Foreign Person's U.S. Source Income Subject to Withholding

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2014

Department of the Treasury
Internal Revenue Service

Instructions for Form 1042-S
Foreign Person's U.S. Source Income Subject to Withholding

Future Developments

2014, financial institutions that are
required to report payments made under
chapter 4 must electronically file Forms
1042-S (regardless of the number of forms
to file). See the instructions under
Electronic Reporting, later.

General Instructions

Specified Federal procurement payments. Specified Federal procurement
payments (described under section
5000C(b)) paid to foreign persons that are
subject to withholding under section
5000C must be reported on Form 1042-S.
For more information, see Specified
Federal Procurement Payments Made to
Foreign Persons, later.

Section references are to the Internal Revenue
Code unless otherwise noted.

For the latest information about
developments related to Form 1042-S,
and its instructions, such as legislation
enacted after they were published, go to
www.irs.gov/form1042.

Except as otherwise provided in
these instructions, use the 2014
CAUTION
Form 1042-S only for amounts
paid during 2014. Do not use the 2014
Form 1042-S for amounts paid during
2013.

!

What's New
Foreign Account Tax Compliance Act
(FATCA). The Form 1042-S for 2014 has
been modified to accommodate payments
and amounts withheld under the
provisions commonly known as FATCA or
Chapter 4 of the Internal Revenue Code
(chapter 4) in addition to those payments
and amounts withheld required to be
reported under Chapter 3 of the Internal
Revenue Code (chapter 3). Form 1042-S
requires the reporting of an applicable
exemption to the extent withholding under
chapter 4 did not apply to a payment of
U.S source fixed or determinable annual
or periodical (FDAP) income (including
deposit interest). Form 1042-S also
requires, in certain cases, the reporting of
additional information about a recipient of
the payment such as the recipient's
account number, date of birth, and foreign
taxpayer identification number, if any. For
withholding agents, intermediaries,
flow-through entities, and recipients, Form
1042-S requires that the chapter 3 status
(or classification) and chapter 4 status be
reported on the form according to codes
provided in these instructions. See these
instructions for a description of any further
changes to 2014 Form 1042-S. For the
requirement of a withholding agent to file a
Form 1042-S for chapter 4 purposes, see
Regulations section 1.1474-1(d).
Publication 515 (cited in these
instructions) has not been updated as of
the date of publication of these
instructions to include the withholding and
reporting provisions of chapter 4.
Electronic filing requirement for financial institutions. Beginning January 1,
Sep 11, 2013

Interest on deposits. Beginning January
1, 2013, deposit interest described in
section 871(i)(2)(A) aggregating $10 or
more paid to certain nonresident alien
individuals with respect to a deposit
maintained at an office within the United
States by a resident of certain countries
must be reported on Form 1042-S. For
more information, see Interest on
deposits, later.

Special Transitional Rule

With respect to a payment of U.S. source
FDAP income paid prior to the time in
which the withholding agent (or an
intermediary or flow-through entity) is
required to identify the chapter 4 status of
the payee or recipient (if other than the
payee), the withholding agent is not
required to include on Form 1042-S the
information required to report the payment
for chapter 4 purposes. For example, if a
withholding agent makes a U.S. source
dividend payment prior to June 30, 2014,
to a qualified intermediary, the withholding
agent is not required to determine the
chapter 4 status of such intermediary and
is not required to complete boxes 4, 4a,
4b, 13b, 16b, or any chapter 4 status code
on Form 1042-S. If, however, the
withholding agent makes another U.S.
dividend payment after June 30, 2014, the
withholding agent is required to complete
a separate Form 1042-S for all such
payments made after June 30, 2014, that
includes the information required for
reporting the payment for chapter 4
purposes.

Reminders
FIRE System. For files submitted on the
FIRE System, it is the responsibility of the
filer to check the status within 5 business
days to verify the results of the

Cat. No. 64278A

transmission. The IRS will not mail error
reports for files that are bad.
Substitute forms. Any substitute forms
must comply with the rules set out in Pub.
1179, General Rules and Specifications
for Substitute Forms 1096, 1098, 1099,
5498, W-2G, and 1042-S. A substitute of
Form 1042-S, Copy A and C must be an
exact copy of Form 1042-S, Copy A and
C. If it is not, the form may be rejected as
incorrect and the IRS may impose
penalties. For more information, see
Substitute Forms, later.

Purpose of Form

Use Form 1042-S to report income
described under Amounts Subject to
Reporting on Form 1042-S, later, and to
report amounts withheld under Chapter 3
or Chapter 4.
Use Form 1042-S to report specified
Federal procurement payments paid to
foreign persons that are subject to
withholding under section 5000C.
Also use Form 1042-S to report
distributions of effectively connected
income by a publicly traded partnership or
nominee. See Publicly Traded
Partnerships (Section 1446 Withholding
Tax), later.
Every person required to deduct
and withhold any tax under
CAUTION
chapter 3 or chapter 4 is liable for
such tax. Every person required to deduct
and withhold any tax on payments made
to expatriates is liable for such tax.

!

Do not use Form 1042-S to report an
item required to be reported on any of the
following forms.
Form W-2 (wages and other
compensation made to employees (other
than compensation for dependent
personal services for which the beneficial
owner is claiming treaty benefits),
including wages in the form of group-term
life insurance).
Form 1099.
Form 8288-A, Statement of
Withholding on Dispositions by Foreign
Persons of U.S. Real Property Interests, or
Form 8805, Foreign Partner's Information
Statement of Section 1446 Withholding
Tax. Withholding agents otherwise
required to report a distribution partly on a
Form 8288-A or Form 8805 and partly on
a Form 1042-S may instead report the
entire amount on Form 8288-A or
Form 8805.

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Form 8966, FATCA Report. Foreign
financial institutions (FFIs) are required to
report on Form 8966 certain account
information regarding accounts held by
recalcitrant account holders. An FFI that is
a withholding agent however may be
required to file Form 1042-S to report
payments of U.S. FDAP income made to
recalcitrant acount holders and tax
deducted and withheld.

Who Must File

Every withholding agent (defined in
Definitions, later) must file an information
return on Form 1042-S to report amounts
paid during the preceding calendar year
that are described under Amounts Subject
to Reporting on Form 1042-S, later.
However, withholding agents who are
individuals are not required to report a
payment on Form 1042-S if they are not
making the payment as part of their trade
or business and no withholding is required
to be made on the payment. For example,
an individual making a payment of interest
that qualifies for the portfolio interest
exception from withholding is not required
to report the payment if the portfolio
interest is paid on a loan that is not
connected to the individual's trade or
business. However, an individual who is a
withholding agent paying an amount that
actually has been subject to withholding is
required to report the payment. Also, an
individual paying an amount on which
withholding is required must report the
payment, whether or not the individual
actually withholds. See Multiple
Withholding Agent Rule, later, for
exceptions to reporting when another
person has reported the same payment to
the recipient. Also see Publicly Traded
Partnerships (Section 1446 Withholding
Tax), later.
Every payor of a specified Federal
procurement payment must file a Form
1042-S for payments withheld upon under
section 5000C.
You must otherwise file a Form 1042-S
even if you did not withhold tax because
the income was exempt from tax under a
U.S. tax treaty or the Code, including the
exemption for income that is effectively
connected with the conduct of a trade or
business in the United States, or you
released the tax withheld to the recipient.
For exceptions, see Amounts That Are Not
Subject to Reporting on Form 1042-S,
later.
Amounts paid to an individual that is a
bona fide resident of a U.S. possession or
territory is not subject to reporting on Form
1042-S if the beneficial owner of the
income is a U.S. citizen, national, or
resident alien (such amounts may be
subject to Form 1099 reporting).

If you are required to file Form
1042-S, you also must file Form
CAUTION
1042, Annual Withholding Tax
Return for U.S. Source Income of Foreign
Persons. See Form 1042, and the
instructions to the form, for more
information.

Internal Revenue Service
Information Returns Branch
Attn: Extension of Time
Coordinator
240 Murall Drive Mail Stop 4360
Kearneysville, WV 25430

!

Where, When, and
How To File

Forms 1042-S, whether filed on paper or
electronically, must be filed with the
Internal Revenue Service by March 15,
2015. You also are required to furnish
Form 1042-S to the recipient of the
income by March 15, 2015.
Copy A is filed with the Internal
Revenue Service. Send all paper Forms
1042-S with Form 1042-T, Annual
Summary and Transmittal of Forms
1042-S, to the address in the Form 1042-T
instructions. You must use Form 1042-T to
transmit paper Forms 1042-S. Use a
separate Form 1042-T to transmit each
type of Form 1042-S. See Payments by
U.S. Withholding Agents, later, and the
Form 1042-T instructions for more
information. If you are a financial institution
or have 250 or more Forms 1042-S to file,
follow the instructions under Electronic
Reporting, later.
Attach only Copy A to Form
1042-T. Copies B, C, and D
should be provided to the
recipient of the income. Copy E should be
retained by the withholding agent.

TIP

Extension of time to file. To request an
extension of time to file Forms 1042-S, file
Form 8809, Application for Extension of
Time To File Information Returns. See the
Form 8809 instructions for where to file
that form. You should request an
extension as soon as you are aware that
an extension is necessary, but no later
than the due date for filing Form 1042-S.
By filing Form 8809, you will get an
automatic 30-day extension to file Form
1042-S. If you need more time, a second
Form 8809 may be submitted before the
end of the initial extended due date. See
Form 8809 for more information.
If you are requesting extensions
of time to file for 2 or more
CAUTION
withholding agents or payers, you
must submit the extension requests
electronically. See Pub. 1187,
Specifications for Filing Form 1042-S,
Foreign Person's U.S. Source Income
Subject to Withholding, Electronically, for
more information.

!

Recipient copies. You may request
an extension of time to provide the
statements to recipients by sending a
letter to:
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See Extension to provide statements to
recipients in Pub. 515, Withholding of Tax
on Nonresident Aliens and Foreign
Entities.
If you are requesting an extension
of time to file for recipients of
CAUTION
more than 10 withholding agents,
you must submit the extension requests
electronically. See Pub. 1187, Part D,
Section 4, for more information.

!

Electronic Reporting

If you are either a financial institution,
whether U.S. or foreign, or a person,
including a corporation, partnership,
individual, trust or estate, that is required
to file 250 or more Forms 1042-S, you are
required to submit them electronically.
Electronic submissions are filed using
the Filing Information Returns
Electronically (FIRE) System. The FIRE
System operates 24 hours a day, 7 days a
week, at fire.irs.gov. For more information,
see Pub. 1187.
The electronic filing requirement
applies separately to original and
amended returns. For a withholding agent
other than an financial institution, the filing
requirement applies individually to each
reporting entity as defined by its separate
taxpayer identification number (TIN). This
requirement applies separately to original
and amended returns. For example, if you
have 300 original Forms 1042-S, they
must be filed electronically. However, if
200 of those forms contained erroneous
information, the amended returns may be
filed on paper forms because the number
of amended Forms 1042-S is less than the
250-or-more filing requirement.
If you file electronically, do not file
the same returns on paper.
CAUTION
Duplicate filing may cause
penalty notices to be generated.

!

Note. Even though as many as 249
Forms 1042-S may be submitted on paper
to the IRS, the IRS encourages filers to
transmit forms electronically.
Hardship waiver. For a withholding
agent other than a participating FFI, QI,
WP, or WT, to receive a hardship waiver
from the required filing of Forms 1042-S
electronically, submit Form 8508, Request
for Waiver From Filing Information Returns
Electronically. Waiver requests should be
filed at least 45 days before the due date
of the returns. See Form 8508 for more
information.
Instructions for Form 1042-S (2014)

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Need assistance? For additional
information and instructions on filing
Forms 1042-S electronically, extensions of
time to file (Form 8809), and hardship
waivers (Form 8508), see Pub. 1187. You
also can call the Information Reporting
Program at 866-455-7438 (toll free) or
304-263-8700 (not a toll-free number). Do
not call the Information Reporting Program
to answer tax law questions. See Caution
below for additional information. The
Information Reporting Program also can
be reached by fax at 877-477-0572 (toll
free) and international fax at
304-579-4105 (not a toll-free number).
This call site does not answer tax
law questions concerning the
CAUTION
requirements for withholding of
tax on payments of U.S. source income
under chapter 3 or chapter 4 of the Code.
If you need such assistance, you can call
267-941-1000 (not a toll-free number)
from 6:00 a.m. to 11:00 p.m. Eastern time
or write to:

!

Internal Revenue Service
International Section
Philadelphia, PA 19255-0725

Additional Information

For more information on the withholding of
tax, see Pub. 515. To order this
publication and other publications and
forms, call 1-800-TAX-FORM
(1-800-829-3676). You also can download
forms and publications from IRS.gov.

Record Retention

Withholding agents should retain a copy of
the information returns filed with the IRS,
or have the ability to reconstruct the data,
for at least 3 years after the reporting due
date.

