W-8BENIndividual & Withholding

Certificate of Foreign Status of Beneficial Owner for U.S. Tax Withholding (Individuals)

Certificate used by foreign individuals to establish non-U.S. status and claim tax treaty benefits. Required by banks, brokerages, and companies that pay you U.S.-source income.

Section 1 of 30/21 fields filled · 0/8 required

Part I – Identification

Line 1 – Name of individual who is the beneficial owner*

Your full legal name as it appears on your passport or other government-issued ID.

Line 2 – Country of citizenship*

Line 3 – Permanent residence address (street)*

Your permanent residential address in your home country. P.O. boxes are not acceptable.

City or town, state or province*

Country*

Line 4 – Mailing address (if different from Line 3)

City or town, state or province

Country

Line 5 – U.S. taxpayer identification number (SSN or ITIN)

Enter if you have one. Not required if claiming treaty benefits.

Line 6a – Foreign tax identifying number (FTIN)

Your tax ID number from your country of residence. Required unless you check the box on Line 6b.

Line 6b – Check if FTIN not legally requiredLine 6b – Check if FTIN not legally required

Line 7 – Reference number(s)

Optional. Used by the withholding agent for identification purposes.

Line 8 – Date of birth*