Part III — Qualified Intermediary

Line 14. Check the box on line 14 if you are a QI (whether or not you assume primary withholding responsibility) for the payments for which you are providing this form. By checking the box, you are certifying to the applicable statements contained on line 14. See the QI agreement for the definition of “account” for purposes of Part III.

Line 15. Complete line 15 only if you are acting as a QI that is not a QDD. To the extent you are a QI acting as a QDD, see the instructions for line 16. If you are acting in both QI capacities, you should complete both lines 15 and 16 to the extent applicable.

Line 15a. Check the box on line 15a if you have assumed primary withholding responsibility under both chapter 3 and chapter 4 with respect to the account(s) identified on a withholding statement attached to this form (or, if no withholding statement is attached to this form, for all accounts). The representation made in this box on line 15a may be made regardless of whether you assume primary withholding responsibility for a PTP distribution (by checking the box on line 15c) as the representation made on this line 15a does not apply to an amount subject to chapter 3 withholding on a PTP distribution.

Furthermore, the box on line 15a may be checked regardless of which boxes you check on lines 15b through 15i for any accounts identified on a withholding statement. Line 15b. Check the box on line 15b if you have assumed primary withholding and reporting responsibilities under section 1446(f) for each payment of an amount realized on a sale of a PTP interest associated with each account identified on a withholding statement attached to this form for receiving such amounts (or, if no withholding statement is attached to this form, for all accounts).

Line 15c. Check the box on line 15c if you have assumed primary withholding responsibility as a nominee for each distribution by a PTP that is associated with each account identified on a withholding statement attached to this form for receiving such distributions (or, if no withholding statement is attached to this form, for all accounts).

Line 15d. Check the box on line 15d if you are a QI that is acting as a QSL with respect to payments associated with each account identified on a withholding statement attached to this form (or, if no withholding statement is attached to this form, for all accounts) that are U.S. source substitute dividends made in 2021 or 2022 by a party to a securities lending transaction (as described in Notice 2010-46) for which you are not acting as a QDD. See Notice 2020-2 and Qualified securities lender (QSL) , earlier, for the limitation on when a QI is permitted to act as a QSL.

Line 15e. Check the box on line 15e to certify that you are a QI that is assuming primary withholding responsibility under chapter 3 and chapter 4 and primary Form 1099 reporting and backup withholding responsibility with respect to all payments associated with this form that are U.S. source interest and substitute interest payments, as permitted by (and described in) the QI agreement. You may act as a QI with respect to such substitute interest payments under the QI agreement regardless of whether you are acting in a principal or intermediary capacity with respect to payments of interest and substitute interest you receive that are associated with this form and regardless of whether you act as a QDD or QSL.

Line 15f. Check the box on line 15f if you have assumed primary Form 1099 reporting and backup withholding responsibility with respect to the accounts identified in a withholding statement associated with this form or if you are a participating FFI or registered deemed-compliant FFI that meets the requirements to report only under Regulations sections 1.6049-4(c)(4)(i) and (c)(4)(ii). For accounts for which you check this box on line 15f, you should not check the boxes on lines 15g through 15i.

If you checked boxes 15a and 15f with respect to any

TIP accounts, or box 15b or 15c (as applicable) and the

box on line 15f when this form is associated with an amount realized or PTP distribution, you do not have to provide a withholding statement for any payments made to those accounts.

Line 15g. Check the box on line 15g if you have not assumed primary Form 1099 reporting and backup withholding responsibility with respect to the account(s) identified on a withholding statement attached to this form (or, if no withholding statement is attached to this form, for all accounts). This box applies to an amount realized only if you have not checked the box on line 15b and does not apply to a payment made by a QSL that is described on line 15d. If you check the box on line 15g, check the applicable certification(s) on line 15h or 15i.

Lines 15h and 15i. If you are allocating any portion of the payment on a withholding statement to a chapter 4 withholding rate pool of U.S. payees in lieu of providing Forms W-9, you must certify by checking the boxes on lines 15h and/or 15i (as applicable):

• For each account holder included in a chapter 4 withholding rate pool of U.S. payees who holds an account that you maintain, you are permitted to provide this pool under Regulations section 1.6049-4(c)(4)(iii) (including for payments of income other than interest for which reporting would be required under chapter 61 but for a coordination rule similar to that provided in Regulations section 1.6049-4(c)(4)(iii)); and/or

• For a withholding rate pool of U.S. payees that includes account holders of another intermediary or flow-through entity, you have obtained or will obtain documentation to establish that the intermediary or flow-through entity is a

participating FFI, registered deemed-compliant FFI, or a qualified intermediary. See Regulations sections 1.1471-3(d) (4) and 1.1471-3(e) for more information on the requirements for documenting such chapter 4 statuses.

A payment that is subject to chapter 3 withholding or