Form W-8ECI - Department of the Treasury Internal Revenue Service
▶ Section references are to the Internal Revenue Code.▶ Go to www.irs.gov/FormW8ECI for instructions and the latest information.▶ Give this form to the withholding agent or payer. Do not send to the IRS.
Note: Persons submitting this form must file an annual U.S. income tax return to report income claimed to be effectively connected with a U.S. trade or business. See instructions.Do not use this form for: Instead, use Form:• A beneficial owner solely claiming foreign status or treaty benefits . . . . . . . . . . . . . . . . . W-8BEN or W-8BEN-E• A foreign government, international organization, foreign central bank of issue, foreign tax-exempt organization, foreign privatefoundation, or government of a U.S. possession claiming the applicability of section(s) 115(2), 501(c), 892, 895, or 1443(b) . . . . W-8EXPNote: These entities should use Form W-8ECI if they received effectively connected income and are not eligible to claim an exemption for chapter 3or 4 purposes on Form W-8EXP.• A foreign partnership or a foreign trust (unless claiming an exemption from U.S. withholding on income effectively connected with theconduct of a trade or business in the United States) . . . . . . . . . . . . . . . . . . . . . W-8BEN-E or W-8IMY• A person acting as an intermediary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . W-8IMYNote: See instructions for additional exceptions
Part I Identification of Beneficial Owner (see instructions)
1 Name of individual or organization that is the beneficial owner
2 Country of incorporation or organization
3 Name of disregarded entity receiving the payments (if applicable)
4 Type of entity (check the appropriate box):
5 Permanent residence address (street, apt. or suite no., or rural route). Do not use a P.O. box or in-care-of address.
City or town
state or province. Include postal code where appropriate.
7 U.S. taxpayer identification number (required—see instructions)
8a Foreign tax identifying number (FTIN)
9 Reference number(s) (see instructions)
10 Date of birth (MM-DD-YYYY)
11 Specify each item of income that is, or is expected to be, received from the payer that is effectively connected with the conduct of a trade orbusiness in the United States (attach statement if necessary).
REAL ESTATE RENTALS
12 Check here to certify that: you are a dealer in securities (as defined in section 475(c)(1)); you are a transferor of an interest in a publicly traded partnership(PTP) claiming an exception from withholding under Regulations section 1.1446(f)-4(b)(6); and any gain from the transfer of the PTP interest associatedwith this form is effectively connected with the conduct of a trade or business within the United States without regard to section 864(c)(8). . . NO
Part II Certification
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, andcomplete. I further certify under penalties of perjury that:• I am the beneficial owner (or I am authorized to sign for the beneficial owner) of all the payments to which this form relates,• The amounts for which this certification is provided are effectively connected with the conduct of a trade or business in the United States,• The income for which this form was provided is includible in my gross income (or the beneficial owner’s gross income) for the taxable year, and• The beneficial owner is not a U.S. person.Furthermore, I authorize this form to be provided to any withholding agent that has control, receipt, or custody of the payments of which I am thebeneficial owner or any withholding agent that can disburse or make payments of the amounts of which I am the beneficial owner.I agree that I will submit a new form within 30 days if any certification made on this form becomes incorrect.
Signature of beneficial owner (or individual authorized to sign for the beneficial owner)
Leave this empty:
Your legal name
Your email address
If you have questions about the contents of this document, you can email the document owner.
Document Name: Form W-8ECI
Agree & Sign