foreign
Financial account. A financial account includes: branch is a qualified intermediary (QI). Generally, a
A depository account maintained by an FFI; payment to a U.S. branch of a foreign person is a payment
A custodial account maintained by an FFI; to a foreign person.
Equity or debt interests (other than interests regularly GIIN. The term GIIN means a global intermediary
traded on an established securities market) in investment identification number. A GIIN is the identification number
entities and certain holding companies, treasury centers, assigned to an entity that has registered with the IRS for
or financial institutions as defined in Regulations section chapter 4 purposes.
1.1471-5(e);
Hybrid entity. A hybrid entity is any person (other than
Certain cash value insurance contracts; and an individual) that is treated as fiscally transparent (rather
Annuity contracts. than as a beneficial owner) for purposes of declaring
For purposes of chapter 4, exceptions are provided for status under the Code but is not treated as fiscally
accounts such as certain tax-favored savings accounts, transparent by a country with which the United States has
term life insurance contracts, accounts held by estates, an income tax treaty. Hybrid entity status is relevant for
escrow accounts, and certain annuity contracts. These claiming treaty benefits. A hybrid entity, is, however,
exceptions are subject to certain conditions. See required to provide its chapter 4 status if it is receiving a
Regulations section 1.1471-5(b)(2). Accounts may also withholdable payment.
be excluded from the definition of financial account under
Intergovernmental agreement (IGA). An
an applicable IGA.
intergovernmental agreement (IGA) means a Model 1 IGA
Financial institution. A financial institution generally or a Model 2 IGA. For a list of jurisdictions treated as
means an entity that is a depository institution, custodial having in effect a Model 1 or Model 2 IGA, see
institution, investment entity, or an insurance company (or www.treasury.gov/resource-center/tax-policy/treaties/
holding company of an insurance company) that issues Pages/FATCA-Archive.aspx.
cash value insurance or annuity contracts. See A Model 1 IGA means an agreement between the U.S.
Regulations section 1.1471-5(e). or the Treasury Department and a foreign government or
Foreign financial institution (FFI). A foreign financial one or more agencies to implement FATCA through
institution (FFI) generally means a foreign entity that is a reporting by FFIs to such foreign government or agency
financial institution. thereof, followed by automatic exchange of the reported
information with the IRS. An FFI in a Model 1 IGA
Fiscally transparent entity. An entity is treated as
jurisdiction that performs account reporting to the
fiscally transparent with respect to an item of income for
jurisdiction’s government is referred to as a reporting
which treaty benefits are claimed to the extent that the
Model 1 FFI.
interest holders in the entity must, on a current basis, take
into account separately their shares of an item of income A Model 2 IGA means an agreement or arrangement
paid to the entity, whether or not distributed, and must between the U.S. or the Treasury Department and a
determine the character of the items of income as if they foreign government or one or more agencies to implement
were realized directly from the sources from which FATCA through reporting by FFIs directly to the IRS in
realized by the entity. For example, partnerships, common accordance with the requirements of an FFI agreement,
trust funds, and simple trusts or grantor trusts are supplemented by the exchange of information between
generally considered to be fiscally transparent with such foreign government or agency thereof and the IRS.
respect to items of income received by them. An FFI in a Model 2 IGA jurisdiction that has entered into
an FFI agreement is a participating FFI, but may be
Flow-through entity. A flow-through entity is a foreign referred to as a reporting Model 2 FFI. The term
partnership (other than a withholding foreign partnership),

Instructions for Form W-8BEN-E (Rev. 4-2016) -5-

reporting IGA FFI refers to both reporting Model 1 FFIs information on a reverse hybrid entity making a claim of
and reporting Model 2 FFIs. treaty benefits on behalf of its owners.
Limited branch. A limited branch means a branch of a Specified U.S. person. A specified U.S. person is any
participating FFI that is described in Regulations section U.S. person other than a person identified in Regulations
1.1471-4(e)(2). section 1.1473-1(c).
Nonparticipating FFI. A nonparticipating FFI means an Substantial U.S. owner. A substantial U.S. owner (as
FFI that is not a participating FFI, deemed-compliant FFI, defined in Regulations section 1.1473-1(b)) means any
or exempt beneficial owner. specified U.S. person that:
Participating FFI. A participating FFI is an FFI (including Owns, directly or indirectly, more than 10 percent (by
a reporting Model 2 FFI covered by an FFI agreement) vote or value) of the stock of any foreign corporation;
that has agreed to comply with the terms of an FFI Owns, directly or indirectly, more than 10 percent of the
agreement. The term participating FFI also includes a QI profits or capital interests in a foreign partnership;
branch of a U.S. financial institution, unless such branch is Is treated as an owner of any portion of a foreign trust
a reporting Model 1 FFI. under sections 671 through 679; or
Holds, directly or indirectly, more than a 10 percent
Participating payee. A participating payee means any beneficial interest in a trust.
person that accepts a payment card as payment or
accepts payment from a third party settlement An investment entity organized in a territory that is not
organization in settlement of a third party network also a depository institution, custodial institution, or
transaction for purposes of section 6050W. specified insurance company is not treated as a financial
institution. Instead, it is a territory NFFE. If such an entity
Payee. A payee is generally a person to whom a cannot qualify as an excepted NFFE as described in
payment is made, regardless of whether such person is Regulations section 1.1472-1(c)(1) (including an excepted
the beneficial owner. For a payment made to a financial territory NFFE), it must disclose its substantial U.S.
account, the payee is generally the holder of the financial owners using this definition (applying the 10 percent
account. However, under certain circumstances a person threshold) under Regulations section 1.1473-1(b)(1).
who receives a payment will not be considered the payee.
For purposes of chapter 3, see Regulations section U.S. person. A U.S. person is defined in section 7701(a)
1.1441-1(b)(2). For purposes of chapter 4, see (30) and includes domestic partnerships, corporations,
Regulations section 1.1471-3(a)(3). and trusts.

Payment settlement entity (PSE). A payment Certain foreign insurance companies issuing
settlement entity is a merchant acquiring entity or third ! annuities or cash value insurance contracts that
party settlement organization. Under section 6050W, a CAUTION elect to be treated as a U.S. person for federal
PSE is generally required to report payments made in tax purposes but are not licensed to do business in the
settlement of payment card transactions or third party United States are treated as FFIs for purposes of
network transactions. However, a PSE is not required to chapter 4. For purposes of providing a withholding agent
report payments made to a beneficial owner that is with documentation for both chapter 3 and chapter 4
documented as foreign with an applicable W-8. purposes, however, such an insurance company is
permitted to use Form W-9 to certify its status as a U.S.
Qualified intermediary (QI). A qualified intermediary person. Likewise, a foreign branch of a U.S. financial
(QI) (as described in Regulations section 1.1441-1(e)(5) institution (other than a branch that operates as a qualified
(ii)) is a person that is a party to an agreement with the intermediary) that is treated as an FFI under an applicable
IRS that is described in Regulations section 1.1441-1(e) IGA is permitted to use Form W-9 to certify its status as a
(5)(iii). A qualified derivatives dealer is a QI that has U.S. person for chapter 3 and chapter 4 purposes.
agreed to certain reporting and withholding requirements
pursuant to Regulations section 1.1441-1(e)(6). Withholdable payment. Withholding under chapter 4
Recalcitrant account holder. A recalcitrant account may apply to payments of U.S. source FDAP income that
holder for purposes of chapter 4 includes an entity (other are withholdable payments as defined in Regulations
than an entity required to be treated as a nonparticipating section 1.1473-1(a) to which an exception does not apply
FFI by the withholding agent) that fails to comply with a under chapter 4. The exceptions from withholding
request by an FFI maintaining the account for provided for under chapter 3 are not applicable when
documentation and information for determining whether determining whether withholding applies under chapter 4.
the account is a U.S. account (as defined in Regulations For exceptions applicable to the definition of a
section 1.1471-5(a)). See Regulations section withholdable payment, see Regulations section
1.1471-5(g). 1.1473-1(a)(4) (exempting, for example, certain
nonfinancial payments).
Reverse hybrid entity. A reverse hybrid entity is any
person (other than an individual) that is not fiscally Withholding agent. Any person, U.S. or foreign, that has
transparent under U.S. tax law principles but that is control, receipt, custody, disposal, or payment of U.S.
fiscally transparent under the laws of a jurisdiction with source FDAP income subject to chapter 3 or 4 withholding
which the United States has an income tax treaty. See is a withholding agent. The withholding agent may be an
Form W-8IMY and accompanying instructions for individual, corporation, partnership, trust, association, or
any other entity, including (but not limited to) any foreign

