Specific Instructions
Part I
Line 1.
Enter your name. By doing so, you are representing to the payer or
withholding agent that you are not the beneficial owner of the amounts
that will be paid to you.
Line 2.
If you are a corporation, enter the country of incorporation. If
you are another type of entity, enter the country under whose laws you
are created, organized, or governed. If you are an individual, enter
N/A (for not applicable).
Line 3.
Check the one box that applies. If you are a foreign
partnership receiving the payment on behalf of your partners, check
the Withholding foreign partnership box or the
Nonwithholding foreign partnership box, whichever is
appropriate. If you are a foreign simple trust or foreign grantor
trust receiving the payment on behalf of your beneficiaries or owners,
check the Withholding foreign trust box, the Nonwithholding
foreign simple trust box, or the Nonwithholding foreign grantor
trust box, whichever is appropriate. If you are a foreign
partnership (or a foreign trust) receiving a payment on behalf of
persons other than your partners (or beneficiaries or owners), check
the Qualified intermediary box or the Nonqualified
intermediary box, whichever is appropriate. A reverse hybrid
entity that is providing documentation from its interest holders to
claim a reduced rate of withholding under a treaty should check the
Nonqualified intermediary box unless it has entered into a
qualified intermediary agreement with the IRS. See Parts II
Through VI on page 4 if you are acting in more than one
capacity.
Line 4.
Your permanent residence address is the address in the country
where you claim to be a resident. Do not show the address of a
financial institution, a post office box, or an address used solely
for mailing purposes. If you do not have a tax residence in any
country, the permanent residence address is where you maintain your
principal office or, if you are an individual, where you normally
reside.
Line 5.
Enter your mailing address only if it is different from the address
you show on line 4.
Line 6.
You must provide an employer identification number (EIN) if you are
a U.S. branch of a foreign bank or insurance company.
If you are acting as a qualified intermediary or a withholding
foreign partnership or a withholding foreign trust, you must use the
EIN that was issued to you in such capacity (your QI-EIN). If
you also act as a nonqualified intermediary with respect to other
amounts subject to withholding, you must complete a separate Form
W-8IMY for those amounts and use the EIN, if any, that is not
your QI-EIN.
A nonqualified intermediary, a nonwithholding foreign partnership,
or a nonwithholding foreign simple or grantor trust is generally not
required to provide a U.S. TIN. However, a nonwithholding foreign
grantor trust with five or fewer grantors is required to provide an
EIN.
Line 7.
If your country of residence for tax purposes has issued you a tax
identifying number, enter it here.
Line 8.
This line may be used by the filer of Form W-8IMY or by the
withholding agent to whom it is provided to include any referencing
information that is useful to the withholding agent in carrying out
its obligations. For example, a withholding agent who is required to
associate a particular Form W-8BEN with this Form W-8IMY may want to
use line 8 for a referencing number or code that will make the
association clear.
Parts II Through VI
You should complete only one part. If you are acting in multiple
capacities, you must provide separate Forms W-8IMY for each capacity.
For example, if you are acting as a qualified intermediary for one
account, but a nonqualified intermediary for another account, you must
provide one Form W-8IMY in your capacity as a qualified intermediary,
and a separate Form W-8IMY in your capacity as a nonqualified
intermediary.
Part II - Qualified Intermediary
Check box 9a if you are a qualified intermediary (QI)
(whether or not you assume primary withholding responsibility) for the
income for which you are providing this form. By checking the box, you
are certifying to all of the statements contained on line 9a.
Check box 9b only if you have assumed primary
withholding responsibility under Chapter 3 of the Code (nonresident
alien withholding) with respect to the accounts identified on this
line or in a withholding statement associated with this form.
Check box 9c only if you have assumed primary Form 1099
reporting and backup withholding responsibility as authorized in a
withholding agreement with the IRS with respect to the accounts
identified on this line or in a withholding statement associated with
this form.
