Form W-14 - Certificate Of Foreign Contracting Party Receiving Federal Procurement Payments Page 2

Download a blank fillable Form W-14 - Certificate Of Foreign Contracting Party Receiving Federal Procurement Payments in PDF format just by clicking the "DOWNLOAD PDF" button.

Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.

Complete Form W-14 - Certificate Of Foreign Contracting Party Receiving Federal Procurement Payments with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.

Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.

Form W-14 (8-2016)

Page

Part IV

Explanation (Complete if Part II or Part III is applicable) (continued)

If you completed Part III, but did not check the box on line 9, state the relevant countries where the goods are manufactured or produced or

services are provided and the international procurement agreements relied upon, if relevant. If applicable, explain the method relied upon to allocate

the total contract price between exempt and nonexempt amounts. (Use additional sheets as necessary.)

If you checked the box on line 9, provide an explanation for each item by stating the relevant countries where the goods are manufactured or

produced or services are provided and the international procurement agreements relied upon, if relevant. If applicable, explain the method relied

upon to allocate the total contract price between exempt and nonexempt amounts. For example, you may attach a spreadsheet listing the various

contract line items with an explanation for the treatment of each line item as exempt or nonexempt. If the contract includes details necessary to

complete this section (such as exempt or nonexempt amounts by contract line item), you may incorporate by reference the relevant information in the

explanation. (Use additional sheets as necessary.)

Part V

Certificate

Under penalties of perjury, I declare that I have examined the information on this certificate (and in the contract, if relevant) and to the best of my knowledge and belief it is

true, correct, and complete. I further certify under penalties of perjury that:

I am the foreign person (or am authorized to sign on behalf of the foreign person) identified in line 1 above,

I am not acting as an agent or nominee for another foreign person,

I agree to pay an amount equal to any tax due under section 5000C that the acquiring agency does not withhold under section 5000C and pay any applicable

penalties and interest,

I acknowledge and understand the rules in Regulations section 1.5000C-4 relating to procedural obligations under section 5000C, and

I have not engaged in any transaction (or series of transactions) with a principal purpose of avoiding the tax imposed under section 5000C as defined in

Regulations section 1.5000C-5.

Sign

Here

Signature of Foreign Person (or Authorized Representative)

Date

Capacity to Act

W-14

Form

(8-2016)