Note:

A photocopy of the completed form is retained for six months.

The French Form 5000–EN is used with the Form 6166 to certify U.S. residency for tax purposes. The Form 5000–EN will generally be accompanied by either a Form 5001–EN, 5002–EN, or 5003–EN depending on the type of income.

Verify the applicant's residency (the applicant has filed the required U.S. tax return):

Stamp the Field Director's signature and seal the French Form 5000–EN in part IV, and

Generate and attach the Form 6166 to the French form.

If a current year application, and the applicant meets all current year requirements, you can issue certification:

Stamp the Field Director's signature and seal the French Form 5000–EN in part IV, and

Generate and attach the Form 6166 to the French form.

A separate Form 5000–EN is required for each category of income:

Form 5001 — dividend income

Form 5002 — interest income

Form 5003 — royalty income