Although a QI obtains withholding certificates or appropriate
documentation from beneficial owners, payees, and, if applicable,
shareholders, as specified in your withholding agreement with the IRS,
a QI does not need to attach the certificates or documentation to this
form. However, to the extent you have not assumed primary Form 1099
reporting or backup withholding responsibility, you must disclose the
names of those U.S. persons for whom you receive reportable amounts
and that are not exempt recipients (as defined in Regulations section
1.6049-4(c)(1)(ii) or under section 6041, 6042, 6045, or 6050N). You
should make this disclosure by attaching to Form W-8IMY the Forms W-9
(or substitute forms) of persons that are not exempt recipients. If
you do not have a Form W-9 for a non-exempt U.S. payee, you must
attach to Form W-8IMY any information you do have regarding that
person's name, address, and TIN.
Withholding statement of a QI.
As a QI, you must provide a withholding statement to each
withholding agent from which you receive reportable amounts. The
withholding statement becomes an integral part of the Form W-8IMY and,
therefore, the certification statement that you sign in Part VII of
the form applies to the withholding statement as well as to the form.
The withholding statement must:
- Designate those accounts for which you act as a QI.
- Designate those accounts for which you assumed primary
withholding responsibility under Chapter 3 of the Code and/or primary
Form 1099 reporting and backup withholding responsibility.
- Provide information regarding withholding rate pools.
A withholding rate pool is a payment of a single type of
income, based on the categories of income reported on Form 1042-S or
Form 1099 (for example, interest or dividends), that is subject to a
single rate of withholding. The withholding rate pool may be
established by any reasonable method agreed upon by you and the
withholding agent. For example, you may agree to establish a separate
account for a single withholding rate pool or you may agree to divide
a payment made to a single account into portions allocable to each
withholding rate pool. You must provide the withholding rate pool
information that is required for the withholding agent to meet its
withholding and reporting obligations. A withholding agent may request
any information reasonably necessary to withhold and report payments
correctly.
If you do not assume primary Form 1099 reporting and backup
withholding responsibility, you must establish a separate withholding
rate pool for each U.S. non-exempt recipient account holder disclosed
to the withholding agent unless the alternative procedure is used (see
below). The withholding rate pools are based on valid documentation
that you obtain under your withholding agreement with the IRS or, if a
payment cannot be reliably associated with valid documentation, under
the applicable presumption rules.
Alternative procedure for U.S. non-exempt recipients.
If permitted by the QI withholding agreement with the IRS and if
approved by the withholding agent, you may establish:
- A single withholding rate pool (not subject to backup
withholding) for all U.S. non-exempt recipient account holders for
whom you have provided Forms W-9 prior to the withholding agent making
any payments. Alternatively, you may include such U.S. non-exempt
recipients in a zero rate withholding pool that includes U.S. exempt
recipients and foreign persons exempt from non-resident alien
withholding provided all the conditions of the alternative procedure
are met and
- A separate withholding rate pool (subject to backup
withholding) for all U.S. non-exempt recipient account holders for
whom you have not provided Forms W-9 prior to the withholding agent
making any payments.
If you elect the alternative procedure, you must provide the
information required by your QI withholding agreement to the
withholding agent not later than January 15 of the year following the
year in which the payments are paid. Failure to provide this
information may result in penalties under sections 6721 and 6722 and
termination of your withholding agreement with the IRS.
Updating the statement.
The statement by which you identify the relevant withholding rate
pools must be updated as often as is necessary to allow the
withholding agent to withhold at the appropriate rate on each payment
and to correctly report the income to the IRS. The updated information
becomes an integral part of Form W-8IMY.
Part III - Nonqualified Intermediary
If you are providing Form W-8IMY as a nonqualified intermediary
(NQI), you must check box 10a. By checking this box, you
are certifying to all of the statements on line 10a. Check box
10b if you are using this form to transmit withholding
certificates or other documentation.
If you are acting on behalf of another NQI or on behalf of a
foreign partnership or foreign trust that is not a withholding foreign
partnership or a withholding foreign trust, you must attach to your
Form W-8IMY the Form W-8IMY of the other NQI or the foreign
partnership or the foreign trust together with the withholding
certificates and other documentation attached to that Form W-8IMY.
Withholding statement of an NQI.
An NQI must provide a withholding statement to obtain reduced rates
of withholding for its customers and to avoid certain reporting
responsibilities. The withholding statement must be provided prior to
a payment and becomes an integral part of the Form W-8IMY and,
therefore, the certification statement that you sign in Part VII of
the form applies to the withholding statement as well as to the form.
