Complete this worksheet to determine whether amounts received are or will be
exempt from United States tax under section 892 or section 895 and exempt from withholding under sections 1441 and 1442.
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Foreign governments and foreign central banks of issue, start with question 1.
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International organizations, go directly to question 6.
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FOREIGN GOVERNMENT
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Yes
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No
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1
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a
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Is the foreign government an integral part of a foreign sovereign (see Definitions)?
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□
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□
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(If “Yes,” go to question 4. If “No,” answer question 1b.)
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b
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Is the foreign government a controlled entity of a foreign sovereign (see Definitions)?
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□
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□
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(If “Yes,” answer question 2a. If “No,” go to question 7a.)
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2
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a
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Is the controlled entity a foreign central bank of issue (see Definitions)?
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□
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□
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(If “Yes,” answer question 2b. If “No,” go to question 3.)
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b
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Is the foreign central bank of issue engaged in commercial activities within the United States?
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□
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□
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(If “Yes,” answer question 7a. If “No,” go to question 4.)
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3
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Is the controlled entity engaged in commercial activities anywhere in the world?
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□
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□
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(If “Yes,” income is not exempt from tax under section 892 and may be subject to withholding. Do
not complete Form W-8EXP for such income. Instead, complete Form W-8BEN or W-8ECI. If “No,” answer question 4.)
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4
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Does the foreign government or foreign central bank of issue (wholly owned by the foreign sovereign) receive income
directly or indirectly from any controlled commercial entities or income derived from the disposition of any interest in a
controlled commercial
entity (see Definitions)?
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□
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□
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(If “Yes,” income is not exempt from tax under section 892 and may be subject to withholding. Do
not complete Form W-8EXP for such income. Instead, complete Form W-8BEN or W-8ECI. If “No,” answer question 5.)
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5
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Is any of the income received by the foreign government or foreign central bank of issue (wholly owned by the
foreign sovereign) from sources other than investments in the United States in stocks, bonds, other domestic securities (as
defined in Temporary
Regulations section 1.892-3T(a)(3)), financial instruments held in the execution of governmental financial or monetary policy
(as defined in Temporary
Regulations section 1.892-3T(a)(4) and (a)(5)), or interest on deposits in banks in the United States?
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□
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□
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(If “Yes,” income is not exempt from tax under section 892 and may be subject to withholding. Do not
complete Form W-8EXP for such income. Instead, complete Form W-8BEN or W-8ECI. If “No,” check the appropriate box on line 9 of
Form W-8EXP.)
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INTERNATIONAL ORGANIZATION
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Yes
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No
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6
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Is the international organization an organization in which the United States participates pursuant to any treaty or
under an Act of Congress authorizing such participation and to which the President of the United States has issued an Executive
Order entitling the
organization to enjoy the privileges, exemptions, and immunities provided under the International Organization Immunities
Act (22 U.S.C. 288, 288e,
288f)?
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□
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□
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(If “Yes,” check the box on line 10 of Form W-8EXP. If “No,” income may be subject to withholding.
Do not complete this form for such income. Instead, complete Form W-8BEN or W-8ECI.)
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FOREIGN CENTRAL BANK OF ISSUE
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Yes
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No
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7
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a
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Is the entity, whether wholly or partially owned by the foreign sovereign, a foreign central bank of issue?
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□
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□
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(If “Yes,” answer question 7b. If “No,” income is not exempt from tax under section 895 and
may be subject to withholding. Do not complete Form W-8EXP for such income. Instead, complete Form W-8BEN or W-8ECI.)
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b
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Is the income received by the foreign central bank of issue from sources other than obligations of the United States
(or any agency or instrumentality thereof) or from interest on deposits with persons carrying on the banking business?
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□
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□
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(If “Yes,” income is not exempt from tax under section 895 and may be subject to withholding. Do
not complete Form W-8EXP for such income. Instead, complete Form W-8BEN or W-8ECI. If “No,” answer question 7c.)
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c
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Are the obligations of the United States (or any agency or instrumentality thereof) or bank deposits owned by the
foreign central bank of issue held for, or used in connection with, the conduct of commercial banking functions or other commercial
activities by the
foreign central bank of issue?
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□
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□
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(If “Yes,” income is not exempt from tax under section 895 and may be subject to withholding. Do
not complete Form W-8EXP for such income. Instead, complete Form W-8BEN or W-8ECI. If “No,” check the box on line 11 of Form
W-8EXP.)
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