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Payment settlement entity (PSE). A payment

use Form W-9 to certify its status as a U.S. person for

settlement entity is a merchant acquiring entity or third

chapter 3 and chapter 4 purposes.

party settlement organization. Under section 6050W, a

PSE is generally required to report payments made in

Withholdable payment. A withholdable payment is

settlement of payment card transactions or third party

defined in Regulations section 1.1473-1(a). For

network transactions. However, a PSE is not required to

exceptions applicable to the definition of a withholdable

report payments made to a beneficial owner that is

payment, see Regulations section 1.1473-1(a)(4) (for

documented as foreign with an applicable Form W-8.

example, certain nonfinancial payments).

Qualified intermediary (QI). A qualified intermediary

Withholding agent. Any person, U.S. or foreign, that has

(QI) is a person that is a party to an agreement with the

control, receipt, custody, disposal, or payment of U.S.

IRS that is described in Regulations section 1.1441-1(e)

source FDAP income subject to chapter 3 or 4 withholding

(5)(iii). A qualified derivatives dealer (QDD) is a QI that

is a withholding agent. The withholding agent may be an

has agreed to certain reporting and withholding

individual, corporation, partnership, trust, association, or

requirements pursuant to Regulations section 1.1441-1(e)

any other entity, including (but not limited to) any foreign

(6).

intermediary, foreign partnership, and U.S. branches of

certain foreign banks and insurance companies.

Recalcitrant account holder. A recalcitrant account

For purposes of section 1446, the withholding agent is

holder includes an entity (other than an entity required to

the partnership conducting the trade or business in the

be treated as a nonparticipating FFI) that fails to comply

United States. For a publicly traded partnership, the

with a request by an FFI maintaining the account for

withholding agent may be the partnership, a nominee

documentation and information for determining whether

holding an interest on behalf of a foreign person, or both.

the account is a U.S. account. See Regulations section

See Regulations sections 1.1446-1 through 1.1446-6.

1.1471-5(g).

Reverse hybrid entity. A reverse hybrid entity is any

Specific Instructions

person (other than an individual) that is not fiscally

transparent under U.S. tax law principles but that is

Part I – Identification

fiscally transparent under the laws of a jurisdiction with

which the United States has an income tax treaty. See

of Beneficial Owner

Form W-8IMY and the accompanying instructions for

information on a reverse hybrid entity making a claim of

Line 1. Enter your name. If you are a disregarded entity

treaty benefits on behalf of its owners.

or branch, do not enter your business name. Instead,

enter the legal name of your owner (or, if you are a

Specified U.S. person. A specified U.S. person is any

branch, the entity that you form a part of) (looking through

U.S. person other than a person identified in Regulations

multiple disregarded entities if applicable). If you are a

section 1.1473-1(c).

disregarded entity that is a hybrid entity filing a treaty

Substantial U.S. owner. A substantial U.S. owner (as

claim, however, see Hybrid entities under Special

defined in Regulations section 1.1473-1(b)) means any

Instructions, later.

specified U.S. person that:

If you are an account holder providing this form to

Owns, directly or indirectly, more than 10 percent (by

an FFI solely for purposes of documenting

vote or value) of the stock of any foreign corporation;

TIP

yourself as an account holder and you are not

Owns, directly or indirectly, more than 10 percent of the

receiving a withholdable payment or reportable amount

profits or capital interests in a foreign partnership;

(as defined in Regulations section 1.1441-1(e)(3)(vi)), you

Is treated as an owner of any portion of a foreign trust

should complete Part I by substituting the references to

under sections 671 through 679; or

“beneficial owner” with “account holder.”

Holds, directly or indirectly, more than a 10 percent

beneficial interest in a trust.

The named holder on the account is not

U.S. person. A U.S. person is defined in section 7701(a)

necessarily the account holder for purposes of

(30) and includes domestic partnerships, corporations,

chapter 4. See Definitions, earlier, or, for an

CAUTION

and trusts.

account maintained by an FFI covered by a Model 1 or

Model 2 IGA with respect to the account, the definition of

Certain foreign insurance companies issuing

account holder in an applicable IGA to determine if you

annuities or cash value insurance contracts that

are the account holder. If you hold an account with an FFI

elect to be treated as a U.S. person for federal tax

CAUTION

and are unsure whether the definition of “account holder”

purposes but are not licensed to do business in the United

under an IGA is applicable to your account, consult with

States are treated as FFIs for purposes of chapter 4. For

the FFI requesting this form.

purposes of providing a withholding agent with

documentation for both chapter 3 and chapter 4 purposes,

Line 2. If you are a corporation, enter your country of

however, such an insurance company is permitted to use

incorporation. If you are another type of entity, enter the

Form W-9 to certify its status as a U.S. person. Likewise,

country under whose laws you are created, organized, or

a foreign branch of a U.S. financial institution (other than a

governed.

branch that operates as a qualified intermediary) that is

Line 3. If you are a disregarded entity receiving a

treated as an FFI under an applicable IGA is permitted to

withholdable payment, enter your name on line 3 if you: 1)

-6-

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 6

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