Chapter 4 Exemption Code, Box 4a

Exemption Code - If applicable, identifies when the agent is applying an exemption from withholding under Chapter 4.

This is a two-position field that may or may not be present.

Only numeric characters (0-9) or blanks are valid.

May be filled in if a three is present in Box 3.

The valid Exemption Codes and definitions are as follows:

Code

Chapter 4 Exemption Codes

13

Grandfathered payment

14

Effectively connected income

15

Payee not subject to Chapter 4 withholding

16

Excluded nonfinancial payment

17

Foreign Entity that assumes primary withholding responsibility

18

U.S. Payees—of participating FFI or registered deemed-compliant FFI

19

Exempt from withholding under IGA

20

Dormant account

21

Other-payment not subject to Chapter 4 withholding