Form W-8BEN-E — Foreign Entities

1. Beneficial owner

Name of organization beneficial owner *

Country of incorporation or organization *

Disregarded entity receiving payment (if applicable)

Chapter 3 status (entity type) *

Chapter 4 / FATCA status *

Email for receipt (optional)

2. Addresses

Permanent residence address (street and number; no P.O. box) *

City or town, region, and postal code *

Permanent residence country *

Mailing address (if different)

Mailing city, region, and postal code

Mailing country (if different)

Use a permanent street address, not a P.O. box or in-care-of address (except where the IRS form permits a registered address).

3. Tax identification and reference

U.S. taxpayer identification number (if required)

Foreign tax identifying number (if applicable)

Foreign TIN is not legally required (only if applicable)

GIIN (if applicable)

Reference number(s) (if applicable)

4. Entity and FATCA details

Automated official PDFs currently support a corporation with Active NFFE status or Passive NFFE status with no substantial U.S. owners. Other statuses require the manual official IRS PDF workflow.

Disregarded entity or branch status (Part II, if applicable)

Disregarded entity or branch address (if applicable)

Branch GIIN (if applicable)

Applicable Chapter 4 certification details (part number and supporting facts)

I affirm that the applicable status certification and supporting facts stated above are correct.

Substantial U.S. owners / controlling U.S. persons (Part XXIX, if applicable)

If Passive NFFE, I certify that there are no substantial U.S. owners or controlling U.S. persons.

If Active NFFE, I certify that this foreign entity is not a financial institution, less than 50% of its gross income for the preceding calendar year is passive income, and less than 50% of its assets produce or are held to produce passive income, calculated as a weighted quarterly average.
If Passive NFFE, I certify that this foreign entity is not a financial institution and is not claiming a different NFFE status; it has no substantial U.S. owners or applicable controlling U.S. persons.

5. Tax treaty benefits (if claiming)

Treaty country (if claiming benefits)

Limitation on benefits provision (if claiming treaty benefits)

Special rates require the article, rate, income type, and conditions. Leave this section blank if you are not claiming treaty benefits.

Treaty article and paragraph (special rate only)

Claimed withholding rate % (special rate only)

Type of income (special rate only)

Additional treaty conditions (special rate only)

6. Certification and signature

I confirm this is the correct form, I am not claiming treaty benefits, and the income does not require Form W-8ECI, W-8IMY, Form 8233, or W-4. The entity is a corporation with no disregarded entity or branch receiving payment. *

Under penalties of perjury, I declare that I have examined the information on this form and to the best of my knowledge and belief it is true, correct, and complete. I further certify under penalties of perjury that: The entity on line 1 is the beneficial owner of the income or proceeds, is certifying its chapter 4 status, or is submitting this form for section 6050W or 6050Y purposes; it is not a U.S. person; this form relates to income not effectively connected with a U.S. trade or business, income effectively connected but not subject to tax under an income tax treaty, a partner’s share of effectively connected taxable income, or an amount realized from a partnership interest transfer subject to section 1446(f) withholding, as applicable; and for broker transactions or barter exchanges, the beneficial owner is an exempt foreign person. I authorize this form to be provided to any withholding agent with control, receipt, or custody of the income, or that can disburse or make payments of it. I agree to submit a new form within 30 days if any certification becomes incorrect.

Read the complete Part XXX certification on the official IRS form before signing.

I make the applicable Form W-8BEN-E certifications. *
I certify that I have capacity to sign for the person or entity identified above. *

Signature *

Draw your signature above (mouse or touch).

Printed name of signer *

Date signed *