-6- Instructions for Form W-8BEN-E (Rev. 4-2016)

intermediary, foreign partnership, and U.S. branches of whether the definition of “account holder” under an IGA is
certain foreign banks and insurance companies. applicable to your account, consult with the FFI requesting
For purposes of section 1446, the withholding agent is this form.
the partnership conducting the trade or business in the
Line 2. If you are a corporation, enter your country of
United States. For a publicly traded partnership, the
incorporation. If you are another type of entity, enter the
withholding agent may be the partnership, a nominee
country under whose laws you are created, organized, or
holding an interest on behalf of a foreign person, or both.
governed.
See Regulations sections 1.1446-1 through 1.1446-6.
Line 3. If you are a disregarded entity receiving a
withholdable payment, enter your name (if required). You
Specific Instructions should complete line 3 only if you are a disregarded entity
A hybrid entity should give Form W-8BEN-E on receiving a withholdable payment or hold an account with
TIP its own behalf to a withholding agent only for an FFI requesting this form and you: 1) have registered
income for which it is claiming a reduced rate of with the IRS and been assigned a GIIN associated with
withholding under an income tax treaty or to document its the legal name of the disregarded entity; 2) are a reporting
chapter 4 status for purposes of maintaining an account Model 1 FFI or reporting Model 2 FFI; and 3) are not a
with an FFI requesting this form (when it is not receiving hybrid entity using this form to claim treaty benefits.
withholdable payments or payments subject to chapter 3 If you are not required to provide the legal name
withholding). Otherwise, an entity treated as a of the disregarded entity, however, you may want
flow-through entity should generally provide Form W-8IMY
!
CAUTION to notify the withholding agent that you are a
for chapter 3 or chapter 4 purposes. A reverse hybrid disregarded entity receiving a payment or maintaining an
entity should give Form W-8BEN-E on its own behalf to a account by indicating the name of the disregarded entity
withholding agent only for income for which no treaty on line 10. However, do not enter the name of the
benefit is being claimed or to establish its status for disregarded entity on this line 3 except in the
chapter 4 purposes (when required). See the special circumstances described.
instructions for hybrid entities and reverse hybrid entities
below. However, a flow-through entity may provide this Line 4. Check the one box that applies. By checking a
Form W-8BEN-E to document its foreign status as a box, you are representing that you qualify for the
participating payee receiving a payment for purposes of classification indicated. You must check the box that
section 6050W. represents your classification (for example, corporation,
partnership, trust, estate, etc.) under U.S. tax principles
Part I – Identification (not under the law of the treaty country). However, if you
are providing Form W-8BEN-E to an FFI solely for
of Beneficial Owner purposes of documenting yourself for chapter 4 purposes
Line 1. Enter your name. If you are a disregarded entity as an account holder of an account maintained by an FFI
or branch, do not enter the business name of the (and you are not receiving a withholdable payment), you
disregarded entity or branch here. Instead, enter the legal do not need to complete line 4.
name of the entity that owns the disregarded entity If you are a partnership, disregarded entity, simple
(looking through multiple disregarded entities if trust, or grantor trust receiving a payment for which treaty
applicable) or maintains the branch. If you are a benefits are being claimed by such entity, you must check
disregarded entity that is a hybrid entity filing a treaty the “Partnership”, “Disregarded entity”, “Simple trust”, or
claim, however, see Hybrid entities under Special “Grantor trust” box. For such a case, you must also check
Instructions, later. the “yes” box to indicate that you are a hybrid entity
If you are an account holder (see Definitions, making a treaty claim. See Hybrid entities under Special
Instructions, later. You may only check the “no” box if (1)
TIP earlier or, in the case of an account holder of an
account maintained by an FFI covered by a you are a disregarded entity, partnership, simple trust, or
Model 1 or Model 2 IGA with respect to the account, an grantor trust and are using the form solely for purposes of
applicable IGA) providing this form to an FFI solely for documenting yourself as an account holder of an FFI and
purposes of documenting yourself as an account holder the form is not associated with a withholdable payment or
and you are not receiving a withholdable payment or a reportable amount (as defined in Regulations section
reportable amount (as defined in Regulations section 1.1441-1(e)(3)(vi)) or (2) you are using this form solely for
1.1441-1(e)(3)(vi)), you should complete Part I by purposes of documenting your status as the participating
substituting the references to “beneficial owner” with payee for purposes of section 6050W. In such cases, you
“account holder”. are not required to complete line 4, but you may check the
“no” box if you choose to complete line 4. You may also
The holder of an account is not always the use Form W-8IMY for this purpose. However, if you are
account holder for purposes of chapter 4. See receiving withholdable payments or reportable amounts
! Definitions, earlier or, for an account maintained (as defined in Regulations section 1.1441-1(e)(3)(vi)), you
are required to provide Form W-8IMY and a withholding
CAUTION

by an FFI covered by a Model 1 or Model 2 IGA with

respect to the account, the definition of account holder in statement (if applicable) or a Form W-8 or W-9, as
an applicable IGA to determine if you are the account appropriate, if you are a disregarded entity with a single
holder. If you hold an account with an FFI and are unsure owner with respect to such payments.

Instructions for Form W-8BEN-E (Rev. 4-2016) -7-

 Only entities that are tax-exempt under section residence should check nonparticipating FFI in line 5. An
! 501(c) should check the “Tax-exempt FFI that is related to a reporting IGA FFI and that is a
CAUTION organization” box for purposes of line 4. Such participating FFI, deemed-compliant FFI, or exempt
organizations should use Form W-8BEN-E only if they are beneficial owner under the U.S. Treasury regulations or
claiming a reduced rate of withholding under an income an applicable IGA should check the appropriate box for its
tax treaty or a Code exception other than section 501(c) or chapter 4 status.
if they are using this form solely for purposes of If you are an FFI in a jurisdiction treated as having an
documenting themselves as an account holder with an IGA in effect, you should not check “Participating FFI” but
FFI. Use Form W-8EXP to document your exemption and rather should check “Reporting Model 1 FFI” or “Reporting
chapter 4 status if you are claiming an exemption from Model 2 FFI” as applicable.
withholding under section 501(c).
See www.treasury.gov/resource-center/tax-policy/
Line 5. Check the one box that applies to your chapter 4 treaties/Pages/FATCA-Archive.aspx for a list of
status. You are not required to provide a chapter 4 status jurisdictions treated as having an IGA in effect.
if you are providing this form with respect to a preexisting
entity account (as described in Regulations section Non-Profit Organizations Covered by an IGA
1.1471-1(b)(102)) prior to July 1, 2016. Additionally, you For purposes of documenting itself as an account holder
are only required to provide a chapter 4 status on this form of an FFI, a non-profit entity that is established and
if you are the payee of a withholdable payment or are maintained in a jurisdiction that is treated as having in
documenting the status of an account you hold with an FFI effect a Model 1 IGA or Model 2 IGA, and that meets the
requesting this form. By checking a box on this line, you definition of Active NFFE under Annex I of the applicable
are representing that you qualify for this classification in IGA, should not check a box for its status on line 5.
your country of residence. Instead, see Entities Providing Certifications Under an
A withholding agent may request your chapter 4 Applicable IGA under Special Instructions, later.
! status in advance of this deadline to allow for time Account That is Not a Financial Account
necessary to apply the status in its systems. In
If you are providing this form to document an account you
CAUTION

