Additional Common Reporting Standard Status printable pdf download

Additional Common Reporting Standard Status

Additional Common Reporting Standard (CRS)

Internal use

only

Status / Foreign Account Tax Compliance Act

(FATCA) Status Form

Important information for completing this form

To be fully completed if your CRS status or FATCA status is as a Non-Reporting Financial Institution, Exempt

Beneficial Owner, Financial Institution or Direct Reporting Non-Financial Entity. If you require guidance as to the

meaning of the terms used in this form you should seek professional assistance, contact HMRC or use the relevant

sections of the HMRC website at

Organisation name

Trading name (if applicable)

Q1. Financial Institution - Investment Entity

If your organisation is a Financial Institution - Investment Entity please tick either box (i) or (ii).

Otherwise tick (iii) Not Applicable and go to Q2.

(i) An Investment Entity located in a Non-Participating Jurisdiction and managed by another

Financial Institution (if ticked, please answer both a) and b) below and go to Q2)

a) Please confirm your organisation’s total number of Beneficial Owners / Controlling Persons

b) Please tick this box to confirm that you have provided all the details for your organisation’s

Beneficial Owners / Controlling Person(s) on the application form

(ii) Other Investment Entity (if ticked go to Q2)

(iii) Not Applicable

Q2. Global Intermediary Identification Number (GIIN)

If your organisation is a Financial Institution (of any type) or a Direct Reporting Non-Financial Entity please

provide its GIIN below:

Note: If your organisation is a collective investment vehicle or similar organisation please specify if the GIIN

provided above is for:

(i) Umbrella fund level

(ii) Sub fund level

If you have provided a GIIN above, no further information is required from you on this form.

Alternatively, if your organisation does not have a GIIN, please indicate why by ticking one of the boxes below:

a) Non-Reporting Financial Institution / Certified Deemed Compliant Financial Institution (if ticked go to Q3)

b) Non-Participating Financial Institution

c) US Financial Institution

d) Any other reason (please specify)___________________________________________

If you have ticked boxes b), c) or d) no further information is required from you on this form.

December 15

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Additional Common Reporting Standard Status