Substitute Forms

The official Form 1042-S is the standard
for substitute forms. Because a substitute
form is a variation from the official form,
you should know the requirements of the
official form for the year of use before you
modify it to meet your needs. The IRS
provides several means of obtaining the
most frequently used tax forms. These
include the Internet and DVD. For details
on the requirements of substitute forms,
see Pub. 1179.
Penalty for filing incorrect
substitute form. Privately printed
substitute Forms 1042-S must be exact
copies of both the format and content of
the official Form 1042-S. If you file a
substitute for Form 1042-S, Copy A, with
the IRS that is not an exact copy of the
official Form 1042-S, Copy A, you may be
subject to a penalty for failure to file a
correct return. See Penalties, later.

Instructions for Form 1042-S (2014)

Deposit Requirements

For information and rules concerning
federal tax deposits, see Depositing
Withheld Taxes in Pub. 515 or Deposit
Requirements in the Instructions for Form
1042.

Definitions
Withholding agent. A withholding agent
is any person, U.S. or foreign, that has
control, receipt, or custody of an amount
subject to withholding under chapter 3,
who can disburse or make payments of an
amount subject to withholding , or who
makes a withholdable payment. The
withholding agent may be an individual,
corporation, partnership, trust,
association, or any other entity. The term
withholding agent also includes, but is not
limited to, a qualified intermediary (QI), a
nonqualified intermediary (NQI), a
withholding foreign partnership (WP), a
withholding foreign trust (WT), a
flow-through entity, a U.S. branch of a
participating FFI or reporting Model 1 FFI
that is treated as a U.S. person, a
nominee under section 1446, a
participating foreign financial institution
(FFI), deemed-compliant FFI, and an
authorized agent. A person may be a
withholding agent even if there is no
requirement to withhold from a payment or
even if another person has already
withheld the required amount from a
payment.
In most cases, the U.S. person who
pays (or causes to be paid) the item of
U.S. source income to a foreign person (or
to its agent) must withhold. However,
other persons may be required to
withhold. For example, if a payment is
made by a QI (whether or not it assumes
primary withholding responsibility) and the
QI knows that withholding was not done
by the person from which it received the
payment, then that QI is required to do the
appropriate withholding. In addition,
withholding must be done by any QI that
assumes primary withholding
responsibility under chapters 3 and 4, a
WP, a WT, a U.S. branch of a foreign
financial institution or of a territory financial
institution that agrees to be treated as a
U.S. person, or an authorized foreign
agent. Finally, if a payment is made by an
NQI or a flow-through entity that knows, or
has reason to know, that withholding was
not done, that NQI or flow-through entity is
required to withhold since it also falls
within the definition of a withholding agent.
Account holder. Generally, the account
holder is the person that holds the
account. See Regulations section
1.1471-5(a).
Authorized agent. An agent is an
authorized agent for purposes of acting as
a reporting agent for filing Form 1042 or
-3-

making tax deposits and payments only if
all five of the following conditions apply.
1. There is a written agreement
between the withholding agent and the
person acting as agent.
2. A Form 8655, Reporting Agent
Authorization, is filed with the IRS.
3. The books and records and
relevant personnel of the agent are
available to the withholding agent.
4. The withholding agent remains fully
liable for the acts of its agent and does not
assert any of the defenses that otherwise
may be available, and
5. If the agent is making deposits and
tax payments or filing Forms 1042-S on
behalf of its principal, the agent should be
included as the payor on Form 1042-S,
box 21.
For complete details on these
conditions, see Regulations sections
1.1441-7(c) and 1.1474-1(a)(3)(ii).
Beneficial owner. For payments other
than those for which a reduced rate of
withholding is claimed under an income
tax treaty, the beneficial owner of income
in most cases is the person who is
required under U.S. tax principles to
include the income in gross income on a
tax return. A person is not a beneficial
owner of income, however, to the extent
that person is receiving the income as a
nominee, agent, or custodian, or to the
extent the person is a conduit whose
participation in a transaction is
disregarded. In the case of amounts paid
that do not constitute income, beneficial
ownership is determined as if the payment
were income.
Foreign partnerships, foreign simple
trusts, and foreign grantor trusts are not
the beneficial owners of income paid to
the partnership or trust. The beneficial
owners of income paid to a foreign
partnership in most cases are the partners
in the partnership, provided that the
partner is not itself a partnership, foreign
simple or grantor trust, nominee, or other
agent. The beneficial owner of income
paid to a foreign simple trust (a foreign
trust that is described in section 651(a)) in
most cases is the beneficiary of the trust, if
the beneficiary is not a foreign partnership,
foreign simple or grantor trust, nominee, or
other agent. The beneficial owner of a
foreign grantor trust (a foreign trust to the
extent that all or a part of the income of the
trust is treated as owned by the grantor or
another person under sections 671
through 679) is the person treated as the
owner of the trust. The beneficial owner of
income paid to a foreign complex trust (a
foreign trust that is not a foreign simple
trust or foreign grantor trust) is the trust
itself.

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The beneficial owner of income paid to
a foreign estate is the estate itself.
A payment to a U.S. partnership, U.S.
trust, or U.S. estate is not subject to
withholding under chapter 3 or 4. A U.S.
partnership, trust, or estate should provide
the withholding agent with a Form W-9,
Request for Taxpayer Identification
Number and Certification. In most cases,
these beneficial owner rules apply for
purposes of section 1446; however, there
are exceptions.
Disregarded entity. A business entity
that has a single owner and is not a
corporation under Regulations section
301.7701-2(b) is disregarded as an entity
separate from its owner.
Dividend equivalent. To the extent
specified in section 871(m), and the
regulations thereunder, a dividend
equivalent is a payment that, directly or
indirectly, is contingent on, or determined
by reference to, the payment of a dividend
from U.S. sources. Dividend equivalent
payments include the following payments.
1. A substitute dividend made under a
securities lending or sale-repurchase
transaction involving a U.S. stock,
2. A payment made under a specified
notional principal contract, and
3. Any payment determined by the
IRS to be substantially similar to a
payment in (1) or (2).
Exempt recipient. An exempt recipient is
any payee that is exempt from the Form
1099 reporting requirements.
Expatriate. A person is considered an
expatriate if he or she relinquishes U.S.
citizenship or, in the case of a long-term
resident of the United States, ceases to be
a lawful permanent resident as defined in
section 7701(b)(6).
Fiscally transparent entity. An entity is
treated as fiscally transparent with respect
to an item of income for which treaty
benefits are claimed to the extent that the
interest holders in the entity must, on a
current basis, take into account separately
their shares of an item of income paid to
the entity, whether or not distributed, and
must determine the character of the items
of income as if they were realized directly
from the sources from which realized by
the entity. For example, partnerships,
common trust funds, and simple trusts or
grantor trusts in most cases are
considered to be fiscally transparent with
respect to items of income received by
them.
Flow-through entity. A flow-through
entity is a foreign partnership (other than a
withholding foreign partnership), a foreign
simple or grantor trust (other than a
withholding foreign trust), or, for any
payments for which a reduced rate of

withholding under an income tax treaty is
claimed, any entity to the extent the entity
is considered to be fiscally transparent
under section 894 with respect to the
payment by an interest holder's
jurisdiction.
Financial Institution. A financial
institution (FI) is an entity described in
Regulations section 1.1471-5(e).
Foreign Financial Institution. A foreign
financial institution (FFI) is an entity
described in Regulations section
1.1471-5(e) or as a financial institution
under an Intergovernmental Agreement
(IGA).
Deemed-Compliant FFI. A
deemed-compliant FFI is a foreign
financial institution that is deemed to
satisfy the requirements of section
1471(b) and is either a
certified-deemed-compliant FFI or
registered-deemed-compliant FFI
(including a reporting Model 1 FFI). See
Regulations sections 1.1471-1(b)(12),
(105), and (107) for the definition of
certified deemed-compliant FFI,
registered-deemed-compliant FFI, and
Reporting Model 1 FFI.
Nonparticipating FFI. A nonparticipating
FFI is a foreign financial institution that is
not a participating FFI, deemed-compliant
FFI, or exempt beneficial owner.
Participating FFI. A participating FFI is a
foreign financial institution that has agreed
to satisfy the obligations of an FFI
agreement under chapter 4, including an
FFI described in a Model 2 IGA that has
agreed to comply with the requirements of
an FFI agreement. See Regulations
section 1.1471-1(b)(73) for the definition
of a Model 2 IGA.
Foreign person. A foreign person
includes a nonresident alien individual, a
foreign corporation, a foreign partnership,
a foreign trust, a foreign estate, and any
other person that is not a U.S. person. The
term also includes a foreign branch or
office of a U.S. financial institution or U.S.
clearing organization if the foreign branch
is a QI. A payment to a U.S. branch of a
foreign person is treated as a payment to
a foreign person for purposes of Form
1042-S.
Global intermediary identification
number. The global intermediary
identification number (GIIN) is the
identification number that is assigned to a
participating FFI or registered
deemed-compliant FFI (including a
Reporting Model 1 FFI).
Intermediary. An intermediary is a
person that acts as a custodian, broker,
nominee, or otherwise as an agent for
another person, regardless of whether that
other person is the beneficial owner of the
-4-

amount paid, a flow-through entity, or
another intermediary.
Qualified intermediary (QI). A QI is
an intermediary that is a party to a
withholding agreement with the IRS. A QI
that is a financial institution must also
agree to the requirements of a
participating FFI or registered
deemed-compliant FFI for chapter 4
purposes. An entity must indicate its
status as a QI on a Form W-8IMY
submitted to a withholding agent. For
information on a QI withholding
agreement, see www.irs.gov/Businesses/
Corporations/Qualified-Intermediaries(QI).
A branch of a financial institution may
not act as a QI in a country that does not
have approved know-your-customer
(KYC) rules. Countries having approved
KYC rules are listed on IRS.gov. Branches
that operate in non-KYC approved
jurisdictions as intermediaries are required
to act as nonqualified intermediaries.
Nonqualified intermediary (NQI). An
NQI is any intermediary that is not a U.S.
person and that is not a QI.
Private arrangement intermediary
(PAI). A QI may enter into a contractual
agreement with another intermediary that
is a registered deemed-compliant or
certified deemed-compliant FFI under
which the other intermediary generally
agrees to perform all of the obligations of
the QI with respect to the accounts
maintained directly by the other
intermediary. See the QI Agreement for
the requirements of a PAI and a QI's
agreement with a PAI.
Nonfinancial foreign entity. A
nonfinancial foreign entity (NFFE) is a
foreign entity or an entity incorporated or
organized under the laws of any U.S.
territory that is not a financial institution.
Excepted Nonfinancial foreign entity.
The term excepted NFFE means an NFFE
that is described in Regulations section
1.1472-1(c)(1) and generally includes a
publicly traded corporation, certain
affiliated entities related to a publicly
traded corporation, certain territories
entities, active NFFEs, and excluded FFIs
described in Regulations section
1.1471-5(e)(5).
Non-exempt recipient. A non-exempt
recipient is any person who is not an
exempt recipient under chapter 61 of the
Code.
Nonresident alien individual. Any
individual who is not a citizen or resident
of the United States is a nonresident alien
individual. An alien individual meeting
either the green card test or the
substantial presence test for the calendar
year is a resident alien. Any person not
meeting either test is a nonresident alien
Instructions for Form 1042-S (2014)

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individual. Additionally, an alien individual
who is a resident of a foreign country
under the residence article of an income
tax treaty, or an alien individual who is a
bona fide resident of Puerto Rico, Guam,
the Commonwealth of the Northern
Mariana Islands, the U.S. Virgin Islands, or
American Samoa, is a nonresident alien
individual. See Pub. 519, U.S. Tax Guide
for Aliens, for more information on resident
and nonresident alien status.
Even though a nonresident alien
individual married to a U.S.
CAUTION
citizen or resident alien may
choose to be treated as a resident alien for
certain purposes (for example, filing a joint
income tax return), such individual is still
treated as a nonresident alien for
withholding tax purposes.

!