addition, a withholding agent may still request a chapter 4

status notwithstanding the account holder's determination hold with a financial institution that is not a financial
of its status as a preexisting account for chapter 4 account under Regulations section 1.1471-5(b)(2), check
purposes. the“Account that is not a financial account” box on line 5.
Line 6. Enter the permanent residence address of the
For most of the chapter 4 statuses, you are entity identified in line 1. Your permanent residence
TIP required to complete an additional part of this address is the address in the country where the entity
form certifying that you meet the conditions of the claims to be a resident for purposes of that country’s
status indicated on line 5 (as defined under Regulations income tax. If you are giving Form W-8BEN-E to claim a
section 1.1471-5 or 1.1471-6). Make sure you complete reduced rate of, or exemption from, withholding under an
the required portion of this form before signing and income tax treaty, you must determine residency in the
providing it to the withholding agent. See, however, manner required by the treaty. Do not show the address of
Entities Providing Certifications Under an Applicable IGA a financial institution (unless you are a financial institution
under Special Instructions, later. providing your own address), a post office box, or an
address used solely for mailing purposes unless it is the
FFIs Covered by an IGA and Related Entities only address used by the entity and such address
A reporting IGA FFI resident in, or established under the appears in the entity’s organizational documents (i.e.,
laws of, a jurisdiction covered by a Model 1 IGA should your registered address). If you do not have a tax
check “Reporting Model 1 FFI.” A reporting FFI resident residence in any country, the permanent residence
in, or established under the laws of, a jurisdiction covered address is where you maintain your principal office.
by a Model 2 IGA should check “Reporting Model 2 FFI.” If Line 7. Enter your mailing address only if it is different
you are treated as a registered deemed-compliant FFI from the address you show on line 6.
under an applicable IGA, you should check “Nonreporting
IGA FFI” rather than “registered deemed-compliant FFI” Line 8. Enter your U.S. employer identification number
and provide your GIIN. In general, if you are treated as a (EIN). An EIN is a U.S. TIN for entities. If you do not have
nonreporting IGA FFI under an applicable IGA, you should a U.S. EIN, apply for one on Form SS-4, Application for
check “Nonreporting IGA FFI” even if you meet the Employer Identification Number, if you are required to
qualifications for deemed-compliant status or are an obtain a U.S. TIN. See Regulations section 1.1441-1(e)(4)
exempt beneficial owner under the chapter 4 regulations. (vii) for when you are required to provide a U.S. TIN on a
In such cases, you need not also check your applicable Form W-8 associated with a payment subject to chapter 3
status under the regulations but should provide your GIIN withholding.
on line 9, if applicable. However, an owner documented A partner in a partnership conducting a trade or
FFI that is treated as a nonreporting IGA FFI under an business in the United States will likely be allocated
applicable IGA must check “Owner-documented FFI” and effectively connected taxable income. The partner is
complete Part X. See the specific instructions for Part XII. required to file a U.S. federal income tax return and must
An FFI that is related to a reporting IGA FFI and that is have a U.S. taxpayer identification number (TIN).
treated as a nonparticipating FFI in its country of You must provide a U.S. TIN if you are:

-8- Instructions for Form W-8BEN-E (Rev. 4-2016)

 Claiming an exemption from withholding under section The jurisdiction does not issue TINs.
871(f) for certain annuities received under qualified plans,
Lines 9a and 9b should accommodate the GIIN
or
TIP or foreign TIN, as appropriate. You may need to
Claiming benefits under an income tax treaty and have
use a smaller font when completing the form. If
not provided a foreign TIN on line 9b.
the GIIN or foreign TIN does not fit in the space provided,
However, a TIN is not required to be shown in order to you may provide a GIIN or foreign TIN that is indicated
claim treaty benefits on the following items of income: and clearly identified somewhere else on the form, or on a
Dividends and interest from stocks and debt obligations separate attached sheet, as long as the GIIN or foreign
that are actively traded; TIN is clearly identified as being furnished with respect to
Dividends from any redeemable security issued by an line 9a or 9b, respectively. For example, a handwritten
investment company registered under the Investment GIIN located just outside of line 9a with a corresponding
Company Act of 1940 (mutual fund); arrow pointing to line 9a is a properly provided GIIN for
Dividends, interest, or royalties from units of beneficial this purpose.
interest in a unit investment trust that are (or were upon
issuance) publicly offered and are registered with the SEC Line 10. This line may be used by the filer of Form
under the Securities Act of 1933; and W-8BEN-E or by the withholding agent or FFI to whom it is
Income related to loans of any of the above securities. provided to include any referencing information that is
useful to the withholding agent to document the beneficial
If you need an EIN, you are encouraged to apply owner. For example, withholding agents who are required
TIP for one online instead of submitting a paper Form to associate the Form W-8BEN-E with a particular Form
SS-4 . For more information, visit www.irs.gov/ W-8IMY may want to use line 10 for a referencing number
Businesses/Small-Businesses- &-Self-Employed/ or code that will make the association clear. A beneficial
Employer-ID-Numbers-EINs. owner may also want to use line 10 to include the number
of the account for which he or she is providing the form. A
Line 9a. If you are a participating FFI, registered
foreign single owner of a disregarded entity may use
deemed-compliant FFI, reporting Model 1 FFI, reporting
line 10 to inform the withholding agent that the account to
Model 2 FFI, direct reporting NFFE, trustee of a trustee
which a payment is made or credited is held in the name
documented trust providing this form for the trust, or
of the disregarded entity (unless the name of the
sponsored direct reporting NFFE, you are required to
disregarded entity is required to be provided on line 3).
enter your GIIN (with regard to your country of residence)
on line 9a. However, if your branch is receiving the You may also use line 10 to identify income from a
payment and is required to be identified in Part II, you are notional principal contract that is not effectively connected
not required to provide a GIIN on this line 9a unless such with the conduct of a trade or business in the United
branch is a U.S. branch or a limited branch. Instead, States.
provide the GIIN of your branch (if applicable) on line 13. Part II – Disregarded Entity
See the instructions for Part II.
In addition, if you are a sponsored entity that has a or Branch Receiving Payment
GIIN, you must provide that GIIN on line 9a. Complete Part II for a disregarded entity that has
For payments made prior to January 1, 2017, a its own GIIN and is receiving a withholdable
sponsored direct reporting NFFE or sponsored FFI that
!
CAUTION payment, or for a branch (including a branch that
has not obtained a GIIN must provide the GIIN of its is a disregarded entity that does not have a GIIN) of the
sponsoring entity. FFI identified in line 1 operating in a jurisdiction other than
If you are in the process of registering with the the country of residence identified in line 2. For example,
IRS as a participating FFI, registered assume ABC Co., which is a participating FFI resident in
TIP
deemed-compliant FFI, reporting Model 1 FFI, Country A, operates through a branch in Country B (which
reporting Model 2 FFI, direct reporting NFFE, or is a Model 1 IGA jurisdiction) and the branch is treated as
sponsored direct reporting NFFE but have not received a a reporting Model 1 FFI under the terms of the Country B
GIIN, you may complete this line by writing “applied for.” Model 1 IGA. ABC Co. should not enter its GIIN on line 9,
However, the person requesting this form from you must and the Country B branch should complete this Part II by
receive and verify your GIIN within 90 days. identifying itself as a reporting Model 1 IGA FFI and
providing its GIIN on line 13. Furthermore, if the Country B
If you are a sponsored entity that is a nonreporting IGA branch receiving the payment is a disregarded entity you
FFI, see Part XII. may be required to provide its legal name on line 3. See
the instructions for Part I, line 3.
Line 9b. If your country of residence for tax purposes has
issued you a taxpayer identification number (TIN), enter it If the disregarded entity receiving a withholdable
here. If you are providing this Form W-8BEN-E to payment has its own GIIN, Part II should be
document yourself with respect to a financial account that
TIP
completed regardless of whether it is in the same
you hold at a U.S. office of a financial institution (including country as the single owner identified in Part I.
a U.S. branch of an FFI), you must provide the taxpayer
identification number (TIN) issued to you by the Line 11. Check the one box that applies. If you check
jurisdiction in which you are a tax resident unless: reporting Model 1 FFI, reporting Model 2 FFI, participating
You have not been issued a TIN, or FFI, or U.S. branch claiming a chapter 4 status other than

