W-8EXP
Certificate of Foreign Government or Other Foreign
Organization for United States Tax
Form
Withholding and Reporting
(Rev. April 2014)
(For use by foreign governments, international organizations, foreign central banks of issue, foreign
OMB No. 1545-1621
tax-exempt organizations, foreign private foundations, and governments of U.S. possessions.)
Information about Form W-8EXP and its separate instructions is at
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Department of the Treasury
Section references are to the Internal Revenue Code.
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Internal Revenue Service
Give this form to the withholding agent or payer. Do not send to the IRS.
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Do not use this form for:
Instead, use Form:
• A foreign government or other foreign organization that is not claiming the applicability of section(s) 115(2), 501(c), 892, 895,
or 1443(b) .
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W-8BEN-E or W-8ECI
• A beneficial owner solely claiming foreign status or treaty benefits
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W-8BEN or W-8BEN-E
• A foreign partnership or a foreign trust
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W-8BEN-E or W-8IMY
• A person claiming that income is effectively connected with the conduct of a trade or business in the United States
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W-8ECI
• A person acting as an intermediary
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W-8IMY
Part I
Identification of Beneficial Owner
1 Name of organization
2 Country of incorporation or organization
3 Type of
Foreign government
Foreign tax-exempt organization
entity
International organization
Foreign private foundation
Foreign central bank of issue (not wholly
Government of a U.S. possession
owned by the foreign sovereign)
4 Chapter 4 Status (FATCA status):
Participating FFI.
Foreign government (including a political subdivision),
government of a U.S. possession, or foreign central bank of
Reporting Model 1 FFI.
issue. Complete Part III.
Reporting Model 2 FFI.
Exempt retirement plan of foreign government. Complete Part III.
Registered deemed-compliant FFI
(other than a Reporting Model 1 FFI).
501(c) organization. Complete Part III.
Nonreporting IGA FFI. Complete Part III.
Passive NFFE. Complete Part III.
Territory financial institution. Complete Part III.
Direct reporting NFFE.
International organization.
Sponsored direct reporting NFFE. Complete Part III.
5 Permanent address (street, apt. or suite no., or rural route). Do not use a P.O. box or in-care-of address (other than a registered address).
Country
City or town, state or province. Include postal code where appropriate.
6 Mailing address (if different from above).
City or town, state or province. Include postal or ZIP code where appropriate.
Country
7 U.S. TIN, if required (see instructions)
8a
GIIN
b
Foreign TIN (see instructions)
9 Reference number(s) (see instructions)
Part II
Qualification Statement for Chapter 3 Status
10
For a foreign government:
a
I certify that the entity identified in Part I is a foreign government within the meaning of section 892 and the payments are
within the scope of the exemption granted by section 892.
Check box 10b or box 10c, whichever applies:
b
The entity identified in Part I is an integral part of the government of
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c
The entity identified in Part I is a controlled entity of the government of
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11
For an international organization:
I certify that:
• The entity identified in Part I is an international organization within the meaning of section 7701(a)(18) and
• The payments are within the scope of the exemption granted by section 892.
12
For a foreign central bank of issue (not wholly owned by the foreign sovereign):
I certify that:
• The entity identified in Part I is a foreign central bank of issue,
• The entity identified in Part I does not hold obligations or bank deposits to which this form relates for use in
connection with the conduct of a commercial banking function or other commercial activity, and
• The payments are within the scope of the exemption granted by section 895.
W-8EXP
For Paperwork Reduction Act Notice, see separate instructions.
Cat. No. 25401F
Form
(Rev. 4-2014)