Payer. A payer is the person for whom
the withholding agent acts as a paying
agent pursuant to an agreement whereby
the withholding agent agrees to withhold
and report a payment.
Payee. Except as otherwise provided, the
payee is the person to whom a payment is
made, regardless of whether such person
is the beneficial owner of the amount or
treated as the recipient of the payment for
purposes of reporting on Form 1042-S.
See Regulations section 1.1471-3(a).
Presumption rules. For withholdable
payments and for amounts subject to
withholding under chapter 3, the
presumption rules are those rules that a
withholding agent must follow to
determine the status of a beneficial owner
or payee (for example, as a U.S. person or
a foreign person) when it cannot reliably
associate a payment with valid
documentation. See, for example,
Regulations sections 1.1441-1(b)(3),
1.1441-4(a), 1.1441-5(d) and (e),
1.1441-9(b)(3), 1.1446-1(c)(3), and
1.6049-5(d). Also see Pub. 515. For a
withholdable payment (defined in
Regulations section 1.1473-1(a)), the
withholding agent must also follow the
presumption rules under Regulations
sections 1.1471-3(f) and, if applicable, for
an FFI, 1.1471-4(c)(4)(i) to determine the
chapter 4 status of the payee when it
cannot reliably associate a payment with
valid documentation.
Publicly traded partnership (PTP). A
PTP is any partnership in which interests
are regularly traded on an established
securities market (regardless of the
number of its partners). However, it does
not include a PTP treated as a corporation
under section 7704.
Qualified securities lender (QSL). A
QSL is a foreign financial institution that
satisfies all of the following.
It is a bank, custodian, broker-dealer, or
clearing organization that is regulated by
Instructions for Form 1042-S (2014)

the government in its home jurisdiction
and that regularly borrows and lends the
securities of U.S. corporations to
unrelated customers.
It is subject to audit by the IRS under
section 7602 or by an external auditor if it
is a QI.
It provides to the withholding agent an
annual certification of its QSL status.
It meets the requirements to qualify as a
QSL provided in Notice 2010-46 for the
transition period and until additional
published guidance is issued. See Notice
2010-46, 2010-24 I.R.B. 757, available at
www.irs.gov/irb/2010-24_IRB/ar09.html.
Recalcitrant account holder. Generally,
a recalcitrant account holder is an account
holder of a participating or
deemed-compliant FFI that failed to
provide the documentation required under
chapter 4 to determine the account
holder's status or to report the account as
a U.S. account. See Regulations section
1.1471-5(g).
Recipient. For chapter 3 purposes, a
recipient includes any of the following.
A beneficial owner of income.
A QI.
A WP or WT.
A U.S. branch of a participating FFI or
Reporting Model 1 FFI that is treated as a
U.S. person.
A foreign partnership or a foreign trust
(other than a WP or WT), but only to the
extent the income is effectively connected
with its conduct of a trade or business in
the United States.
A payee who is not known to be the
beneficial owner, but who is presumed to
be a foreign person under the presumption
rules.
A PAI.
A partner receiving a distribution of
effectively connected income from a PTP
or nominee.
A QSL.
For chapter 3, a recipient does not
include any of the following.
An NQI.
A nonwithholding foreign partnership, if
the income is not effectively connected
with its conduct of a trade or business in
the United States.
A disregarded entity, other than a
hybrid entity.
A foreign trust that is described in
section 651(a) (a foreign simple trust) if
the income is not effectively connected
with the conduct of a trade or business in
the United States.
A foreign trust to the extent that all or a
part of the trust is treated as owned by the
grantor or other person under sections
671 through 679 (a foreign grantor trust).
A U.S. branch that is not treated as a
U.S. person unless the income is, or is
treated as, effectively connected with the
-5-

conduct of a trade or business in the
United States.
For chapter 4 purposes, a recipient
includes any of the following.
A recalcitrant account holder.
A QI.
A WP or WT.
A PAI.
A participating FFI.
A registered deemed-compliant FFI.
A certified deemed-compliant FFI that is
the beneficial owner, including a
nonreporting FFI under a Model 1 or 2 IGA
A U.S. branch of a participating FFI or
Reporting Model 1 FFI treated as a U.S.
person.
A territory FI treated as a U.S. person
that is a flow-through entity or acting as an
intermediary.
An NFFE that is not a flow-through
entity or acting as an intermediary.
A foreign partnership or a foreign trust
(other than a WP or WT), but only to the
extent the income is effectively connected
with its conduct of a trade or business in
the United States.
A partner or beneficiary of a
flow-through entity that is an NFFE (other
than a WP or WT).
A nonparticipating FFI.
An exempt beneficial owner.
For chapter 4 purposes, a recipient is
generally the same person that is a
recipient for chapter 3 purposes but does
not include any of the following.
An account holder, partner, beneficiary,
owner, or payee of a nonparticipating FFI
unless it is an exempt beneficial owner.
A participating FFI or registered
deemed-compliant FFI if the withholding
agent issues a Form 1042-S to the FFI’s
account holder, partner, owner, or payee.
Specified notional principal contract
(SNPC). An SNPC is any notional
principal contract that satisfies one or
more of the following.
In connection with entering into the
contract, any long party to the contract
transfers the underlying security to any
short party to the contract.
In connection with the termination of the
contract, any short party to the contract
transfers the underlying security to any
long party to the contract.
The underlying security is not readily
tradable on an established securities
market.
In connection with entering into the
contract, the underlying security is posted
as collateral by any short party to the
contract with any long party to the
contract.
The IRS identifies the contract as an
SNPC.
Territory FI. A territory FI is a financial
institution that is incorporated or organized
under the law of any U.S. territory and is

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not an investment entity. See Regulations
section 1.1471-5(e)(1)(iii) for the definition
of investment entity.
U.S. branch treated as a U.S. person.
A U.S. branch of a participating FFI or
reporting Model 1 FFI may agree to be
treated as a U.S. person if it meets the
requirements described in the regulations
under chapter 3. See Regulations section
1.1441-1(b)(2). Additionally, a territory FI
may agree to be treated as a U.S. person.
The U.S. branch must provide a Form
W-8IMY evidencing that it is agreeing to
be treated as a U.S. person.
A U.S. branch that is treated as a
U.S. person is treated as such
CAUTION
solely for purposes of
determining whether a payment is subject
to withholding. The branch is, for purposes
of information reporting, a foreign person,
and payments to such a branch must be
reported on Form 1042-S.

!

Withholding certificate. The term
“withholding certificate” refers to Form
W-8 or Form W-9 in most cases.
Note. Throughout these instructions, a
reference to or mention of “Form W-8” is a
reference to Forms W-8BEN, W-8BENE,
W-8ECI, W-8EXP, and/or W-8IMY.
Withholding foreign partnership (WP)
or withholding foreign trust (WT). A
WP or WT is a foreign partnership or trust
that has entered into a withholding
agreement with the IRS in which it agrees
to assume primary withholding
responsibility for all payments that are
made to it for its partners, beneficiaries, or
owners under chapter 3 (except for
sections 1445 and 1446) and under
chapter 4. For information on these
withholding agreements, see Regulations
section 1.1441-5.
Nonwithholding foreign partnership
(NWP) or nonwithholding foreign trust
(NWT). An NWP or NWT is any
partnership or trust (other than a complex
trust) that is not a U.S. person and that is
not a WP or WT.

Amounts Subject to
Reporting on Form 1042-S

Amounts subject to reporting on Form
1042-S are amounts paid to foreign
persons (including persons presumed to
be foreign) that are reportable amounts
under chapters 3 and 4, even if no amount
is deducted and withheld from the
payment because of a treaty or Code
exception to taxation or if any amount
withheld was repaid to the payee.
Amounts subject to reporting are amounts
from sources within the United States that
constitute (a) fixed or determinable annual
or periodical (FDAP) income (including
deposit interest); (b) certain gains from the

disposal of timber, coal, or domestic iron
ore with a retained economic interest; and
(c) gains relating to contingent payments
received from the sale or exchange of
patents, copyrights, and similar intangible
property. Amounts subject to reporting
also include distributions of effectively
connected income by a publicly traded
partnership. Amounts subject to reporting
on form 1042-S include, but are not limited
to, the following amounts to the extent
from U.S. sources.
Interest on deposits. Interest
described in section 871(i)(2)(A)
aggregating $10 or more paid with respect
to a deposit maintained at an office within
the United States if such interest is paid to
a nonresident alien individual who is a
resident of a country identified, in
Revenue Procedure 2012-24 (or a
superseding Revenue Procedure) as of
December 31, prior to the calendar year in
which the interest is paid. A payor may
elect to report interest described above
paid to any nonresident alien individual by
reporting all such interest. See Revenue
Procedure 2012-24 (or superseding
Revenue Procedure) for the current list of
countries with which the United States has
in effect an income tax or other convention
or bilateral agreement relating to
exchange information within the meaning
of section 6103(k)(4).
When completing Form 1042-S, use
income code 29 in box 1 and exemption
code 02 in box 3a for chapter 3 purposes
and the applicable chapter 4 exemption
code in box 4a, if any, (see the
instructions for box 3a and 3b later).
On the statements furnished to the
recipient, you must include a statement
that the information on the form is being
furnished to the United States Internal
Revenue Service.
Interest on deposits subject to
chapter 4 withholding. Interest on
deposit from U.S. sources are
withholdable payments and,
therefore,may be subject to withholding
under chapter 4 and, in such case,
reporting is required.
Corporate distributions. The entire
amount of a corporate distribution
(whether actual or deemed) must be
reported, regardless of any estimate of the
part of the distribution that represents a
taxable dividend. Any distribution,
however, that is treated as gain from the
redemption of stock is not an amount
subject to withholding. For information on
dividends paid by a qualified investment
entity (QIE), see Pub. 515.
Interest. This includes the part of a
notional principal contract payment that is
characterized as interest.
Rents.
Royalties.

-6-

Compensation for independent
personal services performed in the
United States.
Compensation for dependent
personal services performed in the
United States (but only if the beneficial
owner is claiming treaty benefits).
Annuities.
Pension distributions and other
deferred income.
Most gambling winnings. However,
proceeds from a wager placed in
blackjack, baccarat, craps, roulette, or
big-6 wheel are not amounts subject to
reporting.
Cancellation of indebtedness.
Income from the cancellation of
indebtedness must be reported unless the
withholding agent is unrelated to the
debtor and does not have knowledge of
the facts that give rise to the payment.
Effectively connected income (ECI).
ECI includes amounts that are (or are
presumed to be) effectively connected
with the conduct of a trade or business in
the United States even if no withholding
certificate is required. Note that bank
deposit interest is subject to Form 1042-S
reporting if it is ECI or otherwise reportable
on Form 1042-S (see interest on deposits,
earlier). ECI of a PTP distributed to a
foreign partner must be reported on Form
1042-S.
Notional principal contract income.
Income from notional principal contracts
that the payer knows, or must presume, is
effectively connected with the conduct of a
U.S. trade or business is subject to
reporting using income code 32. The
amount to be reported is the amount of
cash paid on the contract during the
calendar year. Any amount of interest
determined under the provisions of
Regulations section 1.446-3(g)(4) (dealing
with interest in the case of a significant
non-periodic payment) is reportable as
interest and not as notional principal
contract income. See, however, the
separate reporting for U.S.-source
dividend equivalent payments.
Insurance premiums. Insurance
premiums for U.S. sources are
withholdable payments and, therefore,
may be subject to withholding under
chapter 4 and, in such case, reporting is
required.
REMIC excess inclusions. Excess
inclusions from REMICs (income code 02)
and withheld tax must be reported on
Form 1042-S. A domestic partnership
must separately state a partner's allocable
share of REMIC taxable income or net
loss and the excess inclusion amount on
Schedule K-1 (Form 1065). If the
partnership allocates all or some part of its
allocable share of REMIC taxable income
to a foreign partner, the partner must
include the partner's allocated amount in
income as if that amount was received on
Instructions for Form 1042-S (2014)

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the earliest to occur of (1) the date of
distribution by the partnership; (2) the date
the foreign partner disposes of its indirect
interest in the REMIC residual interest; or
(3) the last day of the partnership's tax
year.
The partnership must withhold tax on
the part of the REMIC amount that is an
excess inclusion.
An excess inclusion allocated to the
following foreign persons must be
included in that person's income at the
same time as other income from the entity
is included in income.
Shareholder of a real estate investment
trust.
Shareholder of a regulated investment
company.
Participant in a common trust fund.
Patron of a subchapter T cooperative
organization.
Students, teachers, and
researchers. Amounts paid to foreign
students, trainees, teachers, or
researchers as scholarship or fellowship
income, and compensation for personal
services (whether or not exempt from tax
under an income tax treaty), must be
reported. However, amounts that are
exempt from tax under section 117 are not
subject to reporting.
Amounts paid to foreign
governments, foreign controlled banks
of issue, and international
organizations. These amounts are
subject to reporting even if they are
exempt from chapter 3 withholding section
892 or 895.
Foreign targeted registered
obligations. Interest paid on registered
obligations targeted to foreign markets
paid by a U.S. person to a foreign person
other than a financial institution or a
member of a clearing organization is an
amount subject to reporting.
Original Issue Discount (OID) from
the redemption of an OID obligation.
The amount subject to reporting is the
amount of OID actually includible in the
gross income of the foreign beneficial
owner of the income, if known. Otherwise,
the withholding agent should report the
entire amount of OID as if the recipient
held the instrument from the date of
original issuance. See Pub. 1212, Guide
to Original Issue Discount (OID)
Instruments.
Certain dispositions of U.S. real
property interests. See Withholding on
Dispositions of U.S. Real Property
Interests by Publicly Traded Trusts and
Qualified Investment Entities (QIEs), later.
Other U.S.-source dividend
equivalent payments. Other U.S.-source
dividend equivalent payments are
payments other than substitute dividends
that qualify as U.S.-source dividends
under section 871(m) and the regulations
Instructions for Form 1042-S (2014)

thereunder. Report these amounts using
income code 40.
Guarantee of indebtedness. This
includes amounts paid, directly or
indirectly, for the provision of a guarantee
of indebtedness issued after September
27, 2010. They must be paid by a
non-corporate resident or U.S. corporation
or by any foreign person if the amounts
are effectively connected with the conduct
of a U.S. trade or business. Report these
amounts using income code 41.
Specified Federal procurement
payments. Specified Federal
procurement payments subject to
withholding under section 5000C.

Amounts That Are Not
Subject to Reporting
on Form 1042-S
Interest and OID from short-term obligations. Interest and OID from any
obligation payable 183 days or less from
the date of original issue should not be
reported on Form 1042-S. See, however,
the reporting requirements for deposit
interest described earlier.
Registered obligations targeted to foreign markets. Interest on a registered
obligation that is targeted to foreign
markets and that qualifies as portfolio
interest is not subject to reporting if it is
paid to a registered owner that is a
financial institution or member of a
clearing organization and you have
received the required certifications.
Reporting is required on interest
paid on any registered obligation
CAUTION
(regardless of whether targeted
to foreign markets) if the registered
obligation is issued after March 18, 2012.
You must file Form 1042-S to report this
interest.