Instructions for Form W-8BEN-E (Rev. 4-2016) -9-

that of nonparticipating FFI, you must complete line 13 which you are relying to claim treaty benefits. A particular
(see below). If you are a limited branch or branch of a treaty might not include every type of test for which a
reporting IGA FFI that cannot comply with the checkbox is provided. For example, “Company that meets
requirements of an applicable IGA or the regulations the derivative benefits test” is generally not available to a
under chapter 4, you must check “limited branch”. company resident in a treaty country that is not a member
Line 12. Enter the address of the branch or disregarded of the EU, EEA, or NAFTA. In addition, each treaty LOB
entity. article that contains a specific test listed below may have
particular requirements that must be met that differ from
Line 13. If you are a reporting Model 1 FFI, reporting the requirements in another treaty with regard to the same
Model 2 FFI, or participating FFI, you must enter the GIIN test. Accordingly, you must check the relevant treaty LOB
on line 13 of your branch that receives the payment. If you article for the particular requirements associated with
are a disregarded entity that completed Part I, line 3 of this each test. In general, only one LOB checkbox is required
form and are receiving payments associated with this to claim a treaty exemption, even if more than one
form, enter your GIIN. Do not enter your GIIN (if any) on checkbox would suffice to claim the benefits of the treaty
line 9. If you are a U.S. branch, enter a GIIN applicable to for that item of income.
any other branch of the FFI (including in its residence Each of the tests is summarized below for the general
country). convenience of taxpayers but may not be relied upon for
If you are in the process of registering with the making a final determination that you meet an LOB test.
TIP IRS as a participating FFI, reporting Model 1 FFI, Rather you must check the text of the LOB article itself to
or reporting Model 2 FFI but have not received a determine which tests are available under that treaty and
GIIN, you may complete this line by writing “applied for.” the particular requirements of those tests. See Table 4,
However, the person requesting this form from you must Limitation on Benefits, at www.irs.gov/Individuals/
receive and verify your GIIN within 90 days. International-Taxpayers/Tax-Treaty-Tables, for a
summary of the major tests within the Limitation on
Part III – Claim of Tax Treaty Benefits Benefits article that are relevant for documenting any
entity's claim for treaty benefits. See www.irs.gov/
Line 14a. An entity that is claiming a reduced rate of, or Businesses/International-Businesses/United-States-
exemption from, withholding under an income tax treaty Income-Tax-Treaties- - -A-to-Z for a current list of treaties
must enter the country where the entity identified on line 1 in force.
is a resident for income tax treaty purposes and check the Government—this test is met if the entity is the
box to certify that it is a resident of that country. Contracting State, political subdivision, or local authority.
Line 14b. An entity that is claiming a reduced rate of, or Tax-exempt pension trust or pension fund—this test
exemption from, withholding under an income tax treaty generally requires that more than half the beneficiaries or
must check the box to certify that it: participants in the trust or fund be residents of the country
Derives the item of income for which the treaty benefit of residence of the trust or fund itself.
is claimed, and Other tax-exempt organization—this test generally
Meets the limitation on benefits provisions contained in requires that more than half the beneficiaries, members,
the treaty, if any. or participants of religious, charitable, scientific, artistic,
cultural, or educational organizations be residents of the
An item of income may be derived by either the entity country of residence of the organization.
receiving the item of income or by the interest holders in
Publicly-traded corporation—this test generally requires
the entity or, in certain circumstances, both. An item of
the corporation's principal class of shares to be primarily
income paid to an entity is considered to be derived by the
and regularly traded on a recognized stock exchange in
entity only if the entity is not fiscally transparent under the
its country of residence, while other treaties may permit
laws of the entity’s jurisdiction with respect to the item of
trading in either the U.S. or the treaty country, or in certain
income. An item of income paid to an entity shall be
third countries if the primary place of management is the
considered to be derived by the interest holder in the
country of residence.
entity only if:
Subsidiary of publicly-traded corporation—this test
The interest holder is not fiscally transparent in its
generally requires that more than 50% of the vote and
jurisdiction with respect to the item of income, and
value of the company's shares be owned, directly or
The entity is considered to be fiscally transparent under indirectly, by five or fewer companies that are
the laws of the interest holder’s jurisdiction with respect to publicly-traded corporations and that themselves meet the
the item of income. An item of income paid directly to a publicly-traded corporation test, as long as all companies
type of entity specifically identified in a treaty as a resident in the chain of ownership are resident in either the U.S. or
of a treaty jurisdiction is treated as derived by a resident of the same country of residence as the subsidiary.
that treaty jurisdiction.
Company that meets the ownership and base erosion
Limitation on benefits treaty provisions. If you are a test—this test generally requires that more than 50% of
resident of a foreign country that has entered into an the vote and value of the company's shares be owned,
income tax treaty with the United States that contains a directly or indirectly, by individuals, governments,
limitation on benefits (LOB) article, you must complete tax-exempt entities, and publicly-traded corporations
one of the checkboxes in line 14b. You may only check a resident in the same country as the company, as long as
box if the limitation on benefits article in that treaty all companies in the chain of ownership are resident in the
includes a provision that corresponds to the checkbox on same country of residence, and less than 50% of the

