! 501(c) should check — 1021 Inst W-8BEN-E (PDF)

CAUTION organization” box for purposes of line 4. Such

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

Line 5. Check the one box that applies to your chapter 4 status. You are only required to provide a chapter 4 status on this form if you are the payee of a withholdable payment or are documenting the status of a financial account you hold with an FFI requesting this form. By checking a box on this line, you are representing that you qualify for this classification in your country of residence.

For most of the chapter 4 statuses, you are

TIP required to complete an additional part of this form

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

FFIs Covered by an IGA and Related Entities A reporting IGA FFI resident in, or established under the laws of, a jurisdiction covered by a Model 1 IGA should check “Reporting Model 1 FFI.” A reporting FFI resident in, or established under the laws of, a jurisdiction covered by a Model 2 IGA should check “Reporting Model 2 FFI.” If you are treated as a registered deemed-compliant FFI under an applicable IGA, you should check “Nonreporting IGA FFI” rather than “registered deemed-compliant FFI” and provide your GIIN.

In general, if you are treated as a nonreporting IGA FFI under an applicable IGA, you should check “Nonreporting IGA FFI” even if you meet the qualifications for deemed-compliant status or are an exempt beneficial owner under the chapter 4 regulations. In such a case, you should not also check your applicable status under the regulations but should provide your GIIN on line 9, if applicable. If you are an owner-documented FFI that is treated as a nonreporting IGA FFI under an applicable IGA you must check “Owner-documented FFI” and complete Part X.

An FFI that is related to a reporting IGA FFI and that is treated as a nonparticipating FFI in its country of residence should check “Nonparticipating FFI” on line 5.

If you are an FFI in a jurisdiction treated as having an IGA in effect, you should not check “Participating FFI” but rather should check “Reporting Model 1 FFI” or “Reporting Model 2 FFI” as applicable. See www.treasury.gov/ resource-center/tax-policy/treaties/Pages/FATCA- Archive.aspx for a list of jurisdictions treated as having an IGA in effect.

Non-Profit Organizations Covered by an IGA If you are a non-profit entity that is established and maintained in a jurisdiction treated as having an IGA in effect and you meet the definition of “active NFFE”under Annex I of the applicable IGA, you should not check a box on line 5 if you are providing this form to an FFI for purposes of documenting yourself as an account holder. Instead, you should provide a certification of your status under the IGA. See Entities Providing Certifications Under an Applicable IGA under Special Instructions , later.

Account That Is Not a Financial Account If you are providing this form to document an account you hold with a foreign financial institution that is not a

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financial account under Regulations section 1.1471-5(b) (2), check the “Account that is not a financial account” box on line 5.

Line 6. Enter the permanent residence address of the entity identified on line 1. Your permanent residence address is the address in the country where you claim to be a resident for purposes of that country’s income tax. If you are giving Form W-8BEN-E to claim a reduced rate of, or exemption from, withholding under an income tax treaty, you must determine residency in the manner required by the treaty. Do not show the address of a financial institution (unless you are a financial institution providing your own address), a post office box, or an address used solely for mailing purposes unless it is the only address you use and it appears in your organizational documents (that is, your registered address). If you do not have a tax residence in any country, the permanent residence address is where you maintain your principal office.

Line 7. Enter your mailing address only if it is different from the address on line 6.

Line 8. Enter your U.S. employer identification number (EIN). An EIN is a U.S. taxpayer identification number (TIN) for entities. If you do not have a U.S. EIN, apply for one on Form SS-4, Application for Employer Identification Number, if you are required to obtain a U.S. TIN.

A partner in a partnership conducting a trade or business in the United States will likely be allocated effectively connected taxable income. In addition, if the partner transfers an interest in such a partnership, the partner may be subject to tax under section 864(c)(8) on the transfer. As in either case the partner is considered engaged in a U.S. trade or business because it is a partner in a partnership engaged in a U.S. trade or business, the partner is required to file a U.S. federal income tax return and must have a TIN, which the partner is required to provide on this form.

You must also provide a U.S. TIN if you are:

Claiming an exemption from withholding under section 871(f) for certain annuities received under qualified plans, or

If you are in the process of registering with the IRS

TIP as a participating FFI, registered

deemed-compliant FFI (including a sponsored FFI), reporting Model 1 FFI, reporting Model 2 FFI, direct reporting NFFE, sponsored direct reporting NFFE, or nonreporting IGA FFI but have not received a GIIN, you may complete this line by writing “applied for.” However, the person requesting this form from you must receive and verify your GIIN within 90 days.

