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Department of the Treasury Internal Revenue Service
Do NOT use this form if:
Certificate of Foreign Status of Beneficial Owner for United States Tax Withholding and Reporting (Individuals)
For use by individuals. Entities must use Form W-8BEN-E. Go to www.irs.gov/FormW8BEN for instructions and the latest information. Give this form to the withholding agent or payer. Do not send to the IRS.
• You are NOT an individual . . . . . . . . . . . . . . . . . . . . . . . . . . .
• You are a U.S. citizen or other U.S. person, including a resident alien individual . . . . . . . . . . .
• You are a beneficial owner claiming that income is effectively connected with the conduct of trade or business within (other than personal services) . . . . . . . . . . . . . . . . . . . . . . . . . .
• You are a beneficial owner who is receiving compensation for personal services performed in the United States . . • You are a person acting as an intermediary . . . . . . . . . . . . . . . . . . . . . .
OMB No. 1545-1621
Instead, use Form:
. . . . . . W-8BEN-E
. . . . . . . . W-9
the United States . . . . . . . W-8ECI
. . . . . 8233 or W-4
. . . . . . . W-8IMY
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