!

Bearer obligations targeted to foreign
markets. Do not file Form 1042-S to
report interest not subject to withholding
on bearer obligations if a Form W-8 is not
required.
Withholding is required on
interest paid on any bearer
CAUTION
obligations targeted to foreign
markets even if the obligation is issued
after March 18, 2012. You must file Form
1042-S to report this interest.

!

Notional principal contract payments
that are not ECI. Amounts paid on a
notional principal contract other than a
specified notional principal contract
(SNPC) other than income that is not
effectively connected with the conduct of a
trade or business in the United States
should not be reported on Form 1042-S.
All amounts paid on an SNPC that are
treated as dividend equivalent payments
-7-

should be reported as such on Form
1042-S.
Accrued interest and OID. Interest paid
on obligations sold between interest
payment dates and the part of the
purchase price of an OID obligation that is
sold or exchanged in a transaction other
than a redemption is not subject to
reporting unless the sale or exchange is
part of a plan, the principal purpose of
which is to avoid tax, and the withholding
agent has actual knowledge or reason to
know of such plan.
Escrowed Amounts. Amounts withheld
but not deposited under an escrow
procedure permitted under chapter 3 and
4 when the withholding agent is not
required to deposit the tax withheld during
the calendar year. A withholding agent
should also report on Form 1042-S the
gross income paid and amounts withheld
but determined not to be due under an
escrow procedure applied in a prior year
when the deposit becomes due or is
determined not to be due during the
current calendar year. See Regulations
sections 1.1471-2(a)(5)(ii) or 1.1471-4(b)
(6). See the instructions for box 2 and
box 7.

Withholding on
Dispositions of U.S. Real
Property Interests by
Publicly Traded Trusts
and Qualified Investment
Entities (QIEs)

In general, when a publicly traded trust
makes a distribution to a foreign person
attributable to the disposition of a U.S. real
property interest, it must withhold tax
under section 1445. However, this
withholding liability is shifted to the person
who pays the distribution to a foreign
person (or to the account of the foreign
person) if the special notice requirement
of Regulations section 1.1445-8(f) and
other requirements of Regulations section
1.1445-8(b)(1) are satisfied.
The amount subject to withholding for a
distribution by a publicly traded trust is
determined under the large trust rules of
Regulations section 1.1445-5(c)(3).
The rate of withholding is as follows:
1. Distribution by a publicly traded
trust that makes recurring sales of growing
crops and timber—10%.
2. Distribution by a publicly traded
trust not described in (1) above—35%.
Special rules apply to qualified
investment entities (QIEs). A QIE is one of
the following.
A real estate investment trust (REIT).
A regulated investment company (RIC)
that is a U.S. real property holding

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corporation. The special rule for a RIC
applies only for distributions by the RIC
that are directly or indirectly attributable to
distributions the RIC received from a
REIT.
In most cases, any distribution from a QIE
attributable to gain from the sale or
exchange of a U.S. real property interest is
treated as such gain by the nonresident
alien, foreign corporation, or other QIE
receiving the distribution.
A distribution by a QIE to a nonresident
alien or foreign corporation that is treated
as gain from the sale or exchange of a
U.S. real property interest by the
shareholder is subject to withholding at
35%.
Any distribution by a QIE on stock
regularly traded on a securities market in
the United States is not treated as gain
from the sale or exchange of a U.S. real
property interest if the shareholder did not
own more than 5% of that stock at any
time during the 1-year period ending on
the date of the distribution. These
distributions are included in the
shareholder's gross income as a dividend
(income code 06) from the QIE, not as
long-term capital gain.
Use Forms 1042-S and 1042 to report
and pay over the withheld amounts. All
other withholding required under section
1445 is reported and paid over using Form
8288, U.S. Withholding Tax Return for
Dispositions by Foreign Persons of U.S.
Real Property Interests, and Form 8288-A,
Statement of Withholding on Dispositions
by Foreign Persons of U.S. Real Property
Interests.
For more information on reporting
income from real property interests, see
U.S. Real Property Interest in Pub. 515.

Publicly Traded
Partnerships (Section
1446 Withholding Tax)

A publicly traded partnership (PTP)
(defined earlier in Definitions) that has
effectively connected income, gain, or loss
must pay a withholding tax on distributions
of that income made to its foreign partners
and file Form 1042-S using income code
27. A nominee that receives a distribution
of effectively connected income from a
PTP is treated as the withholding agent to
the extent of the amount specified in the
qualified notice received by the nominee.
For this purpose, a nominee is a domestic
person that holds an interest in a PTP on
behalf of a foreign person. See
Regulations section 1.1446-4 and Pub.
515 for details.

If you are a nominee that is the
withholding agent under section
1446, enter the PTP's name and
other required information in boxes 15
through 16f on Form 1042-S.

TIP

Other partnerships that have effectively
connected gross income allocable to
foreign partners must pay a withholding
tax under section 1446. These amounts
are reported on Form 8804, Annual Return
for Partnership Withholding Tax (Section
1446), and Form 8805, Foreign Partner's
Information Statement of Section 1446
Withholding Tax.

Payments by U.S.
Withholding Agents
In general. U.S. withholding agents
making payments described under
Amounts Subject to Reporting on Form
1042-S, earlier, must file a separate Form
1042-S for each recipient who receives
the income. Furthermore, withholding
agents filing paper Forms 1042-S are not
permitted to report multiple types of
income on copy A filed with the IRS.
These filers must use a separate Form
1042-S for information reportable on a
single type of income.
These filers cannot use a single
Form 1042-S to report income if
CAUTION
that income is reportable under
different income, recipient, or exemption
codes, or is subject to different rates of
withholding.

!

See Payments Made to Persons Who
Are Not Recipients, later, if the payment is
made to a foreign person that is not a
recipient.

Payments to Recipients
Payments directly to beneficial owners. A U.S. withholding agent making a
payment directly to a beneficial owner
must complete Form 1042-S and treat the
beneficial owner as the recipient. Boxes
15 through 16f should be left blank. The
Form 1042-S must also include the
appropriate chapter 4 and chapter 3
exemption codes, if applicable, in boxes
3a and 4a as well as the appropriate
recipient codes for the chapter 4 and
chapter 3 status codes for a payment that
is a withholdable payment and an amount
subject to chapter 3 withholding. U.S.
withholding agent should complete box 21
only if it is completing Form 1042-S as a
paying agent acting pursuant to an
agreement to act as an authorized agent
for filing and reporting Form 1042 and
1042-S.
Under a grace period rule, a U.S.
withholding agent may, under certain
circumstances, escrow amounts withheld
under chapter 3 or 4 while the withholding
agent waits for a payee and/or the
-8-

beneficial owner to provide a valid
withholding certificate. A U.S. withholding
agent who relies on the grace period rule
must file Form 1042-S to report all
payments during the period and any
amounts withheld, regardless of whether
the withholding agent was required to
deposit such amounts during the calendar
year under the applicable escrow
procedure, and even if that person is later
determined to be a U.S. person based on
appropriate documentation after the grace
period ends. See Regulations sections
1.1441-1(b)(3)(iv) and 1.1471-2(a).
In the case of foreign joint owners, you
may provide a single Form 1042-S made
out to the owner whose status you relied
upon to determine the applicable rate of
withholding (the owner subject to the
highest rate of withholding). If, however,
any one of the owners requests its own
Form 1042-S, you must furnish a Form
1042-S to the person who requests it, and
you should amend the originally filed Form
1042-S. If more than one Form 1042-S is
issued for a single payment, the aggregate
amount paid and tax withheld that is
reported on all Forms 1042-S cannot
exceed the total amounts paid to joint
owners and the tax withheld on those
payments.
Payments to a qualified intermediary,
withholding foreign partnership, or
withholding foreign trust. A U.S.
withholding agent that makes payments to
a QI (whether or not the QI assumes
primary withholding responsibility), a
withholding foreign partnership (WP), or a
withholding foreign trust (WT) should
complete Form 1042-S in most cases,
treating the QI, WP, or WT as the
recipient. However, see Payments
allocated, or presumed made, to U.S.
non-exempt recipients., later for
exceptions. A QI that does not assume
primary withholding responsibility is
required to provide information regarding
the proportions of income subject to a
particular withholding rate to the
withholding agent on the withholding
statement associated with its Form
W-8IMY. In such a case, the U.S.
withholding agent must complete a
separate Form 1042-S for each
withholding rate pool of the QI. For
purposes of chapter 4, the withholding
agent must complete a Form 1042-S for
payments withheld upon under chapter 4
determined in accordance with the income
codes used to file Form 1042-S. For
chapter 3 purposes, a withholding rate
pool is a payment of a single type of
income, determined in accordance with
the income codes used to file Form
1042-S, that is subject to a single rate of
withholding. A QI that assumes primary
withholding responsibility, a WP, or a WT
is not required to provide withholding rate
pool information.
Instructions for Form 1042-S (2014)

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A U.S. withholding agent making
payments to a QI (whether or not the QI
assumes primary withholding
responsibility), a WP, or a WT must use
recipient code 12 (qualified intermediary),
13 (qualified Intermediary- Branch under
Qualified Intermediary Agreement), 09
(withholding foreign partnership), or 11
(withholding foreign trust) as the chapter 3
status code and must use recipient code
08 (participating FFI- Other), 09
(participating FFI- Reporting Model 2 FFI),
10 (registered Deemed-Compliant FFIReporting Model 1 FFI), 11 (registered
Deemed-Compliant FFI- Sponsoring
Entity), or 12 (registered
Deemed-Compliant FFI- Other) as the
chapter 4 status code if the entity is an
FFI. A U.S. withholding agent must not
use any chapter 3 pooled reporting code
(code 15 or 16) or any chapter 4 pooled
reporting code (code 35-42). Use of an
inappropriate recipient code may cause a
notice to be generated.
A QI, WP, or WT is required to act
in such capacity only for
CAUTION
designated accounts. Therefore,
such an entity also may provide a Form
W-8IMY in which it certifies that it is acting
as an NQI or flow-through entity for other
accounts and, if its an FFI, that it's a
participating FFI or registered
deemed-compliant FFI. A U.S. withholding
agent that receives a Form W-8IMY on
which the foreign person providing the
form indicates that it is not acting as a QI,
WP, or WT may not treat the foreign
person as a recipient except as otherwise
provided in these instructions. A
withholding agent must not use the EIN
that a QI, WP, or WT provides in its
capacity as such to report payments that
are treated as made to an entity in its
capacity as an NQI or flow-through entity.
In that case, use the GIIN, or EIN, if any,
that is provided by the entity on its Form
W-8IMY in which it claims that it is acting
as an NQI or flow-through entity.

!

Note. A withholding agent is required to
use the chapter 4 reporting pool codes as
the chapter 4 status code in the case of
payments made to a QI with respect to its
non-designated QI accounts and in the
case of payments made to a participating
FFI or registered deemed-compliant FFI
that is an NQI, NWP, or NWT provided
such QI, NQI, NWP, or NWT provides
chapter 4 reporting pool information in the
withholding statement associated with its
Form W-8IMY. See the presumption rules
under Regulations section 1.1471-3(f)(5) if
such information is not provided.
Example 1. WA, a U.S. withholding
agent, makes a payment of U.S. source
dividends to QI, a qualified intermediary
that does not assume primary withholding
responsibility and that is a participating
Instructions for Form 1042-S (2014)

