Part II — Qualification Statement for Chapter 3 Status

You are not required to complete a chapter 3

TIP qualification statement if you are submitting this

form to document your chapter 4 status and are not receiving a payment that is subject to withholding under chapter 3. However, in such a case, you may also provide Form W-8BEN-E to document your chapter 4 status.

Line 10. All foreign governments claiming the applicability of section 892 must check box 10a as well as box 10b or box 10c, whichever applies. Enter the name of the foreign sovereign’s country on line 10b (if the entity is an integral part of a foreign government) or on line 10c (if the entity is a controlled entity of a foreign government). A foreign central bank of issue (wholly owned by a foreign sovereign) should check box 10c.

Line 11. Check this box if you are an international organization. By checking this box, you are certifying to all the statements made in line 11.

Line 12. Check this box if you are a foreign central bank of issue for purposes of chapter 3 (see definitions) not wholly owned by a foreign sovereign. By checking this box, you are certifying to all the statements made in line 12.

Line 13. If you are a foreign tax-exempt organization, you must attach a statement setting forth any income that is includible under section 512 in computing your unrelated business taxable income.

officers. The affidavit must include information on your financial support if you are claiming public charity status under sections 509(a)(1) and 170(b)(1)(A)(vi) or section 509(a)(2). See Publication 557, Tax-Exempt Status for Your Organization , for information on determining whether you are a public charity or private foundation.

In lieu of providing information in an affidavit concerning your operations, support, and financial information (when applicable), you may satisfy this requirement by referencing the opinion of U.S. counsel provided in accordance with Box 13b of these instructions when the opinion:

• Concludes that you qualify under section 509(a)(1), (2), (3), or (4); and

• Meets the requirements of current written advice rendered for a public charity equivalency determination in Rev. Proc. 2017-53, 2017-40 I.R.B. 263 .

TIP

If the opinion of U.S. counsel satisfies the above requirements, you may check this box despite that it references only the affidavit on this form.

An opinion of counsel or affidavit must be renewed if there has been a change in facts relevant to your tax-exempt status under section 501(c) or your public charity status under section 509.

Box 13d. Check this box if you are a section 501(c)(3) organization and you are a private foundation described in section 509.

Box 13a. Check this box if you have been issued a determination letter by the IRS. Enter the date of the IRS determination letter.

Box 13b. Check this box if you do not have an IRS determination letter, but are providing an opinion of U.S. counsel concluding that you are an organization described in section 501(c).

Box 13c. If you are a section 501(c)(3) organization, check this box if you are not a private foundation. You must attach to the withholding certificate an affidavit setting forth sufficient facts concerning your operations and support to enable the IRS to determine that you would be likely to qualify as an organization described in section 509(a)(1), (2), (3), or (4) rather than as a private foundation.

Line 14. Check this box if you are a government of a U.S. territory. By checking this box you are certifying to the statements made in line 14.

Line 15. Check the applicable box if you are a withholding qualified holder. By checking one of these boxes, you are certifying to the statement made in either line 15a or line 15b, as applicable.