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applicable IGA). The references to “controlling U.S.

Line 37b. If you are an NFFE that is a member of the

persons” in this part and Part XXIX apply only if the form is

same expanded affiliated group as a publicly-traded U.S.

being provided to an FFI treated as a reporting Model 1

or foreign entity you must check this box, provide the

FFI or reporting Model 2 FFI.

name of the publicly-traded entity, and identify the

securities market on which the stock of the publicly-

Part XXVII – Excepted

traded entity is traded. See Regulations section

Inter-Affiliate FFI

1.1472-1(c)(1)(i) to determine if the stock of an entity is

regularly traded on an established securities market

Line 41. If you are an excepted inter-affiliate FFI you

(substituting the term “U.S. entity” for “NFFE,” as

must check the box to certify that you meet all of the

appropriate, for purposes of testing whether an entity is

requirements of this classification. This classification will

publicly traded).

only apply for an excepted inter-affiliate FFI that holds

Part XXIV – Excepted Territory NFFE

deposit accounts described in the certification for this part

and that is documenting itself to the financial institution

Line 38. If you are an excepted territory NFFE you must

that maintains the deposit account. You are not eligible for

check the box to certify that you meet all of the

this classification if you receive or make withholdable

requirements for this classification. See Regulations

payments to or from any person other than a member of

section 1.1472-1(c)(1)(iii) for the definition of an excepted

your expanded affiliated group, other than the depository

territory NFFE.

institution described in the previous sentence. See

Regulations section 1.1471-5(e)(5)(iv) for all the

Part XXV – Active NFFE

requirements of this status.

Line 39. If you are an active NFFE you must check the

Part XXVIII – Sponsored

box to certify that you meet all of the requirements for this

Direct Reporting NFFEs

status, including the assets and passive income test

described in the certification for this part. For purposes of

Lines 42 and 43. If you are a sponsored direct reporting

applying this test, passive income includes dividends,

NFFE you must enter the name of the sponsoring entity

interest, rents, royalties, annuities, and certain other forms

on line 42 and check the box to certify that you meet all of

of passive income. See Regulations section 1.1472-1(c)

the requirements for this classification. You must also

(1)(iv)(A) for additional detail for the definition of passive

provide your GIIN in line 9a.

income. Also see Regulations section 1.1472-1(c)(1)(iv)

(B) for exceptions from the definition of passive income for

Part XXIX – Substantial U.S.

certain types of income.

Owners of Passive NFFE

Part XXVI – Passive NFFE

If you identified yourself as a passive NFFE (including an

investment entity that is a territory NFFE but is not an

Line 40a. If you are a passive NFFE you must check the

excepted territory NFFE under Regulations section

box to certify that you are not a financial institution and are

1.1472-1(c)) with one or more substantial U.S. owners in

not certifying your status as a publicly-traded NFFE, NFFE

Part XXVI, you must identify each substantial U.S. owner.

affiliate of a publicly-traded company, excepted territory

Provide the name, address, and TIN of each substantial

NFFE, active NFFE, direct reporting NFFE, or sponsored

U.S. owner in the relevant column. You may attach this

direct reporting NFFE.

information on a separate statement, which remains

Note. If you would be a passive NFFE but for the fact that

subject to the same perjury statement and other

you are managed by certain types of FFIs (see

certifications made in Part XXX. If you are reporting

Regulations section 1.1471-5(e)(4)(i)(B)), you should not

controlling U.S. persons (as defined in an applicable IGA)

complete line 40a as you would be considered a financial

to a Model 1 FFI or reporting Model 2 FFI with which you

institution and not a passive NFFE.

maintain an account that requests such ownership

information with this form, you may use this space or

If you are an NFFE that may qualify as an active

attach a separate statement to report such persons.

NFFE (or other NFFE described in another part of

TIP

this form), you may still check line 40a and

Part XXX – Certification

disclose your substantial U.S. owners or certify that you

Form W-8BEN-E must be signed and dated by an

have no substantial U.S. owners.

authorized representative or officer of the beneficial

owner, participating payee (for purposes of section

Line 40b. Check this box to certify that you have no

6050W), or account holder of an FFI requesting this form.

substantial U.S. owners.

You must check the box to certify that you have the legal

Line 40c. If you do not check the box and make the

capacity to sign for the entity identified on line 1 that is the

certification on line 40b, you must check this box 40c and

beneficial owner of the income. If Form W-8BEN-E is

complete Part XXIX to identify and provide the name,

completed by an agent acting under a duly authorized

address, and TIN of each of your substantial U.S. owners.

power of attorney, the form must be accompanied by the

power of attorney in proper form or a copy thereof

Note. If you are an NFFE that is providing Form

specifically authorizing the agent to represent the principal

W-8BEN-E to an FFI treated as a reporting Model 1 FFI or

in making, executing, and presenting the form. Form

reporting Model 2 FFI, you may also use Part XXIX to

2848, Power of Attorney and Declaration of

report controlling U.S. persons (as defined in an

-14-

Instructions for Form W-8BEN-E (Rev. 7-2017)

Instructions For Form W-8ben(E) - Certificate Of Entities Status Of Beneficial Owner For United States Tax Withholding And Reporting (Entities) Page 14

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