Seller'S Affidavit Of Non-Foreign Status (Foreign Investment In Real Property Tax Act

Seller'S Affidavit Of Non-Foreign Status (Foreign Investment In Real Property Tax Act - Firpta)

ESCROW NO. _____________________

SELLER'S AFFIDAVIT OF NON-FOREIGN STATUS

(Foreign Investment in Real Property Tax Act - FIRPTA)

Section 1445 of the Internal Revenue Code provides that a transferee of a U.S. real property interest must

withhold tax if the transferor is a foreign person/entity. To inform the transferee that withholding of tax is not

required upon my disposition of a U.S. real property interest located at:

Property Adderss: _________________________________________________

I hereby certify the following, on behalf of the transferor:

is not a foreign corporation, foreign partnership, foreign trust, or foreign estate (as those terms are defined

in the Internal Revenue Code and Income Tax Regulations);

U.S. employer identification number is:

official address is:

I, the undersigned individual, declare that I have the authority to sign this document on behalf of

The undersigned understands that this certification may be disclosed to the Internal Revenue Service by

transferee and that any false statement contained herein could be punishable by fine, imprisonment, or both.

Under penalties of perjury, I declare that I have examined this certification and to the best of my

knowledge and belief it is true, correct and complete.*

Dated:

Seller's Name

Signature

*IMPORTANT NOTICE: An affidavit should be signed by each entity transferor to which it applies. Before you

sign, any questions relating to the legal sufficiency of this form, or whether it applies to a particular transaction, or

to the definition of any of the terms used, should be referred to an attorney, a certified public accountant, or other

professional tax advisor, or the Internal Revenue Service.

Seller'S Affidavit Of Non-Foreign Status (Foreign Investment In Real Property Tax Act - Firpta)