Form 8957 - Foreign Account Tax Compliance Act (Fatca) Registration Page 3
Download a blank fillable Form 8957 - Foreign Account Tax Compliance Act (Fatca) Registration 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 8957 - Foreign Account Tax Compliance Act (Fatca) Registration 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.
ADVERTISEMENT
1
2
3
4Form 8957 (8-2013)
3
Page
11b
This line 11b must be completed by the Financial Institution's RO. Upon entering the POC information below, checking the box that
follows, and submitting this registration form, the RO is providing the IRS with written authorization to release FATCA information to
the POC. This authorization specifically includes authorization for the POC to complete this Form 8957: FATCA Registration, to take
other FATCA-related actions, and to obtain access to the Financial Institution's tax information.
Business Title of POC
Legal Name of POC
Last (Family)
First (Given)
Middle
City
Country
Business Address Line 1
Business Address Line 2
State/Province/Region
ZIP/Postal Code
Business Telephone Number
Business Fax Number
Business Email Address of POC
Five POCs are allowed per Financial Institution. Use additional sheets to add POCs.
By checking this box, I,
, as RO for the Financial Institution, provide the authorization described above to the
identified POCs listed in this line 11b. Once this authorization is granted, it is effective until revoked by either the Financial Institution
or the POC.
Part 2
Expanded Affiliated Group
Lead Financial Institutions must read the instructions before filling out Part 2.
12
Provide the following for each Financial Institution member of the Expanded Affiliated Group
Legal name of Member Financial Institution
Country of residence for tax purposes
Member type *
* Enter one of the following:
Participating Financial Institution not covered by an IGA; or a Reporting Financial Institution under a Model 2 IGA
Registered Deemed-Compliant Financial institution (including a Reporting Financial Institution under a Model 1 IGA)
Limited Financial Institution
Part 3
Renewal of Agreement for QIs, WPs, or WTs
13
Has QI/WP/WT's legal name changed since the effective date of its most recent QI/WP/WT agreement?
Yes. Provide new legal business name
Provide reason for name change
Merger
Liquidation
Re-branding (name change only)
No
8957
Form
(8-2013)
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Financial