Certificate of Foreign Status of Beneficial Owner
for United States Tax Withholding
_ See separate instructions.
_ Give this form to the withholding agent or payer. Do not send to the IRS.
OMB No. 1545-1621
Do not use this form for:
● A U.S. citizen or other U.S. person, including a resident alien individual, instead use W9
● A foreign partnership, a foreign simple trust, or a foreign grantor trust (see instructions for exceptions) W-8ECI or W-8IMY
● A foreign government, international organization, foreign central bank of issue, foreign tax-exempt organization,
foreign private foundation, or government of a U.S. possession that received effectively connected income or that is
claiming the applicability of section(s) 115(2), 501(c), 892, 895, or 1443(b) (see instructions) W-8ECI or W-8EXP
● A person acting as an intermediary W-8IMY
● A person claiming an exemption from U.S. withholding on income effectively connected with the conduct
of a trade or business in the United States W-8ECI
[Edited at 2007-12-29 13:44]