FFI. QI provides WA with a valid Form
W-8IMY with which it associates a
withholding statement that allocates 95%
of the payment to a chapter 3, 15%
withholding rate pool and 5% of the
payment to a chapter 4, 30% withholding
rate pool. WA must complete a Form
1042-S, for the dividends allocated to the
chapter 3, 15% withholding rate pool,
showing “15.00” in box 3b (chapter 3 tax
rate), “00” in box 3a (chapter 3 exemption
code), chapter 4 exemption code 15
(payee not subject to chapter 4
withholding) in box 4a, “00.00” in box 4b
(chapter 4 tax rate) and QI as the recipient
in box 14a along with recipient code 12
(qualified intermediary) as the chapter 3
status code and recipient code 08
(participating FFI- other) as the chapter 4
status code. WA must also complete a
Form 1042-S, for the dividends allocated
to the chapter 4, 30% withholding rate
pool, showing chapter 3 exemption code
12 (payee subjected to chapter 4
withholding) in box 3a,“00.00” in box 3b
(chapter 3 tax rate), “00” in box 4a)
(chapter 4 exemption code), and “30.00”
in box 4b with QI as the recipient in
box 13a and recipient code 12 (qualified
intermediary) as the chapter 3 status code
and recipient code 08 (participating
FFI-other) as the chapter 4 status code.
Payments allocated, or presumed
made, to U.S. non-exempt recipients.
A QI may provide Forms W-9 or other
information regarding U.S. non-exempt
recipients that the QI (or other entity
maintaining the account) is not required to
report as U.S. accounts under chapter 4
and for which the QI does not assume
primary Form 1099 reporting
responsibility. QI may also provide
information regarding U.S. non-exempt
recipients that QI elects to backup
withhold under section 3406 instead of
withholding under chapter 4 on payments
made to an account holder. If Forms W-9
or other information is provided together
with information allocating all or a part of
the payment to U.S. non-exempt
recipients, you must report income
allocable to a U.S. non-exempt recipient
unless included in a pool of U.S. payees,
on the appropriate Form 1099 and not on
Form 1042-S even though you are paying
that income to a QI.
You also may be required under the
presumption rules to treat a payment
made to a QI as made to a payee that is a
U.S. non-exempt recipient from which you
must withhold on the payment under the
backup withholding provisions of the
Code. In this case, you must report the
payment on the appropriate Form 1099.
See the General Instructions for Certain
Information Returns.
Example 2. WA, a U.S. withholding
agent, makes a payment of U.S. source
-9-

dividends to QI, a qualified intermediary
and registered deemed-compliant FFI that
is a local FFI described in Regulations
section 1.1471-5(f)(1)(i)(A). QI provides
WA with a valid Form W-8IMY certifying
that it is transmitting Forms W-9 for U.S.
non-exempt recipients and with which it
associates a withholding statement that
allocates 95% of the payment to a
chapter 3 15% withholding rate pool and
5% of the payment to C, a U.S. individual.
QI also provides WA with C's Form W-9. C
is an account holder of the QI and a U.S.
citizen, resident in the QI's local
jurisdiction that QI is not required under
chapter 4 (see Regulations section
1.1471-5(f)(1)(i)(A)). WA must complete a
Form 1042-S, showing QI as the recipient
in box 14a and recipient code 12 (qualified
intermediary), for the dividends allocated
to the 15% withholding rate pool. WA also
must complete a Form 1099-DIV issued to
C reporting the part of the dividend
allocated to C.
Example 3. WA, a withholding agent,
makes a payment of U.S. source
dividends to QI, a qualified intermediary
that is a reporting Model 1 FFI. QI
provides WA with a valid Form W-8IMY
with which it associates a withholding
statement that allocates 40% of the
payment to a chapter 3, 15% withholding
rate pool and 40% to a chapter 3, 30%
withholding rate pool. QI does not provide
any withholding rate pool information
regarding the remaining 20% of the
payment. WA must apply the presumption
rule to the part of the payment (20%) that
has not been allocated. Under the
presumption rules of Regulations section
1.1471-3(f)(5), 20% of the payment is
treated as paid to a nonparticipating FFI.
WA must complete three Forms 1042-S.
First, a Form 1042-S for dividends subject
to 15% withholding, showing “00” in
box 3a (chapter 3 exemption code),
chapter 4 exemption code 15 (payee not
subject to chapter 4 withholding) in
box 4a, QI as the recipient in box 14a,
recipient code 12 (qualified intermediary)
as the chapter 3 status code, and recipient
code 08 (participating FFI-other) as the
chapter 4 status code. Second, a Form
1042-S for dividends subject to 30%
withholding, showing “00” in box 3a
(chapter 3 exemption code), chapter 4
exemption code 15 (payee not subject to
chapter 4 withholding) in box 4a, QI as the
recipient in box 14a, recipient code 12
(qualified intermediary) as the chapter 3
status code, and recipient code 08
(participating FFI-other) as the chapter 4
status code. Third, a Form 1042-S for
dividends subject to 30% withholding,
showing chapter 3 exemption code 12
(payee subjected to chapter 4
withholding), “00” in box 4a (chapter 4
exemption code), QI as the recipient in
box 14a, and recipient code 40

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(nonparticipating FFI pool) as the
chapter 4 status code.
Amounts paid to qualified securities
lenders. A withholding agent that makes
payments of substitute dividends to a
qualified securities lender (QSL) should
complete Form 1042-S treating the QSL
as the recipient. Use income code 34. Use
recipient code 16 or 17 (qualified
securities lender- qualified intermediary or
qualified securities lender-other) as the
chapter 3 status code.
The withholding agent is not required to
withhold on a substitute dividend payment
that is part of a series of dividend
equivalent payments if it receives, at least
annually, a certificate from the QSL that
includes a statement with the following
information.
The recipient of the substitute dividend
is a QSL, and
With respect to the substitute dividend it
receives from the withholding agent, the
QSL states that it will withhold and remit or
pay the proper amount of U.S. gross-basis
tax. Use exemption code 11.
If the QSL is also a QI with primary
withholding responsibility, use exemption
code 11 and not exemption code 06 for
chapter 3 purposes.
Amounts paid to certain U.S. branches. A U.S. withholding agent making a
payment to a “U.S. branch of participating
FFI or reporting model 1 FFI” (defined in
Definitions, earlier) completes Form
1042-S as follows:
If a withholding agent makes a payment
to a U.S. branch of a participating FFI or
reporting model 1 FFI that has provided
the withholding agent with a Form W-8IMY
stating that it has agreed to be treated as a
U.S. person, the U.S. withholding agent
treats the U.S. branch as the recipient.
If a withholding agent makes a payment
to a U.S. branch of a participating FFI that
has provided a Form W-8IMY to transmit
information regarding its chapter 4
reporting pools and, to the extent
applicable, recipient specific information
for chapter 3 purposes, the U.S.
withholding agent must complete a
separate Form 1042-S for each chapter 4
reporting pool treating the U.S. branch as
the recipient or, for chapter 3 purposes, for
each recipient that is a foreign person
whose documentation is associated with
the U.S. branch's Form W-8IMY. If a
payment cannot be reliably associated
with recipient documentation, the U.S.
withholding agent must complete Form
1042-S in accordance with the
presumption rules.
If a withholding agent cannot reliably
associate a payment with a Form W-8IMY
from a U.S. branch, and if a withholding
agent has both an EIN for the branch and
a valid GIIN for the home office
establishing that the U.S. branch is a

branch of a participating FFI or reporting
model 1 FFI, then the payment may be
reported on a single Form 1042-S treating
the U.S. branch as the recipient and
reporting the income as effectively
connected income.
Amounts paid to a foreign estate. If a
U.S. withholding agent makes a payment
to a foreign estate, a Form 1042-S must
be completed showing the estate as the
recipient. Use recipient code 20 (estate),
as the chapter 3 status code and the
applicable recipient code for the chapter 4
status code.
Dual claims. A U.S. withholding agent
may make a payment to a foreign entity
(for example, a hybrid entity) that is
simultaneously claiming an exemption
from chapter 4 withholding and a reduced
rate of tax under chapter 3 on its own
behalf for a part of the payment and an
exemption from chapter 4 withholding and
a reduced rate of tax under chapter 3 on
behalf of persons in their capacity as
interest holders in that entity on the
remaining part. If the claims are consistent
and the withholding agent has accepted
the multiple claims, a separate Form
1042-S must be filed for the entity for
those payments for which the entity is
treated as claiming a reduced rate of
withholding and separate Forms 1042-S
must be filed for each of the interest
holders for those payments for which the
interest holders are claiming a reduced
rate of withholding. The Forms 1042-S
must include the chapter 4 status of the
payee (including the applicable chapter 4
exemption). If the claims are consistent
but the withholding agent has not chosen
to accept the multiple claims, or if the
claims are inconsistent, a separate Form
1042-S must be filed for the person(s)
being treated as the recipient(s).
Special instructions for U.S. trusts and
estates. Report the entire amount of
income subject to reporting, regardless of
estimates of distributable net income.

Payments Made to Persons
Who Are Not Recipients
Disregarded entities. If a U.S.
withholding agent makes a payment to a
disregarded entity other than an FFI, that
is not a hybrid entity making a treaty claim
and receives a valid Form W-8BEN or
W-8ECI from a foreign person that is the
single owner of the disregarded entity, the
withholding agent must file a Form 1042-S
in the name of the foreign single owner.
The taxpayer identifying number (TIN) on
the Form 1042-S, if required, must be the
foreign single owner's TIN.
Example. WA, a withholding agent,
makes a payment of interest to LLC, a
foreign limited liability company that is not
an FFI. LLC is wholly-owned by FC, a
-10-

foreign corporation that is an excepted
non-financial foreign entity. LLC is treated
as a disregarded entity. WA has a Form
W-8BENE from FC on which it states that
it is the beneficial owner of the income
paid to LLC. WA reports the interest
payment on Form 1042-S showing FC as
the recipient. The result would be the
same if LLC was a domestic entity.
A disregarded entity can, however,
claim to be the beneficial owner of a
payment if it is a hybrid entity claiming
treaty benefits. See Form W-8BENE and
its instructions for more information. If a
disregarded entity claims on a valid Form
W-8BEN to be the beneficial owner, the
U.S. withholding agent must complete a
Form 1042-S treating the disregarded
entity as a recipient and using recipient
code 02 (corporation) as the chapter 3
status code and the applicable recipient
code for the chapter 4 status code of the
payee.
Amounts paid to a nonqualified intermediary or flow-through entity. If a
U.S. withholding agent makes a payment
to an NQI or a flow-through entity, (other
than a nonparticipating FFI), it must
complete a separate Form 1042-S for
each recipient on whose behalf the NQI or
flow-through entity acts as indicated by its
withholding statement and the
documentation associated with its Form
W-8IMY. If a payment is made through
tiers of NQIs or flow-through entities, the
withholding agent must nevertheless
complete Form 1042-S for the recipients
to which the payments are remitted. A
withholding agent completing Form
1042-S for a recipient that receives a
payment through an NQI or a flow-through
entity must include in boxes 15 through
16f of Form 1042-S the name, country
code, address, and TIN, if any, and GIIN
of the NQI or flow-through entity from
whom the recipient directly receives the
payment.
If, however, a U.S. withholding agent
makes payments to a NQI or a
flow-through entity that is a participating
FFI or registered deemed-compliant FFI
that is allocable to a chapter 4 reporting
pool as indicated by the FFI’s withholding
statement, the U.S. withholding agent
should complete a separate Form 1042-S
for each chapter 4 reporting pool (i.e., pool
of recalcitrant account holders, pool of
nonparticipating FFIs, pool of payees that
are U.S. persons) treating the participating
FFI or registered deemed-compliant FFI
as the recipient and must include the
applicable chapter 4 reporting pool code
as the chapter 4 status code. If a payment
is made through tiers of NQIs or
flow-through entities that are participating
FFIs or registered deemed-compliant
FFIs, the withholding agent must
nevertheless complete Form 1042-S for
Instructions for Form 1042-S (2014)

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each chapter 4 reporting pool to which the
payments are allocated.
If a U.S. withholding agent makes
payments to an NQI or flow-through entity
that is a participating FFI or
deemed-compliant FFI, and cannot
reliably associate the payment, or any part
of the payment, with a valid withholding
certificate (Forms W-8 or W-9) or other
valid appropriate documentation from a
recipient (either because a recipient
withholding certificate has not been
provided or because the NQI or
flow-through entity has failed to provide
the information required on a withholding
statement), the withholding agent must
follow the appropriate presumption rules
for that payment. For this purpose, if the
allocation information provided to the
withholding agent indicates an allocation
of more than 100% of the payment, then
no part of the payment should be
considered to be associated with a Form
W-8, Form W-9, or other appropriate
documentation. The Form 1042-S should
be completed treating participating FFI or
registered deemed-compliant FFI as the
recipient in box 14a and recipient code 40
(nonparticipating FFI pool) as the
chapter 4 status code. Alternatively, in the
case of a certified deemed-compliant FFI,
Form 1042-S should be completed by
entering “Unknown Recipient” in box 14a
and recipient code 33 (unknown recipient)
as the chapter 3 status code and recipient
code 17 (nonparticipating FFI) as the
chapter 4 status code. Also, the name,
country code, address, TIN, if any, of the
certified deemed-compliant FFI should be
entered in box 15 through 16f.
If a U.S. withholding agent makes
payments to an NQI or flow-through entity
that is a nonparticipating FFI, the
withholding agent must treat the payment
as made to an unknown recipient
regardless of whether it can reliably
associate the payment, or any part of the
payment, with a valid withholding
certificate (Forms W-8 or W-9) or other
valid appropriate documentation from a
recipient (See Regulations section
1.1471-3(d)(8)). The withholding agent
should complete a Form 1042-S showing
“Unknown Recipient” in box 14a and
recipient code 24 (unknown recipient) as
the chapter 3 status code and recipient
code 31 (unknown recipient) as the
chapter 4 status code. Also, the name,
country code, address, TIN, if any, of the
nonparticipating FFI should be entered on
Form 1042- S in box 15 through 16f.
If, however, an NQI or flow-through
entity that is a nonparticipating FFI
provides documentation described in
Regulations section 1.1471-3(d)(8(ii) to
establish that the payment or a portion of
the payment is beneficially owned by an
exempt beneficial owner, then the
withholding agent should complete a Form
Instructions for Form 1042-S (2014)