-10- Instructions for Form W-8BEN-E (Rev. 4-2016)

company's gross income is accrued or paid, directly or If you are an entity that derives the income as a
indirectly, to persons who would not be good TIP resident of a treaty country, you may check this
shareholders for purposes of the ownership test. box if the applicable income tax treaty does not
Company that meets the derivative benefits test—this contain a “limitation on benefits” provision.
test is generally limited to NAFTA, EU, and EEA country
treaties, and may apply to all benefits or only to certain Line 14c. If you are a foreign corporation claiming treaty
items of income (interest, dividends, and royalties). It benefits under an income tax treaty that entered into force
generally requires that more than 95% of the aggregate before January 1, 1987 (and has not been renegotiated)
vote and value of the company's shares be owned, on (a) U.S. source dividends paid to you by another
directly or indirectly, by seven or fewer equivalent foreign corporation or (b) U.S. source interest paid to you
beneficiaries (ultimate owners who are resident in an EU, by a U.S. trade or business of another foreign corporation,
EEA, or NAFTA country and are entitled to identical you must generally be a “qualified resident” of a treaty
benefits under their own treaty with the U.S. under one of country. See section 884 for the definition of interest paid
the ownership tests included within the LOB article (other by a U.S. trade or business of a foreign corporation
than the stock ownership and base erosion test)). In (“branch interest”) and other applicable rules.
addition, this test requires that less than 50% of the In general, a foreign corporation is a qualified resident
company's gross income be paid or accrued, directly or of a country if any of the following apply.
indirectly, to persons who would not be equivalent It meets a 50% ownership and base erosion test.
beneficiaries. It is primarily and regularly traded on an established
Company with an item of income that meets the active securities market in its country of residence or the United
trade or business test—this test generally requires that the States.
company be engaged in an active trade or business in its It carries on an active trade or business in its country of
country of residence, that its activities in that country be residence.
substantial in relation to its U.S. activities, if the payer is a It gets a ruling from the IRS that it is a qualified resident.
related party, and the income be derived in connection to See Regulations section 1.884-5 for the requirements that
or incidental to that trade or business. must be met to satisfy each of these tests.
Favorable discretionary determination received—this
test requires that the company obtain a favorable If you are claiming treaty benefits under an
determination granting benefits from the U.S. competent ! income tax treaty entered into force after
authority that, despite the company's failure to meet a CAUTION December 31, 1986, do not check box 14c.
specific objective LOB test in the applicable treaty, it may Instead, check box 14b.
nonetheless claim the requested benefits. Note: Unless a
Line 15. Line 15 must be used only if you are claiming
treaty or technical explanation specifically provides
treaty benefits that require that you meet conditions not
otherwise, you may not claim discretionary benefits while
covered by the representations you make in line 14 (or
your claim for discretionary benefits is pending.
other certifications on the form). This line is generally not
Other—for other LOB tests that are not listed above applicable to claiming treaty benefits under an interest or
(e.g., a headquarters test). Identify the other test relied dividends (other than dividends subject to a preferential
upon, or enter N/A if the treaty has no LOB article. For rate based on ownership) article of a treaty or other
example, if you meet the headquarters test under the income article, unless such article requires additional
U.S.-Netherlands income tax treaty, you should write representations. For example, certain treaties allow for a
“Headquarters test, Article 26(5)” in the space provided. zero rate on dividends for certain qualified residents
If an entity is claiming treaty benefits on its own behalf, provided that additional requirements are met, such as
it should complete Form W-8BEN-E. If an interest holder ownership percentage, ownership period, and that the
in an entity that is considered fiscally transparent in the resident meet a combination of tests under an applicable
interest holder’s jurisdiction is claiming a treaty benefit, LOB article. You should indicate the specific treaty article
the interest holder should complete Form W-8BEN (if an and paragraph or subparagraph, as applicable. You
individual) or Form W-8BEN-E (if an entity) on its own should also use this space to set out the requirements you
behalf as the appropriate treaty resident, and the fiscally meet under the identified treaty article.
transparent entity should associate the interest holder’s The following are examples of persons who should
Form W-8BEN or Form W-8BEN-E with a Form W-8IMY complete this line.
completed by the fiscally transparent entity (see Hybrid
Exempt organizations claiming treaty benefits under the
entities under Special Instructions, later).
exempt organization articles of the treaties with Canada,
An income tax treaty may not apply to reduce the Mexico, Germany, and the Netherlands.
! amount of any tax on an item of income received Foreign corporations that are claiming a preferential
CAUTION by an entity that is treated as a domestic rate applicable to dividends based on ownership of a
corporation for U.S. tax purposes. Therefore, neither the specific percentage of stock in the entity paying the
domestic corporation nor its shareholders are entitled to dividend and owning the stock for a specified period of
the benefits of a reduction of U.S. income tax on an item time. Such persons should provide the percentage of
of income received from U.S. sources by the corporation. ownership and the period of time they owned the stock.
For example, under the U.S.-Italy treaty, to claim the 5%
dividend rate, the Italian corporation must own 25% of the
voting stock for a 12-month period.

Instructions for Form W-8BEN-E (Rev. 4-2016) -11-

 In addition, for example, if you qualify for and are Enter the GIIN of the sponsoring entity identified in
claiming a zero rate on dividend payments under Article line 16.
10(3) of the U.S.-Germany income tax treaty, you should
fill out line 15 with “Article 10(3)”,“0”, and “dividends” in the Note. A sponsored FFI is not required to have obtained
spaces provided. In the space provided for an its own GIIN before the date specified in published
explanation, you may write that you are the beneficial guidance (i.e. January 1, 2017). However, a sponsored
owner of the dividends, you are a resident of Germany, entity that has obtained a GIIN must provide it on line 9a.
you have directly owned shares representing 80% or Line 17. You must check the applicable box to certify that
more of the voting power of the company paying the you are either a sponsored investment entity or sponsored
dividends for the 12-month period ending on the date the controlled foreign corporation (within the meaning of
entitlement to the dividend is determined, and that you section 957(a)) and that you satisfy the other relevant
satisfy the conditions of Article 28(2)(f)(aa) and (bb) and requirements for this status.
Article 28(4) of the treaty with respect to the dividends.
Persons claiming treaty benefits on royalties if the Part V – Certified Deemed-Compliant
treaty contains different withholding rates for different Nonregistering Local Bank
types of royalties.
Persons claiming treaty benefits on interest other than Line 18. A certified deemed-compliant nonregistering
the generally applicable rate. For example, under the local bank must check the box to certify that it meets all of
U.S.-Australia treaty, the generally applicable interest rate the requirements for this certified deemed-compliant
is 10% under Article 11(2). However, interest may be status.
exempt from withholding if the specific conditions under
Article 11(3) are met. Part VI – Certified Deemed-Compliant
Parts IV Through XXVIII – FFI with Only Low-Value Accounts
Certification of Chapter 4 Status Line 19. A certified deemed-compliant FFI with only low
value accounts must check the box to certify that it
You should complete only one part of Parts IV through
satisfies all of the requirements for this certified
XXVIII certifying to your chapter 4 status (if required, see
deemed-compliant classification.
the specific instructions for line 5). Identify which part (if
any) you should complete by reference to the box you Part VII – Certified Deemed-Compliant
checked on line 5. An entity that selects nonparticipating
FFI, participating FFI, registered deemed-compliant FFI Sponsored, Closely
(other than a sponsored FFI), reporting Model 1 FFI, Held Investment Vehicle
reporting Model 2 FFI, or direct reporting NFFE (other
than a sponsored direct reporting NFFE) on line 5 is not Line 20. Enter the name of your sponsoring entity that
required to complete any of the certifications in Parts IV has agreed to fulfill the due diligence, reporting, and
through XXVIII. If you check “Account that is not a withholding obligations of the entity identified in line 1 as if
financial account” on line 5, the requester of the form will the entity in line 1 were a participating FFI. You must also
evaluate whether you must certify to another chapter 4 enter the GIIN of your sponsoring entity on line 9a.
status. Line 21. A sponsored, closely held investment vehicle
IGA. In lieu of the certifications contained in Parts IV must check the box to certify that it meets all of the
through XXVIII of Form W-8BEN-E, a reporting Model 1 requirements for this certified deemed-compliant status.
FFI or reporting Model 2 FFI in certain cases may request
alternate certifications to document its account holders Part VIII – Certified
pursuant to an applicable IGA or you may otherwise Deemed-Compliant
provide an alternate certification to a withholding agent.
See Entities Providing Certifications Under an Applicable Limited Life Debt
IGA under Special Instructions, later. Investment Company
You are not required to complete a chapter 4 Line 22. A limited life debt investment entity must check
TIP status certification if you are not the payee of a the box to certify that it meets all of the requirements for
withholdable payment or an account holder this certified deemed-compliant status.
holding an account with an FFI requesting this form.
However, you are not required to provide a chapter 4 Part IX – Certified Deemed-Compliant
status if you are providing this form with respect to a
preexisting entity account (as described in Regulations Investment Advisors
section 1.1471-1(b)(102)) prior to July 1, 2016. and Investment Managers
Part IV – Sponsored FFI Line 23. An investment advisor or investment manager
must check the box to certify that it meets all of the
Line 16. Enter the name of the sponsoring entity that has requirements for this certified deemed-compliant status.
agreed to fulfill the due diligence, reporting, and
withholding obligations (as applicable) on behalf of the
sponsored FFI identified in line 1.