The withholding statement must:
- Contain the name, address, U.S. TIN (if any), and the type
of documentation (documentary evidence, Form W-9, or type of Form W-8)
for every person for whom documentation has been received and must
state whether that person is a U.S. exempt recipient, a U.S.
non-exempt recipient, or a foreign person. The statement must indicate
whether a foreign person is a beneficial owner or an intermediary,
flow-through entity, or U.S. branch and the type of recipient, based
on the recipient codes reported on Form 1042-S.
- Allocate each payment by income type to every payee for whom
documentation has been provided. The type of income is based on the
income codes reported on Form 1042-S (or, if applicable, the income
categories for Form 1099). If a payee receives income through another
NQI, flow-through entity, or U.S. branch, your withholding certificate
must also state the name, address, and U.S. TIN, if known, of the
other NQI or U.S. branch from which the payee directly receives the
payment or the flow-through entity in which the payee has a direct
ownership interest. If another NQI, flow-through entity, or U.S.
branch fails to allocate a payment, you must provide, for that
payment, the name of the NQI, flow-through entity, or U.S. branch that
failed to allocate the payment.
- If a payee is identified as a foreign person, you must
specify the rate of withholding to which the payee is subject, the
payee's country of residence and, if a reduced rate of withholding is
claimed, the basis for that reduced rate (for example, treaty benefit,
portfolio interest, exempt under section 501(c)(3), 892, or 895). The
statement must also include the U.S. TIN (if required) and, if the
beneficial owner is not an individual and is claiming treaty benefits,
state whether the limitation on benefits and section 894 statements
have been provided by the beneficial owner. You must inform the
withholding agent as to which payments those statements relate.
- Contain any other information the withholding agent requests
in order to fulfill its withholding and reporting obligations under
Chapter 3 of the Code and/or Form 1099 reporting and backup
withholding responsibility.
Alternative procedure for NQIs.
Under this procedure, you may provide information allocating a
payment of a reportable amount to each payee (including U.S.-exempt
recipients) after a payment is made. To use the alternative procedure
you must inform the withholding agent on your withholding statement
that you are using the procedure and the withholding agent must agree
to the procedure.
This alternative procedure cannot be used for payments that are
allocable to U.S. non-exempt recipients.
Under this procedure, you must provide a withholding agent with all
the information required on the withholding statement (see above) and
all payee documentation, except the specific allocation information
for each payee, prior to the payment of a reportable amount. In
addition, you must provide the withholding agent with withholding rate
pool information. The withholding statement must assign each payee to
a withholding rate pool prior to the payment of a reportable amount. A
withholding rate pool is a payment of a single type of income, based
on the income codes reported on Form 1042-S (for example, interest or
dividends), that is subject to a single rate of withholding. The
withholding rate pool may be established by any reasonable method
agreed upon by you and the withholding agent. For example, you may
agree to establish a separate account for a single withholding rate
pool, or you may agree to divide a payment made to a single account
into portions allocable to each withholding rate pool. You must
determine withholding rate pools based on valid documentation or, to
the extent a payment cannot be reliably associated with valid
documentation, the applicable presumption rules.
You must provide the withholding agent with sufficient information
to allocate the income in each withholding rate pool to each payee
(including U.S. exempt recipients) within the pool no later than
January 31 of the year following the year of payment. If you fail to
provide allocation information, if required, by January 31 for any
withholding rate pool, you may not use this procedure for any payment
made after that date for all withholding rate pools. You may remedy
your failure to provide allocation information by providing the
information to the withholding agent no later than February 14. See
Regulations section 1.1441-1.
Part IV - Certain United States Branches
Line 11
Check the box to certify that you are either:
- A U.S. branch of a foreign bank subject to regulatory
supervision by the Federal Reserve Board or
- A U.S. branch of a foreign insurance company required to
file an annual statement on a form approved by the National
Association of Insurance Commissioners with the insurance department
of a state, a territory, or the District of Columbia.
By checking the box you are also certifying that the income you are
receiving is not effectively connected with the conduct of your trade
or business in the United States. You must provide your EIN on line 6
of Part I.