1042- S for each exempt beneficial owner
showing the chapter 4 exemption code 15
(payee not subject to chapter 4
withholding), the exempt beneficial owner
as the recipient in box 14a, and the name,
country code, address, TIN, if any, of the
nonparticipating FFI in box 15 through 16f.
For any remaining portion of the payment,
the withholding agent should complete a
Form 1042-S to an unknown recipient as
described directly above.
Pro-rata reporting. If the withholding
agent has agreed that an NQI (other than
a nonparticipating FFI), may provide
information allocating a payment to its
account holders under the alternative
procedure of Regulations section
1.1441-1(e)(3)(iv)(D) (no later than
February 14, 2015) and the NQI fails to
allocate more than 10% of the payment in
a withholding rate pool to the specific
recipients in the pool, the withholding
agent must file Forms 1042-S for each
recipient in the pool on a pro-rata basis. If,
however, the NQI fails to timely allocate
10% or less of the payment in a
withholding rate pool to the specific
recipients in the pool, the withholding
agent must file Forms 1042-S for each
recipient for which it has allocation
information and report the unallocated part
of the payment on a Form 1042-S.
Payments allocated, or presumed
made, to U.S. non-exempt recipients.
You may be given Forms W-9 or other
information regarding U.S. non-exempt
recipients from an NQI or flow-through
entity together with information allocating
all or a part of the payment to U.S.
non-exempt recipients. You must report
income allocable to a U.S. non-exempt
recipient on the appropriate Form 1099
and not on Form 1042-S, even though you
are paying that income to an NQI or a
flow-through entity. If, however, a
participating FFI or registered
deemed-compliant FFI provides a
withholding statement allocating all or part
of the payment to a pool of U.S. payees
along with a statement that it is reporting
its U.S. accounts under chapter 4, you
must report the income allocable to such
pool on Form 1042-S.
Example 4. FP is a nonwithholding
foreign partnership (flow-through entity)
that is a certified deemed-compliant FFI.
FP receives from WA a U.S. withholding
agent, a payment of interest described by
income code 01 (interest paid by U.S.
obligors—general). FP has three partners,
A, B, and C, all of whom are individuals.
FP provides WA with a Form W-8IMY
certifying that it is transmitting Forms W-9
for U.S. non-exempt recipients and Forms
W-8BEN from A and B and a Form W-9
from C, a U.S. non-exempt recipient. In
addition, FP provides a complete
withholding statement in association with
-11-

its Form W-8IMY that allocates the interest
payments among A, B, and C. WA must
file two Forms 1042-S, one each for A and
B, and a Form 1099-INT for C.
Example 5. The facts are the same as
in Example 4, except that FP does not
provide any documentation from its
partners. Because WA cannot reliably
associate the interest with documentation
from a payee, it must apply the
presumption rules. Under the presumption
rules of Regulations section 1.1471-3(f)
(5), the interest is deemed paid to a
nonparticipating FFI. A Form 1042-S
should be completed by entering
“Unknown Recipient” in box 14a and
recipient code 24 (unknown recipient) as
the chapter 3 status code and recipient
code 17 (nonparticipating FFI) as the
chapter 4 status code. Also, the name,
country code, address, TIN, if any, of the
certified deemed-compliant FFI should be
entered in box 15 through 16f.

Specified Federal Procurement
Payments Made to Foreign
Persons

For purposes of section 5000C, a payor of
a specified Federal procurement payment
to a foreign person must complete a Form
1042-S for payments withheld upon in the
name of the foreign person. Use the
income code 44 to report payments
subject to withholding under section
5000C. Box 2 should include the amount
of the specified Federal procurement
payments subject to withholding and Box
7 should include the amount of tax
withheld under section 5000C.

Amounts Paid by
Qualified Intermediaries
In general. For purposes of chapter 4,
the QI must complete a Form 1042-S for
payments withheld under chapter 4
determined in accordance with the income
codes used to file Form 1042-S. A QI that
is a participating FFI or registered
deemed-compliant FFI may use the
chapter 4 pooled reporting codes 35
through 41 to allocate payments made to
its recalcitrant account holders, payees
that are nonparticipating FFIs, and payees
that are U.S. persons. For payments that
are exempt from chapter 4 withholding,
and made by the QI directly to foreign
beneficial owners (or that are treated as
paid directly to beneficial owners), the QI
may report on the basis of reporting pools,
in most cases. A QI may not report on the
basis of reporting pools in the
circumstances described in
Recipient-by-Recipient Reporting, later. A
reporting pool consists of income that falls
within a particular withholding rate and
within a particular income code, chapter 4
exemption code, chapter 3 exemption
code (if applicable) or recipient code as

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determined on Form 1042-S. For
payments not subject to chapter 4
withholding, a QI may use a single
chapter 4 exemption code 15 (payees not
subject to chapter 4 withholding) and a
single chapter 3 reporting pool code 31
(Withholding rate pool --general) as the
chapter 3 status code for all reporting
pools, except for amounts paid to foreign
tax-exempt recipients for which chapter 3
reporting pool code 32 should be used.
Note, however, that a QI should use
recipient code 32 only for pooled account
holders that have claimed an exemption
based on their tax-exempt status and not
some other exemption (tax treaty or other
Code).
Example 6. QI, a qualified
intermediary, has four direct account
holders, A and B, foreign individuals, and
X and Y, foreign corporations. The
payments made to these direct account
holders are exempt from chapter 4
withholding. A and X are residents of a
country with which the United States has
an income tax treaty and have provided
documentation that establishes that they
are entitled to a lower treaty rate of 15%
on withholding of dividends from U.S.
sources. B and Y are not residents of a
treaty country and are subject to 30%
withholding on dividends. QI receives U.S.
source dividends on behalf of its four
customers. QI must file one Form 1042-S
for the 15% withholding rate pool. This
Form 1042-S must show income code 06
(dividends paid by U.S.
corporations—general) in box 1, “15.00” in
box 3b (chapter 3 tax rate), chapter 4
exemption code 15 (payee not subject to
chapter 4 withholding) in box 4a, “00.00” in
box 4b (chapter 4 tax rate), “Withholding
rate pool” in box 14a (recipient's name),
and chapter 3 reporting pool code 31
(withholding rate pool—general) as the
chapter 3 status code. QI also must file
one Form 1042-S for the 30% withholding
rate pool that contains the same
information as the Form 1042-S filed for
the 15% withholding rate pool, except that
it will show “30.00” in box 3b (chapter 3)
(tax rate).
Example 7. The facts are the same as
in Example 6, except that Y is an
organization that has tax-exempt status in
the United States and in the country in
which it is located, and A is a recalcitrant
account holder with U.S. indicia. QI must
file three Forms 1042-S. One Form
1042-S (for amounts allocable for B and
Y) will contain the same information as in
Example 6. The third Form 1042-S (for
amounts allocable to B and Y) will contain
information for the withholding rate pool
consisting of the amounts paid to X. This
Form 1042-S will show income code 06
(dividends paid by U.S.
corporations—general) in box 1,
exemption code 02 (exempt under an

Internal Revenue Code section (income
other than portfolio interest)) in box 3a,
“00.00” in box 3b (chapter 3 tax rate),
chapter 4 exemption code 15 (payee not
subject to chapter 4 withholding) in
box 4a, “00.00” in box 4b (chapter 4 tax
rate), “Zero rate withholding pool—exempt
organizations,” or similar designation, in
box 14a (recipient's name), and chapter 3
code 32, (withholding rate pool—exempt
organizations). The fourth Form 1042-S
will contain information for the recalcitrant
pool consisting of amounts paid to A. This
Form 1042-S will show income code 06
(dividends paid by U.S. corporations -general) in box 1, exemption code 12
(payee subjected to chapter 4 withholding)
in box 3a, “00.00” in box 3b (tax rate),
“00.00” in box 4a (chapter 4 exemption
code), “30.00” in box 4b (tax rate),
“recalcitrant pool-U.S. Indicia” or similar
designation, in box 14a (recipient's name),
and chapter 4 recipient code 36
(Recalcitrant pool-U.S. indicia) as the
chapter 4 status code.
Under the terms of its Qualified
Intermediary (or QI) agreement
CAUTION
with the IRS, the QI may be
required to report the amounts paid to
U.S. non-exempt recipients on Form 1099
or Form 8966 using the name, address,
and TIN of the payee to the extent those
items of information are known. These
amounts must not be reported on Form
1042-S. In addition, amounts paid to U.S.
exempt recipients are not subject to
reporting on Form 1042-S or Form 1099.

!

Amounts Paid to Private
Arrangement Intermediaries

In most cases, a QI must report payments
made to each private arrangement
intermediary (PAI) (defined earlier in
Definitions) as if the PAI's direct account
holders were its own. For purposes of
chapter 4, if the PAI is a participating FFI
or deemed-compliant FFI, a QI that is a
participating FFI or registered
deemed-compliant FFI may use the
chapter 4 reporting pool codes 35 through
41 to allocate payments made to the PAI's
recalcitrant account holders, payees that
are nonparticipating FFIs, and payees that
are U.S. persons and may treat the PAI as
the recipient on Form 1042-S. The QI may
only use chapter 4 reporting pool code 41
(U.S. payees pool), however, if the PAI
reports its U.S. accounts under chapter 4.
Otherwise, see the conditions specified in
the QI agreement. For chapter 3
purposes, if the payment is made directly
by the PAI to the recipient, the QI may
report the payment on a pooled basis. A
separate Form 1042-S is required for each
withholding rate pool of each PAI.
However, the QI must include the name
and address of the PAI and use reporting
pool code 33 or 34 (PAI- withholding rate
-12-

pool- general and PAI-withholding rate
pool-exempt organization) as the
chapter 3 status code. If the PAI is
providing recipient information from an
NQI or flow-through entity, the QI may not
report the payments on a pooled basis.
Instead, it must follow the same
procedures as a U.S. withholding agent
making a payment to an NQI or
flow-through entity.
Example. QI, a qualified intermediary,
pays U.S. source dividends to direct
account holders that are foreign persons
and beneficial owners. It also pays a part
of the U.S. source dividends to two private
arrangement intermediaries, PAI1 and
PAI2. The private arrangement
intermediaries pay the dividends they
receive from QI to foreign persons that are
beneficial owners and direct account
holders of PAI1 or PAI2. All payees are
exempt from chapter 4 withholding and
the dividends paid are subject to a 15%
rate of withholding. QI must file a Form
1042-S for the dividends paid to its own
direct account holders that are beneficial
owners. QI also must file two Forms
1042-S, one for the dividends paid to the
direct account holders of each of PAI1 and
PAI2. Each of the Forms 1042-S that QI
files for payments made to PAI1 and PAI2
must contain the name and address of
PAI1 or PAI2 and recipient code 33
(private arrangement intermediary
withholding rate pool—general) as the
chapter 3 status code.

Amounts Paid to
Certain Partnerships
and Trusts

A QI that is applying the special pool
reporting allowance provided in the QI
agreement for certain partnerships or
trusts must file separate Forms 1042-S
reflecting reporting pools for each
partnership or trust that has provided
reporting pool information in its
withholding statement. For purposes of
chapter 4, if the PAI is a
deemed-compliant FFI, a QI that is a
participating FFI or registered
deemed-compliant FFI may use the
chapter 4 reporting pool codes 35 through
41 to allocate payments made to the
partnership or trust's recalcitrant account
holders, payees that are nonparticipating
FFIs, and payees that are U.S. persons, to
the extent applicable, and may treat the
partnership or trust as the recipient on
Form 1042-S. The QI may only use
chapter 4 reporting pool code 41 (U.S.
payees pool), however, if the partnership
or trust reports its U.S. accounts under
chapter 4. Otherwise, see the conditions
specified in the QI agreement. For
chapter 3 purposes, if the payment is
made directly by the partnership or trust to
the recipient, the QI may use reporting
pool code 35 or 36 (Agent-withholding rate
Instructions for Form 1042-S (2014)

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pool-general and Agent- withholding rate
pool-exempt organization) as the
chapter 3 status code. However, to the
extent required in the QI agreement, the
QI must file separate Forms 1042-S for
partners, beneficiaries, or owners of such
partnership or trust that are indirect
partners, beneficiaries, or owners, and for
direct partners, beneficiaries, or owners of
such partnership or trust that are
intermediaries or flow-through entities.

