Fillable Form 8957 - Foreign Account Tax Compliance Act (Fatca) Registration printable pdf download

Form 8957 - Foreign Account Tax Compliance Act (Fatca) Registration

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8957

Foreign Account Tax Compliance Act (FATCA) Registration

Form

OMB No. 1545-2246

(Rev. October 2015)

Department of the Treasury

Information about Form 8957 and its separate instructions is at

▶

Internal Revenue Service

• All applicants must complete Part 1.

• This form will not be processed if it is not signed.

• DO NOT fill out this form if you have begun registering at

• The IRS strongly recommends that applicants register by accessing the online version of this form at The

use of this paper form will take longer for the IRS to process and if any information is missing or incomplete the delay in

registration may be significant.

• This form should be mailed to:

FATCA, Stop 6099 AUSC

3651 South IH 35

Austin, Texas 78741

Part 1

Financial Institution Registration

Select Financial Institution Type (check only one)

Single (not a member of an Expanded Affiliated Group)

Lead of an Expanded Affiliated Group

Member (not Lead) of an Expanded Affiliated Group. If a Member, you must provide the FATCA ID issued for such Member and provided

by your Lead:

Sponsoring Entity

Legal Name of the Financial Institution

What is the Financial Institution's country/jurisdiction of residence for tax purposes?

3 a

What is the Financial Institution's country/jurisdiction tax ID?

Select the Financial Institution's FATCA classification in its country/jurisdiction of tax residence (check only one)

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

None of the above

Mailing Address of Financial Institution

Country/Jurisdiction

Address Line 1

Address Line 2

City

State/Province/Region

ZIP/Postal Code

8957

For Paperwork Reduction Act Notice, see separate instructions.

Cat. No. 37778V

Form

(Rev. 10-2015)

Form 8957 - Foreign Account Tax Compliance Act (Fatca) Registration

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