Instructions For The Requester Of Forms W-8ben, W-8ben-E, W-8eci, W-8exp, And W-8imy - 2014 Page 15
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15manner as in the preceding sentence and must appear
intermediaries to which a U.S. withholding agent makes
immediately above the single signature line: “The Internal
payments are qualified intermediaries that are
Revenue Service does not require your consent to any
participating FFIs, the withholding agent may use a
provisions of this document other than the certifications
substitute Form W-8IMY that contains only the required
required to establish your status as a foreign government,
information from Part I (including line 9 to collect the
international organization, foreign central bank of issue,
intermediaries’ GIINs), plus the statements and
foreign tax-exempt organization, foreign private
certifications from Part III. A substitute Form W-8IMY must
foundation, or government of a U.S. possession.”
also incorporate the same attachments as the official form
(such as a withholding statement and beneficial owner
Form W-8IMY. The substitute Form W-8IMY must
documentation, to the extent otherwise required). A
contain all of the information required in Part I, lines 1
withholding agent may also include any information in a
through 6, line 8 if a U.S. TIN is required, and line 9, if a
substitute Form W-8IMY, or require any information to be
GIIN is required. The information required in Part II must
associated with the form, that is reasonably related to his
be included in a substitute form if you are making a
obligation to withhold and correctly report payments.
withholdable payment to a branch or disregarded entity
Penalties of perjury statement. The design of the
provided by the payee that is a class of FFI identified in
substitute Form W-8IMY must be such that the information
Part II operating in a jurisdiction other than the jurisdiction
and certifications that are being attested to by the
of residence of the entity named in Part I of the form. See
penalties of perjury statement clearly stand out from any
discussion regarding payments to branches or
other information contained on the form. Additionally, the
disregarded entities in
Further Notes for Validating Form
following statement must be presented in the same
W-8BEN-E, earlier in these instructions. The substitute
manner as in the preceding sentence and must appear
Form W-8IMY must also contain all of the statements and
immediately above the single signature line: “The Internal
certifications relevant to chapter 3 contained in Parts III
Revenue Service does not require your consent to any
through VIII if you are making a payment subject to
provisions of this document other than the certifications
withholding under chapter 3 and, except as otherwise
required to establish:1) your status as a qualified
indicated in the form’s instructions, the statements and
intermediary, a nonqualified intermediary, a specific type
certifications relevant to the chapter 4 status contained in
of U.S. branch, a withholding foreign partnership, a
Parts IX through XXVI for the intermediary or flow-through
withholding foreign trust, a nonwithholding foreign
entity providing the form if you are making a withholdable
partnership, a nonwithholding foreign simple trust, or a
payment or if you are an FFI documenting your account
nonwithholding foreign grantor trust; 2) your chapter 4
holders for purposes of chapter 4 or the applicable IGA.
status; and/or 3) your status as a qualified securities
However, a specific part needs to be included (in its
lender.”
entirety) only if it is relevant. For example, if the only
-15-
Instructions for the Requester of Forms W-8 (Rev. 7-2014)
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