-12- Instructions for Form W-8BEN-E (Rev. 4-2016)

Part X – Owner-Documented FFI Line 26. Check the box to indicate that you are treated as
a nonreporting IGA FFI under an applicable IGA, including
Line 24a. An owner-documented FFI must check the box an entity treated as a registered deemed-compliant FFI
to certify that it meets all of the requirements for this status under an applicable IGA. You must identify the applicable
and is providing this form to a U.S. financial institution, IGA by entering the name of the jurisdiction that has the
participating FFI, reporting Model 1 FFI, or reporting applicable IGA treated as in effect with the United States,
Model 2 FFI that agrees to act as a designated and indicate whether it is a Model 1 or Model 2 IGA. You
withholding agent with respect to the FFI identified on must also provide the withholding agent with the specific
line 1. See Regulations section 1.1471-5(f)(3) for more category of FFI described in Annex II of the IGA applicable
information about an owner-documented FFI, including to your status. In providing the specific category of FFI
with respect to a designated withholding agent. described in Annex II, you should use the language from
Check either line 24b or line 24c. Do not check Annex II that best and most specifically describes your
TIP both boxes. status in the IGA. For example, indicate “investment entity
wholly owned by exempt beneficial owners” rather than
“exempt beneficial owner”. If you are a nonreporting IGA
Line 24b. Check the box to certify that you have provided FFI claiming a deemed-compliant status under the
or will provide the documentation set forth in the regulations, you must instead indicate on this line which
certifications, including the FFI owner reporting statement section of the regulations you qualify under.
and the valid documentation for each person identified on
If you are a nonreporting FFI under an applicable IGA
the FFI owner reporting statement described on line 24b.
because you qualify as an owner-documented FFI under
If you check the box on line 24b, you should not check the
the regulations, do not check “Nonreporting IGA FFI”.
box on line 24c.
Instead, you must check “Owner-documented FFI” and
Line 24c. Check the box to certify that you have provided complete Part X rather than this Part XII.
or will provide the auditor’s letter (in lieu of the information If you are an FFI treated as a registered
required by line 24b) that satisfies the requirements deemed-compliant FFI under an applicable Model 2 IGA
reflected on this line. (other than a sponsored FFI) you must also provide your
Line 24d. Check the box if you do not have any GIIN on line 9a. See www.treasury.gov/resource-center/
contingent beneficiaries or designated classes with tax-policy/treaties/Pages/FATCA-Archive.aspx for a list of
unidentified beneficiaries. While this certification is not jurisdictions treated as having an IGA in effect for
required, a Form W-8BEN-E provided by an purposes of making this certification. If you are a
owner-documented FFI will remain valid indefinitely for sponsored FFI not claiming your chapter 4 status under
chapter 4 purposes absent a change in circumstances the regulations, see the requirements of your applicable
with respect to offshore obligations (as defined in IGA to determine when you are required to obtain a GIIN.
Regulations section 1.6049-5(c)(1)) only if this
certification is provided and the account balance of all Note. If you are a nonreporting IGA FFI and you have
accounts held by the owner-documented FFI with the registered and received a GIIN and have not provided it in
withholding agent does not exceed $1,000,000 on the line 9a because your trustee's or sponsor's GIIN is in
later of June 30, 2014, or the last day of the calendar year line 9, you should provide it here.
in which the account was opened, and the last day of
each subsequent calendar year preceding the payment,
Part XIII – Foreign Government,
applying the account aggregation rules of Regulations Government of a U.S. Possession, or
section 1.1471-5(b)(4)(iii). Foreign Central Bank of Issue
Part XI – Restricted Distributor Line 27. A foreign government or political subdivision of
Line 25a. A restricted distributor must check the box to a foreign government (including wholly owned agencies
certify that it meets all of the requirements for this status. and instrumentalities thereof), government of a U.S.
possession, or foreign central bank of issue (each as
Lines 25b and 25c. Check the appropriate box to certify defined in Regulations section 1.1471-6) must check the
as to your status. Do not check both boxes. box and certify that it satisfies all of the requirements for
A restricted distributor may certify only with this status (including that it does not engage in the type of
respect to an account it maintains in connection commercial financial activities described on this line
!
CAUTION with a distribution agreement with a restricted except to the extent permitted under Regulations section
fund described in this Part XI. A restricted distributor that, 1.1471-6(h)(2)).
in connection with such a distribution agreement, receives If you are a foreign government or political
a payment subject to chapter 3 withholding or a TIP subdivision of a foreign government (including
withholdable payment should complete Form W-8IMY and wholly owned agencies and instrumentalities
not this form except to the extent it holds interests in thereof), government of a U.S. possession, or foreign
connection with such an agreement as a beneficial owner. central bank of issue, you should only complete this Form
W-8BEN-E for payments for which you are not claiming
Part XII – Nonreporting IGA FFI the applicability of section(s) 115(2), 892, or 895;
otherwise you should use Form W-8EXP.