Recipient-by-Recipient
Reporting

If a QI is not permitted to report on the
basis of reporting pools, it must follow the
same rules that apply to a U.S. withholding
agent. For chapter 3 purposes, Aa QI may
not report the following payments on a
reporting pool basis, but rather must
complete Form 1042-S for each
appropriate recipient and must provide the
applicable chapter 4 exemption code.
Payments made to another QI, QSL,
WP, or WT. The QI must complete a
Form 1042-S treating the other QI, QSL,
WP, or WT as the recipient.
Payments made to an NQI (including
an NQI that is an account holder of a
PAI). For chapter 3 purposes, the QI must
complete a Form 1042-S for each
recipient who receives the payment from
the NQI. A QI that is completing Form
1042-S for a recipient that receives a
payment through an NQI must include in
boxes 15 through 16f the name, country
code, address, TIN, and GIIN, if any, of
the NQI from whom the recipient directly
receives the payment. In the case of an
NQI that is a participating FFI or registered
deemed-compliant FFI, the QI must
complete a Form 1042-S for each pool of
recalcitrant account holders,
nonparticipating FFIs, and payees that are
U.S. persons. In such a case, the QI must
include the name and address of the NQI
as the recipient and use chapter 4 pool
reporting codes 35 through 41 as the
chapter 4 status code.
Example. QI, a qualified intermediary,
has NQI, a nonqualified intermediary that
is a participating FFI, as an account
holder. NQI has two account holders, A
and B, both recalcitrant account holders
with U.S. indicia who receive U.S. source
dividends from QI. NQI provides QI with a
valid Form W-8IMY and a complete
withholding statement that allocates the
dividends paid to NQI to recalcitrant poolU.S. indicia for both A and B. QI must
complete one Form 1042-S reporting NQI
as the recipient and using reporting pool
code 36 (recalcitrant pool-U.S. indicia) as
the chapter 4 status code.
Payments made to a flow-through entity. The QI must complete a Form 1042-S
for each recipient who receives the
payment from the flow-through entity. A QI
Instructions for Form 1042-S (2014)

that is completing a Form 1042-S for a
recipient that receives a payment through
a flow-through entity must include in boxes
15 through 16f the name, country code,
address, and TIN, if any, of the
flow-through entity from which the
recipient directly receives the payment.
For chapter 4 purposes and in the case
of a flow-through entity that is a
participating FFI or registered
deemed-compliant FFI (other than a WP
or WT), the QI must complete a Form
1042-S for each pool of recalcitrant
account holders, nonparticipating FFIs,
and payees that are U.S. persons
provided in the withholding statement
associated with the Form W-8IMY of the
flow-through entity. The QI must include
the name and address of the flow-through
entity as the recipient and use pooled
reporting codes 35 through 41 as the
chapter 4 status code.
Example. QI, a qualified intermediary,
has FP, a nonwithholding foreign
partnership that is a registered
deemed-compliant FFI, as an account
holder. QI pays interest described by
income code 01 (interest paid by U.S.
obligors—general) to FP. FP has three
partners, A, B, and C, all of whom are
exempt from withholding under chapter 4.
FP provides QI with a Form W-8IMY with
which it associates the Forms W-8BEN
from each of A, B, and C. In addition, FP
provides a complete withholding
statement in association with its Form
W-8IMY that allocates the interest
payments among A, B, and C. QI must file
three Forms 1042-S, one each for A, B,
and C. The Forms 1042-S must show
information relating to FP in boxes 15
through 16f.

Amounts Paid by
Withholding Foreign
Partnerships and Trusts
In general. For chapter 4 purposes,
payments that are made by a withholding
foreign partnership (WP) or withholding
foreign trust (WT) that are FFIs directly to
its recalcitrant account holders, payees
that are nonparticipating FFIs, and payees
that are U.S. persons may be reported on
the basis of reporting pools. In most
cases, for chapter 3 purposes ,a
withholding foreign partnership (WP) or
withholding foreign trust (WT) must file a
separate Form 1042-S for each direct
partner, beneficiary, or owner that is
exempt from chapter 4 withholding and to
whom the WP or WT distributes, or in
whose distributive share is included, an
amount subject to withholding under
chapter 3, in the same manner as a U.S.
withholding agent. However, if the WP or
WT has made a pooled reporting election
in its WP or WT agreement, the WP or WT
may instead report payments to such
-13-

direct partners, beneficiaries, or owners
on the basis of reporting pools and file a
separate Form 1042-S for each reporting
pool. A reporting pool consists of income
that falls within a particular withholding
rate and within a particular income code,
chapter 4 exemption code, chapter 3
exemption code (if applicable) and
recipient code, as determined on Form
1042-S. For payments not subject to
chapter 4 withholding, a WP or WT may
use a single chapter 4 exemption code 15
(payees not subject to chapter 4
withholding) and a single chapter 3
reporting pool code 31(withholding rate
pool—general) as the chapter 3 status
code for all chapter 3 reporting pools,
except for amounts paid to foreign
tax-exempt recipients for which a separate
recipient code 32 must be used. For this
purpose, a foreign tax-exempt recipient
includes any organization that is not
subject to withholding and is not liable to
tax in its country of residence because it is
a charitable organization, pension fund, or
foreign government.

Amounts Paid
by Nonqualified
Intermediaries and
Flow-Through Entities

An NQI and a flow-through entity are
withholding agents and must file Forms
1042-S for amounts paid to recipients.
However, an NQI or flow-through entity is
not required to file Form 1042-S if it is not
required to file Form 1042-S under the
Multiple Withholding Agent Rule, later. An
NQI or flow-through entity may report
payments made to recipients to the extent
it has failed to provide to another
withholding agent the appropriate
documentation and complete withholding
statement. If the NQI or flow-through entity
chooses to or must file Form 1042-S, as
described above, the NQI or flow-through
entity must also file Form 1042 and, if
applicable, attach the Form 1042-S it
received from withholding agent to
establish any credit for amounts withheld
by the withholding agent. See Instructions
for Form 1042.
If another withholding agent has
withheld tax on an amount that should
have been exempt (for example, where
the withholding agent applied the
presumption rules because it did not
receive proper documentation or other
required information from the NQI or
flow-through entity), and the payee or
beneficial owner will make a claim for
refund, the NQI or flow-through entity
should report on Form 1042-S the correct
tax rate and the combined amount of U.S.
federal tax withheld with respect to the
recipient and should enter the applicable
chapter 3 and 4 exemption codes.

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If another withholding agent
underwithholds, even though it received
proper documentation from the NQI or
flow-through entity, the NQI or
flow-through entity must withhold
additional amounts to bring the total
withholding to the correct amount.
Example 1. NQI, a foreign bank that is
a participating FFI acts as a nonqualified
intermediary for four different foreign
persons (A, B, C, and D) who own
securities from which they receive interest.
The interest is paid by a U.S. withholding
agent (WA) as custodian of the securities
for NQI. A, B, C, and D each own a 25%
interest in the securities. NQI has
furnished WA a Form W-8IMY to which it
has attached Forms W-8BEN from A and
B. NQI's Form W-8IMY contains an
attachment stating that 25% of the
securities are allocable to each of A and
B, and 50% a pool of recalcitrant account
holders. WA pays $100 of interest during
the calendar year. WA treats the $25 of
interest allocable to A and the $25 of
interest allocable to B as portfolio interest
and completes a Form 1042-S for A and
for B as the recipients. WA includes
information relating to NQI in boxes15
through 16f on the Forms 1042-S for A
and B. WA subjects the remaining $50 of
interest to 30% withholding under
chapter 4 and reports the interest on a
Form 1042-S by treating NQI as the
recipient in box 14a (using reporting pool
code 36 (recalcitrant pool-U.S. indicia) as
the chapter 4 status code, “30.00” in
box 4b (tax rate), and $15 as the amount
withheld in box 7 and box 10. Under the
multiple withholding agent rule, NQI is not
required to file a Form 1042-S but may file
a Form 1042-S, if, for example, C and D
make a claim for refund and NQI has not
filed a collective refund claim permissible
(see Regulations section 1.1471-4(f)).
Example 2. WA a U.S. withholding
agent makes a $100 dividend payment to
a foreign bank (NQI) that is a participating
FFI, and acts as a nonqualified
intermediary. NQI receives the payment
on behalf of A, documented as a foreign
individual exempt from chapter 4
withholding and a resident of a treaty
country who is entitled to a 15% rate of
withholding, under chapter 3 and B,
documented as a foreign individual
exempt from chapter 4 withholding and a
resident of a country that does not have a
tax treaty with the United States and who
is subject to 30% withholding under
chapter 3. NQI provides WA with its Form
W-8IMY to which it associates the Forms
W-8BEN from both A and B and a
complete withholding statement that
allocates 50% of the dividend to A and
50% to B. A's Form W-8BEN claims a
15% treaty rate of withholding. B's Form
W-8BEN does not claim a reduced rate of
withholding. WA, however, mistakenly

withholds only 15%, $15, from the entire
$100 payment. WA completes a Form
1042-S for each A and B as the recipients,
showing on each form $50 of dividends in
box 2, a withholding rate of “15.00” in
box 3b (chapter 3 tax rate), and $7.50 as
the amount withheld in boxes 7 and 10.
Under the multiple withholding agent rule,
NQI is not required to file a Form 1042-S
for A. However, because NQI knows (or
should know) that B is subject to a 30%
rate of withholding, and assuming it knows
that WA only withheld 15%, the multiple
withholding agent rule does not apply to
the dividend paid to B, and NQI must
withhold an additional 15% from the
payment to B. NQI then must file a Form
1042-S for B showing $50 of dividends in
box 2, enter “00” in box 3a (chapter 3
exemption code). “30.00” in box 2b (the
correct chapter 3 tax rate), and $7.50
withheld by NQI in box 7, $7.50 withheld
by WA in box 8, and $15 in box 9 (the
combined amount withheld). NQI also
must enter chapter 4 exemption code 15
(payee not subject to chapter 4
withholding) in box 4a and “00.00” in
box 4b (chapter 4 tax rate). See the
instructions for box 3a, later.

Multiple Withholding
Agent Rule

A withholding agent is not required to file
Form 1042-S if a return is filed by another
withholding agent reporting the same
amount and the withholding agent has
withheld correctly.
The multiple withholding agent rule
does not relieve withholding agents from
Form 1042-S reporting responsibility in the
following circumstances.

Any withholding agent making a
payment to a QI, QSL, WP, or WT must
report that payment as made to the QI,
QSL, WP, or WT.
Any withholding agent making a
payment to a U.S. branch treated as a
U.S. person must report the payment as
made to that branch.
Any withholding agent that withholds an
amount from a payment under chapters 3
or 4 must report that amount to the
recipient from whom it was withheld,
unless the payment is reportable on
another IRS form.
Furthermore, the multiple withholding
agent rule does not relieve the following
from Form 1042-S reporting responsibility.
Any QI, WP, or WT required to report an
amount to chapter 4 reporting pool or
chapter 3 withholding rate pool.
An NQI or flow-through entity that
knows, or has reason to know, that the
correct amount has not been withheld by
another withholding agent.

-14-

Penalties

The following penalties apply to the
person required to file Form 1042-S. The
penalties apply to both paper filers and
electronic filers.
Late filing of correct Form 1042-S. A
penalty may be imposed for failure to file
each correct and complete Form 1042-S
when due (including extensions), unless
you can show that the failure was due to
reasonable cause and not willful neglect.
The penalty, based on when you file a
correct Form 1042-S, is:
$30 per Form 1042-S if you correctly file
within 30 days after the required filing
date; the maximum penalty is $250,000
per year ($75,000 for a small business). A
small business, for this purpose, is defined
as having average annual gross receipts
of $5 million or less for the 3 most recent
tax years (or for the period of its existence,
if shorter) ending before the calendar year
in which the Forms 1042-S are due.
$60 per Form 1042-S if you correctly file
more than 30 days after the due date but
by August 1; the maximum penalty is
$500,000 per year ($200,000 for a small
business).
$100 per Form 1042-S if you file after
August 1 or you do not file correct Forms
1042-S; the maximum penalty is
$1,500,000 per year ($500,000 for a small
business).
If you intentionally disregard the
requirement to report correct information,
the penalty per Form 1042-S is increased
to the greater of $250 or 10% of the total
amount of items required to be reported,
with no maximum penalty.
Failure to furnish correct Form 1042-S
to recipient. If you fail to provide
statements to recipients and cannot show
reasonable cause, a penalty of up to $100
may be imposed for each failure to furnish
Form 1042-S to the recipient when due.
The penalty also may be imposed for
failure to include all required information or
for furnishing incorrect information on
Form 1042-S. The maximum penalty is
$1,500,000 for all failures to furnish
correct recipient statements during a
calendar year. If you provide the correct
statement on or before August 1, reduced
penalties similar to those for failing to file a
correct Form 1042-S with the IRS may be
imposed. See Late filing of correct Form
1042-S., earlier. If you intentionally
disregard the requirement to report correct
information, each $100 penalty is
increased to the greater of $250 or 10% of
the total amount of items required to be
reported, with no maximum penalty.
Failure to file electronically. If you are
required to file electronically but fail to do
so, and you do not have an approved
waiver on record, you may be subject to a
$50 penalty per return unless you
Instructions for Form 1042-S (2014)

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establish reasonable cause. The penalty
applies separately to original returns and
amended returns. The maximum penalty
is $100,000.

