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Representative, may be used for this purpose. The agent,

Line 2. Enter the country under whose laws you are

as well as the beneficial owner, payee, or account holder

created, organized, or governed.

(as applicable), may incur liability for the penalties

Line 3. Leave this line blank. For purposes of completing

provided for an erroneous, false, or fraudulent form. By

this form as a hybrid entity making a treaty claim

signing Form W-8BEN-E, the authorized representative,

(including a disregarded entity), you are treated as the

officer, or agent of the entity also agrees to provide a new

beneficial owner and should be identified in line 1.

form within 30 days following a change in circumstances

affecting the correctness of the form.

Line 4. Check the box that applies among disregarded

entity, partnership, grantor trust, or simple trust. You must

A withholding agent may allow you to provide this form

also check the box indicating that you are a hybrid making

with an electronic signature. The electronic signature must

a treaty claim and complete Part III.

indicate that the form was electronically signed by a

person authorized to do so (for example, with a time and

Line 5. Leave this line blank, except in the circumstances

date stamp and statement that the form has been

described above.

electronically signed). Simply typing your name into the

Lines 6, 7, and 8. Complete lines 6, 7, and 8 as provided

signature line is not an electronic signature.

in the specific instructions, earlier.

Broker transactions or barter exchanges. Income

Line 9b. If your country of residence for tax purposes has

from transactions with a broker or a barter exchange is

issued you a tax identifying number, enter it here. Do not

subject to reporting rules and backup withholding unless

enter the tax identifying number of your owner(s).

Form W-8BEN-E or a substitute form is filed to notify the

Line 10. This reference line is used to associate this

broker or barter exchange that you are an exempt foreign

Form W-8BEN-E with another applicable withholding

person.

certificate or other documentation provided for purposes

You are an exempt foreign person for a calendar year

of chapter 4. For example, if you are a partnership making

in which:

a treaty claim, you may want to provide information for the

You are a foreign corporation, partnership, estate, or

withholding agent to associate this Form W-8BEN-E with

trust; and

the Form W-8IMY and owner documentation you provide

You are neither engaged, nor plan to be engaged

for purposes of establishing the chapter 4 status of your

during the year, in a U.S. trade or business that has

owner(s).

effectively connected gains from transactions with a

broker or barter exchange.

You must complete Parts III and XXX in accordance

with the specific instructions above. Complete Part II if

Special Instructions

applicable.

Foreign Reverse Hybrid Entities

Hybrid Entity Making a Claim of Treaty Benefits

A foreign reverse hybrid entity should only file a Form

If you are a hybrid entity making a claim for treaty benefits

W-8BEN-E for payments for which it is not claiming treaty

as a resident on your own behalf, you may do so as

benefits on behalf of its owners and must provide a

permitted under an applicable tax treaty. You should

chapter 4 status when it is receiving a withholdable

complete this Form W-8BEN-E to claim treaty benefits in

payment. A foreign reverse hybrid entity claiming treaty

the manner described in the instructions for Part III and

benefits on behalf of its owners should provide the

complete Part I to the extent indicated below. Note that

withholding agent with Form W-8IMY (including its

you should not complete line 5 indicating your chapter 4

chapter 4 status when receiving a withholdable payment)

status unless you are a disregarded entity that is treated

along with a withholding statement and Forms W-8BEN or

as the payee for chapter 4 purposes.

W-8BEN-E (or documentary evidence to the extent

If you are a flow-through entity claiming treaty benefits

permitted) on behalf of each of its owners claiming treaty

on a payment that is a withholdable payment, you should

benefits. See Form W-8IMY and accompanying

also provide Form W-8IMY along with a withholding

instructions for more information.

statement (if required) establishing the chapter 4 status of

Entities Providing Certifications

each of your partners or owners. Allocation information is

not required on this withholding statement unless one or

Under an Applicable IGA

more partners or owners are subject to chapter 4

An FFI in an IGA jurisdiction with which you have an

withholding (such as a nonparticipating FFI). If you are a

account may provide you with a chapter 4 status

disregarded entity claiming treaty benefits on a payment

certification other than as shown in Parts IV through XXVIII

that is a withholdable payment, unless you are treated as

in order to satisfy its due diligence requirements under the

the payee for chapter 4 purposes and have your own

applicable IGA. In such a case, you may attach the

GIIN, your single owner should provide Form W-8BEN-E

alternative certification to this Form W-8BEN-E in lieu of

or Form W-8BEN (as applicable) to the withholding agent

completing a certification otherwise required in Parts IV

along with this form. You or the withholding agent may use

through XXVIII provided that you: (1) determine that the

line 10 to inform the withholding agent to associate the

certification accurately reflects your status for chapter 4

two forms.

purposes or under an applicable IGA; and (2) the

Line 1. Enter your legal name (determined by reference

withholding agent provides a written statement to you that

to your legal identity in your country of incorporation or

it has provided the certification to meet its due diligence

organization).

requirements as a participating FFI or registered

-15-

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 15

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