Instructions for Form W-8BEN-E (Rev. 4-2016) -13-

Part XIV – International Organization it meets all of the requirements for this status. You must
also provide the date that you filed a plan of liquidation,
Line 28a. Check this box to certify that you are an plan of reorganization, or bankruptcy petition.
international organization described in section 7701(a)
(18). Part XXI – 501(c) Organization
If you are an entity that has been designated as Line 35. An entity claiming chapter 4 status as a section
TIP an international organization by executive order 501(c) organization pursuant to Regulations section
(pursuant to 22 U.S.C. 288 through 288f), check 1.1471-5(e)(5)(v) must check the box and provide the
box 28a. If you are claiming an exemption from date that the IRS issued the organization a determination
withholding for purposes of chapter 3, however, use Form letter or provide a copy of an opinion from U.S. counsel
W-8EXP. certifying that the organization qualifies as a section
501(c) organization (without regard to whether the
Line 28b. If you are an international organization other organization is a foreign private foundation).
than an international organization described in line 28a,
If you are a section 501(c) organization claiming
check the box to certify that you satisfy all of the
TIP an exemption from withholding for purposes of
requirements for this status.
chapter 3, however, use Form W-8EXP.
Part XV – Exempt Retirement Plans
Part XXII – Nonprofit Organization
Lines 29a, b, c, d, e, and f. An exempt retirement plan
must check the appropriate box to certify that it meets all Line 36. A nonprofit organization (other than an entity
of the requirements for this status. claiming chapter 4 status as a section 501(c) organization
pursuant to Regulations section 1.1471-5(e)(5)(v)) must
Part XVI – Entity Wholly Owned check the box to certify that it meets all of the
by Exempt Beneficial Owners requirements for this status.
Nonprofit organization under an IGA. For an entity
Line 30. An entity wholly owned by exempt beneficial that is established and maintained in a jurisdiction that is
owners must check the box to certify that it meets all of treated as having in effect an IGA and that is described in
the requirements for this status. You must also provide the Annex I as a nonprofit organization that is an Active NFFE,
owner documentation described in this line establishing see Entities Providing Certifications Under an Applicable
that each direct owner or debt holder of the entity is an IGA under Special Instructions, later.
exempt beneficial owner described in Regulations section
1.1471-6(b). Part XXIII – Publicly Traded
Part XVII – Territory NFFE or NFFE Affiliate of
Financial Institution a Publicly Traded Corporation
Line 31. A territory financial institution must check the Line 37a. A publicly-traded NFFE must check the box to
box to certify that it meets all of the requirements for this certify that you are not a financial institution and provide
status. the name of a securities exchange on which the stock of
the NFFE is publicly traded.
Part XVIII – Excepted Line 37b. An NFFE that is a member of the same
Nonfinancial Group Entity expanded affiliated group as a publicly-traded U.S. or
foreign entity must check this box, provide the name of the
Line 32. An excepted nonfinancial group entity must publicly-traded entity, and identify the securities market on
check the box to certify that it meets all of the which the stock of the publicly- traded entity is traded. See
requirements for this status. Regulations section 1.1472-1(c)(1)(i) to determine if the
Part XIX – Excepted Nonfinancial stock of an entity is regularly traded on an established
securities market (substituting the term “U.S. entity” for
Start-Up Company NFFE, as appropriate for purposes of testing whether an
entity is publicly traded).
Line 33. An excepted nonfinancial start-up company
must check the box to certify that it meets all of the Part XXIV – Excepted Territory NFFE
requirements for this status. You must also provide the
date you were formed or your board passed a resolution Line 38. An excepted territory NFFE must check the box
(or equivalent measure) approving a new line of business to certify that it meets all of the requirements for this
(which cannot be that of a financial institution or passive classification. See Regulations section 1.1472-1(c)(1)(iii)
NFFE). for the definition of an excepted territory NFFE.

Part XX – Excepted Nonfinancial Part XXV – Active NFFE

Entity in Liquidation or Bankruptcy Line 39. An active NFFE must check the box to certify
that it meets all of the requirements for this status,
Line 34. An excepted nonfinancial group entity in including the assets and passive income test described in
liquidation or bankruptcy must check the box to certify that the certification for this part. For purposes of applying this

-14- Instructions for Form W-8BEN-E (Rev. 4-2016)

test, passive income includes dividends, interest, rents, Part XXVIII – Sponsored
royalties, annuities, and certain other forms of passive
income. See Regulations section 1.1472-1(c)(1)(iv)(A) for Direct Reporting NFFEs
additional detail for the definition of passive income. Also
Line 42. A sponsored direct-reporting NFFE must check
see Regulations section 1.1472-1(c)(1)(iv)(B) for
the box to certify that it meets all of the requirements for
exceptions from the definition of passive income for
this classification. You must also provide the name of your
certain types of income.
sponsoring entity in the space provided and provide your
Part XXVI – Passive NFFE GIIN in line 9a (or, for payments prior to the date specified
in published guidance (i.e. January 1, 2017), you may
Line 40a. A passive NFFE must check the box to certify provide only the GIIN of your sponsoring entity).
that you are not a financial institution and are not certifying Enter the GIIN of the sponsoring entity identified in
your status as a publicly-traded NFFE, NFFE affiliate of a line 42.
publicly-traded company, excepted territory NFFE, active
NFFE, direct-reporting NFFE, or sponsored Part XXIX – Substantial U.S.
direct-reporting NFFE.
Owners of Passive NFFE
Note. If you would be a passive NFFE but for the fact that If you identified yourself as a passive NFFE (including an
you are professionally managed, you should not complete investment entity that is a territory NFFE but is not an
line 40a as you should be considered a financial institution excepted territory NFFE under Regulations section
and not a passive NFFE. 1.1472-1(c)) with one or more substantial U.S. owners in
Part XXVI, you must identify each substantial U.S. owner.
If you are an NFFE that may qualify as an active
Provide the name, address, and TIN of each substantial
TIP NFFE (or other NFFE described in another part of
U.S. owner in the relevant column. You may attach this
this form), you may still check line 40a and
information on a separate statement, which remains
disclose your substantial U.S. owners or certify that you
subject to the same perjury statement and other
have no substantial U.S. owners (see instructions to lines
certifications made in Part XXX. If you are reporting
40b and 40c below).
controlling U.S. persons (as defined in an applicable IGA)
Line 40b. Check this box to certify that you have no to a Model 1 FFI or reporting Model 2 FFI with which you
substantial U.S. owners. maintain an account that requests such ownership
information with this form, you may use this space or
Line 40c. If you do not check the box and make the attach a separate statement to report such persons.
certification on line 40b, you must check this box 40c and
complete Part XXIX to identify each of your substantial Part XXX – Certification
U.S. owners and provide their name, address, and TIN. Form W-8BEN-E must be signed and dated by an
authorized representative or officer of the beneficial
Note. If you are an NFFE that is providing Form owner, participating payee (for purposes of section
W-8BEN-E to an FFI treated as a reporting Model 1 FFI or 6050W), or account holder of an FFI requesting this form.
reporting Model 2 FFI, you may also use Part XXIX to An authorized representative or officer must check the
report controlling U.S. persons (as defined in an box to certify that you have the legal capacity to sign for
applicable IGA). The references to “controlling U.S. the entity identified on line 1 that is the beneficial owner of
persons” in Part XXVI and Part XXIX apply only if the form the income. If Form W-8BEN-E is completed by an agent
is being provided to an FFI treated as a reporting Model 1 acting under a duly authorized power of attorney, the form
FFI or reporting Model 2 FFI. must be accompanied by the power of attorney in proper
Part XXVII – Excepted form or a copy thereof specifically authorizing the agent to
represent the principal in making, executing, and
Inter-Affiliate FFI presenting the form. Form 2848, Power of Attorney and
Declaration of Representative, may be used for this
Line 41. An excepted inter-affiliate FFI must check the
purpose. The agent, as well as the beneficial owner,
box to certify that it meets all of the requirements of this
payee, or account holder (as applicable), may incur
classification. This classification will only apply for an
liability for the penalties provided for an erroneous, false,
excepted inter-affiliate FFI that holds a deposit account
or fraudulent form. By signing Form W-8BEN-E, the
described in the certification for this part and that is
authorized representative, officer, or agent of the entity
documenting itself to the financial institution that maintains
also agrees to provide a new form within 30 days following
the deposit account. You are not eligible for this
a change in circumstances affecting the correctness of the
classification if you receive or make withholdable
form.
payments to or from any person other than a member of
your expanded affiliated group, other than the depository Broker transactions or barter exchanges. Income
institution described in the previous sentence. See from transactions with a broker or a barter exchange is
Regulations section 1.1471-5(e)(5)(iv) for all the subject to reporting rules and backup withholding unless
requirements of this status. Form W-8BEN-E or a substitute form is filed to notify the
broker or barter exchange that you are an exempt foreign
person. See certification described in the 4th bullet point
on the form.