Line 12 or 13
If you are one of the types of U.S. branches specified in the
instructions for line 11 on page 5, then you may choose to be treated
in one of two ways:
- Check box 12 if you have an agreement with the
withholding agent to which you are providing this form to be treated
as a U.S. person. In this case, you will be treated as a U.S. person.
Therefore, you will receive the payment free of Chapter 3 withholding
but you will yourself be responsible for Chapter 3 withholding and
backup withholding for any payments you make or credit to the account
of persons for whom you are receiving the payment.
- Check box 13 if you do not have an agreement with
the withholding agent to be treated as a U.S. person.
Withholding statement of a U.S. branch not treated as a U.S. person.
If you checked box 13, you must provide the withholding agent with
a written withholding statement. The withholding statement becomes an
integral part of the Form W-8IMY. The withholding statement must
provide the same information outlined under Withholding statement
of an NQI on page 5.
Part V - Withholding Foreign Partnership or Withholding Foreign Trust
Check box 14 if you are a withholding foreign
partnership or a withholding foreign trust for the accounts for which
you are providing this form and you are receiving the income from
those accounts on behalf of your partners, beneficiaries, or owners.
If you are not receiving the income on behalf of your partners,
beneficiaries, or owners, do not complete Part V. Instead,
complete Part II or Part III, whichever is appropriate.
If you are acting as a withholding foreign partnership or as a
withholding foreign trust, you must assume primary withholding
responsibility for all payments that are made to you for your
partners, beneficiaries, or owners. Therefore, you are not required to
provide information to the withholding agent regarding each partner's,
beneficiary's, or owner's distributive share of the payment. If you
are also receiving payments from the same withholding agent for
persons other than your partners, beneficiaries, or owners, you must
provide a separate Form W-8IMY for those payments.
Part VI - Nonwithholding Foreign Partnership, Simple Trust, or Grantor Trust
Check box 15 if you are a foreign partnership or a
foreign simple or grantor trust that is not a withholding foreign
partnership or a withholding foreign trust. By checking this box, you
are certifying to both of the statements on line 15.
Note:
If you are receiving income that is effectively connected with the
conduct of a trade or business in the United States, provide Form
W-8ECI (instead of Form W-8IMY).
If you are not receiving the income on behalf of your partners,
beneficiaries, or owners, do not complete Part VI. Instead,
complete Part II or Part III, whichever is appropriate.
If you are acting on behalf of an NQI or another foreign
partnership or foreign trust that is not a withholding foreign
partnership or a withholding foreign trust, you must associate with
your Form W-8IMY the Form W-8IMY of the other foreign partnership or
foreign trust together with the withholding certificates and other
documentation attached to that other form.
Withholding statement of nonwithholding foreign partnership or nonwithholding foreign trust.
You must provide the withholding agent with a written withholding
statement to obtain reduced rates of withholding and relief from
certain reporting obligations. The withholding statement becomes an
integral part of the Form W-8IMY. The withholding statement must
provide the same information outlined under Withholding statement
of an NQI on page 5.
Part VII - Certification
Form W-8IMY must be signed and dated by a person authorized to sign
a declaration under penalties of perjury on behalf of the person whose
name is on the form.
Paperwork Reduction Act Notice.
We ask for the information on this form to carry out the Internal
Revenue laws of the United States. If you are acting in any capacity
described in these instructions, you are required to give us the
information. We need it to ensure that you are complying with these
laws and to allow us to figure and collect the right amount of tax.
You are not required to provide the information requested on a form
that is subject to the Paperwork Reduction Act unless the form
displays a valid OMB control number. Books or records relating to a
form or its instructions must be retained as long as their contents
may become material in the administration of any Internal Revenue law.
Generally, tax returns and return information are confidential, as
required by section 6103.
The time needed to complete and file this form will vary depending
on individual circumstances. The estimated average time is:
| Recordkeeping
|
5 hr., 58 min.
|
| Learning about the law or the form
|
4 hr., 38 min.
|
| Preparing and sending the form to IRS
|
6 hr., 8 min.
|
If you have comments concerning the accuracy of these time
estimates or suggestions for making this form simpler, we would be
happy to hear from you. You can write to the Tax Forms Committee,
Western Area Distribution Center, Rancho Cordova, CA 95743-0001.
Do not send Form W-8IMY to this office. Instead, give it to
your withholding agent.
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