Line 9b. If you are providing this Form W-8BEN-E to document yourself as an account holder with respect to a financial account (as defined in Regulations section 1.1471-5(b)) that you hold at a U.S. office of a financial institution (including a U.S. branch of an FFI) and you receive U.S. source income reportable on Form 1042-S associated with this form, you must provide on line 9b the FTIN issued to you by the jurisdiction in which you are a tax resident identified on line 6 unless:

TIP

If you need an EIN, you are encouraged to apply for one online instead of submitting a paper Form SS-4. For more information, visit IRS.gov/EIN.

Line 9a. If you are a participating FFI, registered deemed-compliant FFI (including a sponsored FFI described in the Treasury regulations), reporting Model 1 FFI, reporting Model 2 FFI, direct reporting NFFE, trustee of a trustee-documented trust that is a foreign person providing this form for the trust, or sponsored direct reporting NFFE, you are required to enter your GIIN (with regard to your country of residence) on line 9a. If you are a trustee of a trustee-documented trust and you are a foreign person, you should provide the GIIN that you received when you registered as a participating FFI or reporting Model 1 FFI. If your branch is receiving the payment and is required to be identified in Part II, you are not required to provide a GIIN on line 9a. Instead, provide the GIIN of your branch (if applicable) on line 13.

You must provide your GIIN on line 9 if you are a nonreporting IGA FFI that is (1) treated as registered deemed-compliant under Annex II to an applicable Model 2 IGA or (2) a registered deemed-compliant FFI under Regulations section 1.1471-5(f)(1).

Claiming benefits under an income tax treaty and have not provided a FTIN on line 9b.

However, a TIN is not required to be shown in order to claim treaty benefits on the following items of income:

Dividends and interest from stocks and debt obligations that are actively traded;
Dividends from any redeemable security issued by an investment company registered under the Investment Company Act of 1940 (mutual fund);
Dividends, interest, or royalties from units of beneficial interest in a unit investment trust that are (or were upon issuance) publicly offered and are registered with the SEC under the Securities Act of 1933; and
You properly identified yourself as a government (including a controlled entity that is a foreign government under section 892), central bank of issue, or international organization on line 4;
You are a resident of a U.S. territory; or
Your jurisdiction of residence is identified on the List of Jurisdictions That Do Not Issue Foreign TINs at IRS.gov/ businesses/corporations/list-of-jurisdictions-that-do-not- issue-foreign-tins .

You also do not need to provide an FTIN on line 9b if you meet the requirement for checking the box on line 9c.

In addition, if you are not using this form to document a financial account described above, you may provide the FTIN issued to you by your jurisdiction of tax residence on line 9b for purposes of claiming treaty benefits (rather than providing a U.S. TIN on line 8, if required).

Income related to loans of any of the above securities. See Regulations section 1.1441-1(e)(4)(vii) for other circumstances when you are required to provide a U.S. TIN for an amount subject to chapter 3 withholding.

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Lines 9a and 9b should accommodate the GIIN or foreign TIN, as appropriate. You may need to use a smaller font when completing the form. If the

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GIIN or FTIN does not fit in the space provided, you may provide a GIIN or FTIN that is indicated and clearly identified somewhere else on the form, or on a separate attached sheet, as long as the GIIN or FTIN is clearly identified as being furnished with respect to line 9a or 9b, respectively. For example, a handwritten GIIN located just outside of line 9a with a corresponding arrow pointing to line 9a is a properly provided GIIN for this purpose.

Line 9c. You may check the box in this line 9c if you are an account holder as described for purposes of line 9b and you are not legally required to obtain an FTIN from your jurisdiction of residence (including if the jurisdiction does not issue FTINs). By checking this box you will be treated as having provided an explanation for not providing an FTIN on line 9b. If you wish to provide a further (or other) explanation why you are not required to provide an FTIN on line 9b, you may do so in the margins of this form or on a separate statement attached to this form.

Line 10. This line may be used by you or by the withholding agent or FFI to include any referencing information that is useful to the withholding agent to document the beneficial owner. For example, withholding agents who are required to associate the Form W-8BEN-E with a particular Form W-8IMY may want to use line 10 for a referencing number or code that will make the association clear. You may also want to use line 10 to include the number of the account for which you are providing the form. If you are a single owner of a disregarded entity you may use line 10 to inform the withholding agent that the account to which a payment is made or credited is held in the name of the disregarded entity (unless the name of the disregarded entity is required to be provided on line 3).

You may also use line 10 to identify income from a notional principal contract that is not effectively connected with the conduct of a trade or business in the United States.