Instructions for Form W-8BEN-E (Rev. 4-2016) -15-

 You are an exempt foreign person for a calendar year for purposes of establishing the chapter 4 status of your
in which: owner(s).
You are a foreign corporation, partnership, estate, or
trust; and Parts III & XXX
You are neither engaged, nor plan to be engaged You must complete Parts III and XXX in accordance with
during the year, in a U.S. trade or business that has the specific instructions above. Complete Part II if
effectively connected gains from transactions with a applicable.
broker or barter exchange.
Foreign Reverse Hybrid Entities
Special Instructions A foreign reverse hybrid entity should only file a Form
W-8BEN-E for payments for which it is not claiming treaty
Hybrid Entities benefits on behalf of its owners and must provide a
chapter 4 status when it is receiving a withholdable
Hybrid entity making a claim of treaty benefits. If you payment. A foreign reverse hybrid entity claiming treaty
are a hybrid entity making a claim for treaty benefits as a benefits on behalf of its owners should provide the
resident on your own behalf, you may do so as permitted withholding agent with Form W-8IMY (including its
under an applicable tax treaty. You should complete this chapter 4 status when receiving a withholdable payment)
Form W-8BEN-E to claim treaty benefits in the manner along with a withholding statement and Forms W-8BEN or
described earlier (see instructions for completing Part III). W-8BEN-E (or documentary evidence to the extent
If you are a flow-through entity receiving a withholdable permitted) on behalf of each of its owners claiming treaty
payment, you should also provide Form W-8IMY for the benefits. See Form W-8IMY and accompanying
entity along with a withholding statement (if required) instructions for more information.
establishing the chapter 4 status of each of your partners
or owners. If you are a disregarded entity claiming treaty Entities Providing Certifications
benefits, unless you are treated as the payee for chapter 4 Under an Applicable IGA
purposes and have your own GIIN, your single owner
should provide Form W-8BEN-E or Form W-8BEN (as An FFI in an IGA jurisdiction with which you have an
applicable) to the withholding agent along with this form. account may provide you with a chapter 4 status
You may use line 10 to inform the withholding agent to certification other than as shown in Parts IV through XXVIII
associate the two forms. in order to satisfy its due diligence requirements under the
applicable IGA. In such a case, you may attach the
Line 1. Enter your legal name (determined by reference alternative certification to this Form W-8BEN-E in lieu of
to your legal identity in your country of incorporation or completing a certification otherwise required in Parts IV
organization). through XXVIII provided that you: 1) determine that the
Line 2. Enter the country under whose laws you are certification accurately reflects your status for chapter 4
created, organized, or governed. purposes or under an applicable IGA; and 2) the
withholding agent provides a written statement to you that
Line 3. Leave this line blank. For purposes of completing it has provided the certification to meet its due diligence
this form as a hybrid entity making a treaty claim requirements as a participating FFI or registered
(including a disregarded entity), you are treated as the deemed-compliant FFI under an applicable IGA. For
beneficial owner and should be identified in line 1. example, Entity A organized in Country A holds an
Line 4. Check the box that applies among disregarded account with an FFI in Country B. Country B has a Model
entity, partnership, grantor trust, or simple trust. You must 1 IGA in effect. The FFI in Country B may ask Entity A to
also check the box indicating that you are a hybrid making provide a chapter 4 status certification based on the terms
a treaty claim and complete Part III. of the Country B IGA in order to fulfil its due diligence and
documentation requirements under the Country B IGA.
Line 5. Do not complete line 5.
Lines 6 and 7. Complete lines 6 and 7 as provided in the You may also provide with this form an applicable IGA
specific instructions, earlier. certification if you are determining your chapter 4 status
under the definitions provided in an applicable IGA and
Line 8. Complete line 8 in accordance with the specific your certification identifies the jurisdiction that is treated
instructions for line 8, earlier. as having an IGA in effect and describes your status as an
Line 9b. If your country of residence for tax purposes has NFFE or FFI in accordance with the applicable IGA.
issued you a tax identifying number, enter it here. Do not However, if you determine your status under an applicable
enter the tax identifying number of your owner(s). IGA as an NFFE, you must still determine if you are an
excepted NFFE under the Regulations in order to
Line 10. This reference line is used to associate this complete this form unless you are provided an alternative
Form W-8BEN-E with another applicable withholding certification by an FFI described in the preceding
certificate or other documentation provided for purposes paragraph that covers your certification as an NFFE (such
of chapter 4. For example, if you are a partnership making as “active NFFE”) as defined in an applicable IGA.
a treaty claim, you may want to provide information for the Additionally, you are required to comply with the
withholding agent to associate this Form W-8BEN-E with conditions of your status under the law of the IGA
the Form W-8IMY and owner documentation you provide jurisdiction to which you are subject if you are determining
your status under that IGA. If you cannot provide the

-16- Instructions for Form W-8BEN-E (Rev. 4-2016)

certifications in Parts IV through XXVIII, or if you are a laws of the United States. You are required to provide the
nonprofit entity that meets the definition of “active NFFE” information. We need it to ensure that you are complying
under the applicable IGA, do not check a box in line 5. with these laws and to allow us to figure and collect the
However, if you determine your status under the right amount of tax.
definitions of the IGA and can certify to a chapter 4 status
You are not required to provide the information
included on this form, you do not need to provide the
requested on a form that is subject to the Paperwork
certifications described in this paragraph unless required
Reduction Act unless the form displays a valid OMB
by the FFI to whom you are providing this form.
control number. Books or records relating to a form or its
Any certifications provided under an applicable IGA instructions must be retained as long as their contents
remain subject to the penalty of perjury statement and may become material in the administration of any Internal
other certifications made in Part XXX. Revenue law. Generally, tax returns and return
information are confidential, as required by section 6103.
Entities Providing Alternate
Certifications Under Regulations The time needed to complete and file this form will vary
If you qualify for a chapter 4 status that is not shown in depending on individual circumstances. The estimated
Part I, line 5, of this form, you may attach applicable average time is:
certifications for such status from any other Form W-8 on
which the relevant certifications appear. If the applicable Recordkeeping . . . . . . . . . . . . . . . . . 12 hr., 40 min.
certifications do not appear on any Form W-8 (if, for Learning about the law or the form . . . 4 hr., 17 min.
example, new regulations provide for an additional Preparing and sending the form . . . . . 8 hr., 16 min.
chapter 4 status and this form has not been updated to
incorporate the status) then you may provide an
attachment certifying that you qualify for the applicable If you have comments concerning the accuracy of
status described in a particular Regulations section in lieu these time estimates or suggestions for making this form
of checking a box in Part I, line 5, and providing any simpler, we would be happy to hear from you. You can
chapter 4 status certifications included on this form. send us comments from www.irs.gov/formspubs. Click on
Include a citation to the applicable provision in the “More Information” and then on “Give us feedback”. You
Regulations. Any such attached certification becomes an can write to the Internal Revenue Service, Tax Forms and
integral part of this Form W-8BEN-E and is subject to the Publications, SE:W:CAR:MP:TFP, 1111 Constitution Ave.
penalty of perjury statement and other certifications made NW, IR-6526, Washington, DC 20224. Do not send Form
in Part XXX. W-8BEN-E to this office. Instead, give it to your
withholding agent.
Paperwork Reduction Act Notice. We ask for the
information on this form to carry out the Internal Revenue

Instructions for Form W-8BEN-E (Rev. 4-2016) -17-