Avoid Common Errors

To ensure that your Forms 1042-S can be
correctly processed, be sure that you:
Carefully read the information provided
in Pub. 515 and these instructions.
Comply with the requirements in Pub.
1187 if you are an electronic filer.
Complete all required fields. At a
minimum, you must enter information in
boxes 1, 2, 3a, 3b, 4a, 4b, 7, 10,12
through 13f, 14a, 14c, 14d, 17, and
chapters 3 and 4 status code boxes for the
withholding agent and recipient (except in
the case of pool reporting in which case
only a chapter 3 or 4 status code box for
the recipient is required). Other boxes
must be completed if the nature of the
payment requires it.
Note. You may leave box 5 blank if you
are reporting a payment to an artist or
athlete and there is a central withholding
agreement. See Exception for central
withholding agreements in the instructions
for box 5. You may leave box 6 blank if
you are applying backup withholding to
the payment being reported.
Use only income, recipient, exemption,
and country codes specifically listed in
these instructions.
Use only tax rates that are allowed by
statute, regulations, or treaty. Do not
attempt to “blend” rates. Instead, if
necessary, submit multiple Forms 1042-S
to show changes in tax rate. See the Valid
Tax Rate Table, later.
All information you enter when
reporting the payment must correctly
reflect the intent of the statute and
regulations. In most cases, you should rely
on the withholding documentation you
have collected (Form W-8 series, Form
8233, etc.) to complete your Form 1042-S
submissions.
Also note the following:
The gross income you report in box 2
cannot be zero.
The income code you report in box 1
must correctly reflect the type of income
you pay to the recipient.
The withholding agent's name, address,
and EIN, QI-EIN, WP-EIN, or WT-EIN, or
GIIN must be reported in boxes 12a, 12b,
12c, and 12f in all cases.
The recipient's name, chapters 3 and 4
status code, (chapter 3 or 4 status code in
the case of pooled reporting), address,
and U.S. TIN, if any, and country code
must be reported in boxes 13a through
13d and 14. In most cases, you must
report a foreign address. See the
instructions for box 13 , later.
Instructions for Form 1042-S (2014)

The recipient's country code that you
report in box 16 must be present and
correctly coded and cannot be “US.”
Additionally, do not use “OC” or “UC”
except as specifically allowed in these
instructions.
For direct account holders, you must
report the recipient's account number in
box 19.
The exemption code you report in
box 3a must correctly identify the proper
tax status for the type of income you pay
to the recipient. The exemption code you
report in box 4a must correctly identify the
proper tax status for the type of income
you pay to the recipient or exemption code
15 is used (payee not subject to chapter 4
withholding), then the chapter 4 status
code of the recipient must correctly reflect
this exemption.
Note. If you use exemption code 04
(exempt under tax treaty), the country
code that you report in box 16 must be a
valid treaty country. Countries with which
the United States has a tax treaty are
shown in bold italics in the country code
list, later.
You, the withholding agent, are
liable for the tax if you know, or
CAUTION
should have known, that
underwithholding on a payment has
occurred.

!

Specific Instructions for
Withholding Agents

!

All amounts must be reported in
U.S. dollars.

CAUTION

Rounding Off
to Whole Dollars

You may round off cents to whole dollars.
If you do round to whole dollars, you must
round all amounts. To round off amounts
to the nearest whole dollar, drop amounts
under 50 cents and increase amounts
from 50 to 99 cents to the next dollar. For
example, $1.39 becomes $1 and $2.50
becomes $3. If you have to add two or
more amounts to figure the amount to
enter on a line, include cents when adding
and only round off the total.

AMENDED Checkbox
See Amended Returns, later.

PRO-RATA BASIS
REPORTING Checkbox

Withholding agents must check this box to
notify the IRS that an NQI that used the
alternative procedures of Regulations
section 1.1441-1(e)(3)(iv)(D) failed to
properly comply with those procedures.

-15-

See Pro-rata reporting, earlier, for
additional information.

Box 1, Income Code

All filers must enter the appropriate 2-digit
income code from the list, earlier. Use the
income code that is the most specific. See
Pub. 515 for further explanation of the
income codes. Below are examples on
how to use some of the income codes.
1. Use code 09 for the following types
of capital gain:
a. Gains on disposal of timber, coal,
or domestic iron ore with a retained
economic interest, unless an election is
made to treat those gains as income
effectively connected with a U.S. trade or
business;
b. Gains on contingent payments
received from the sale or exchange after
October 4, 1966, of patents, copyrights,
secret processes and formulas, goodwill,
trademarks, trade brands, franchises, and
other like property;
c. Gains on certain transfers of all
substantial rights to, or an undivided
interest in, patents if the transfers were
made before October 5, 1966; and
d. Certain gains from the sale or
exchange of original issue discount
obligations issued after March 31, 1972.
2. Use code 16 for payments for
personal services performed by an
independent contractor as contrasted with
those performed by an employee. This
includes payments that are subject to the
business profits article of a treaty.
3. Use code 29 (deposit interest) if
you are paying bank deposit interest, not
code 01 (interest paid by U.S.
obligors—general).
4. Use code 24 (real estate
investment trust (REIT)) for distributions of
capital gains from a real estate investment
trust (REIT). Use code 36 (capital gains
distribution) for capital gain distributions
(dividends) paid or credited by mutual
funds (or other regulated investment
companies). Include short-term capital
gain dividends (use exemption code 02
(exempt under IRC) in box 6).
Note. Exempt-interest dividends should
be reported under income code 01
(interest paid by U.S. obligors-general)
(use exemption code 02 (exempt under
IRC) in box 6).
5. Use code 28 for gambling
winnings. These are proceeds from a
game other than blackjack, baccarat,
craps, roulette, or big-6 wheel. For more
information, see Pub. 515.
6. Use code 33, 34, or 35 for all
substitute payment transactions. For more
information, see Regulations sections

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Income Codes and Exemption Codes
Box 1.

Enter the appropriate income code.

Code

15

Scholarship or fellowship grants

16
17
18
19
20
24

Compensation for independent personal services1
Compensation for dependent personal services1
Compensation for teaching1
Compensation during studying and training1
Gross income—Other
Real estate investment trust (REIT) distributions of capital gains

29
30

Interest paid by U.S. obligors—general
Interest paid on real property mortgages
Interest paid to controlling foreign corporations
Interest paid by foreign corporations
Interest on tax-free covenant bonds
Interest paid on deposit with a foreign branch of a
domestic corporation or partnership
Deposit interest
Original issue discount (OID)

25
26

31

Short-term OID

27

33

Substitute payment—interest

28

Trust distributions subject to IRC section 1445
Unsevered growing crops and timber distributions by a trust
subject to IRC section 1445
Publicly traded partnership distributions subject to IRC section
1446
Gambling winnings2

01
02
03
04
05
22

Code

Interest Income

Dividend Income

32
 35
36
37
38

06
07
08

Dividends paid by U.S. corporations—general
Dividends qualifying for direct dividend rate
Dividends paid by foreign corporations

21

Gross income-Capital Gain dividend

39

34
40

Substitute payment—dividends
Other U.S.-source dividend equivalents under IRC
section 871(m) (formerly 871(l))
Other Income
Capital gains
Industrial royalties
Motion picture or television copyright royalties
Other royalties (for example, copyright, recording,
publishing)
Real property income and natural resources royalties
Pensions, annuities, alimony, and/or insurance premiums

41
42

Code
09
10
11
12
13
14

43
50
51

Notional principal contract income3
Substitute payment—other
Capital gains distributions
Return of capital
Eligible deferred compensation items subject to IRC section
877A(d)(1)
Distributions from a nongrantor trust subject to IRC section
877A(f)(1)
Guarantee of indebtedness
Earnings as an artist or athlete—no central withholding
agreement4
Earnings as an artist or athlete—central withholding agreement4
Income previously reported under escrow procedure5
Other income

See back of Copy D for additional codes

If compensation that otherwise would be covered under Income Codes 16 through 19 is directly attributable to the recipient's occupation as an
artist or athlete, use Income Code 42 or 43 instead.
Subject to 30% withholding rate unless the recipient is from one of the treaty countries listed under Gambling winnings (Income Code 28) in Pub.
515.
3
Use appropriate Interest Income Code for embedded interest in a notional principal contract.
4
If Income Code 42 or 43 is used, Recipient Code 09 (artist or athlete) should be used instead of Recipient Code 01 (individual), 02 (corporation), or
03 (partnership other than withholding foreign partnership).
5
Use only to report gross income the tax for which is being deposited in the current year because such tax was previously escrowed for chapters 3
and 4 and the withholding agent previously reported the gross income in a prior year and checked the box to report the tax as not deposited under
the escrow procedure.
1
2

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Boxes 3a and 4a. Exemption code (applies if the tax rate entered in
boxes 3a and 4a is 00.00).
Code
Authority for Exemption
Chapter 3
01
Effectively connected income 02 Exempt under IRC
(other than portfolio interest)
02
Exempt under IRC (other than portfolio interest)
03
Income is not from U.S. sources
04
Exempt under tax treaty
05
Portfolio interest exempt under IRC
06
QI that assumes primary withholding responsibility
07
WFP or WFT

04

08

U.S. branch treated as U.S. Person

14

09
10
11
12

Territory FI treated as U.S. Person
QI represents that income is exempt
QSL that assumes primary withholding responsibility
Payee subjected to chapter 4 withholding

Chapter 4
13
14
15
16
17
18
19
21

Grandfathered payment
Effectively connected income
Payee not subject to chapter 4 withholding
Excluded nonfinancial payment
Foreign reportable amounts
Foreign Entity that assumes primary withholding
responsibility
U.S. Payees—of participating FFI or registered
deemed-compliant FFI
Dormant account6

Type of Recipient, Withholding Agent, or
Intermediary
Chapter 3 Status Codes
01
U.S. Withholding Agent—FI
02
U.S. Withholding Agent—Other
03
Territory FI treated as U.S. Person
Code

6

05
06
07
08
09
10
11
12
13

15
16
17
18
19
20
21
22
23
24
25
26

Territory FI—not treated as U.S. Person
U.S. branch of Participating FFI—treated as U.S. Person
U.S. branch of Participating FFI—not treated as U.S. Person
U.S. branch of Registered Deemed-Compliant FFI—treated as
U.S. Person
Partnership other than Withholding Foreign Partnership
Withholding Foreign Partnership
Trust other than Withholding Foreign Trust
Withholding Foreign Trust
Qualified Intermediary
Qualified Intermediary—Branch under Qualified Intermediary
Agreement
Qualified Intermediary—Branch not under Qualified Intermediary
Agreement
Qualified Intermediary—Foreign Branch of U.S. FI
Qualified Securities Lender—Qualified Intermediary
Qualified Securities Lender—Other
Corporation
Individual
Estate
Private Foundation
International Organization
Tax Exempt Organization (Section 501(c) entities
Unknown Recipient
Artist or Athlete
Pension

27

Foreign Government—Integral Part

28
29
30

Foreign Government—Controlled Entity
Government of U.S. territory
Foreign Central Bank of Issue

Pooled Reporting Codes
31
Withholding Rate Pool—General
32
Withholding Rate Pool—Exempt Organization

Use only when tax not withheld under chapter 4 because escrow procedure for dormant accounts applied under chapter 4 but tax withheld under
chapter 3.

Instructions for Form 1042-S (2014)

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Recipient Codes
Code

Type of Recipient, Withholding Agent, or
Intermediary
Chapter 4 Status Codes
01
U.S. Withholding Agent—FI
02
U.S. Withholding Agent—Other
03
Territory FI—not treated as U.S. Person
04
Territory FI—treated as U.S. Person
05
U.S. branch of Participating FFI—treated as U.S. Person
06
U.S. branch of Participating FFI—not treated as U.S.
Person
07
U.S. branch of Registered Deemed-Compliant
FFI—treated as U.S. Person
08
Participating FFI—Other
09
Participating FFI—Reporting Model 2 FFI
10
11
12
13
14
15
16
17
18
19
20
21
22
23

Registered Deemed-Compliant FFI—Reporting Model 1
FFI
Registered Deemed-Compliant FFI—Sponsored Entity
Registered Deemed-Compliant FFI—Other
Certified Deemed-Compliant FFI—Other
Certified Deemed-Compliant FFI—FFI with Low Value
Accounts
Certified Deemed-Compliant FFI—Non-Registering
Local Bank
Certified Deemed-Compliant FFI—Sponsored Entity
Nonparticipating FFI
Owner-Documented FFI
Limited Branch treated as Nonparticipating FFI

24

Active NFFE

25
26
27
28
29
30
31

Excepted NFFE—Other
Individual
Section 501(c) Entities
Excepted Territory NFFE
Exempt Beneficial Owner
Entity Wholly Owned By Exempt Beneficial Owners
Unknown Recipient

32

Recalcitrant Account Holder

33
34

NFFE—WP or WT
Nonreporting IGA FFI

Pooled Reporting Codes
35
36
37
38

Recalcitrant Pool—No U.S. Indicia
Recalcitrant Pool—U.S. Indicia
Recalcitrant Pool—Dormant Account
Recalcitrant Pool—U.S. Persons

39

Recalcitrant Pool—Passive NFFEs

40
41
42

Nonparticipating FFI Pool
QI—Exempt from Chapter 4 Withholding Pool
U.S. Payees Pool

Limited FFI treated as Nonparticipating FFI
Passive NFFE identifying Substantial U.S. Owners
Passive NFFE with no Substantial U.S. Owners
Publicly Traded Corporation or Affiliate of Publicly Traded
Corporation

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1.861-2(a)(7) and 1.861-3(a)(6) and
Notice 2010-46.
7. Use code 37 (return of capital) for a
nondividend distribution. This is a
distribution that is not paid out of the
earnings and profits of a corporation. It
represents a distribution in part or full
payment in exchange for stock.
8. Use code 40 (other dividend
equivalents under IRS section 871(m)) for
other U.S.-source dividend equivalents.
These are dividend equivalent payments
under section 871(m) that are not
substitute dividend payments identified
with income code 34.
9. Use code 41 (guarantee of
indebtedness) for certain guarantee of
indebtedness payments. These are
amounts paid for the provision of a
guarantee of indebtedness that was
issued after September 27, 2010.
10. Use either code 42 (earnings as an
artist or athlete—no central withholding
agreement) or 43 (earnings as an artist or
athlete—central withholding agreement)
for payments to an artist or athlete. A
central withholding agreement is Form
13930, Application for Central Withholding
Agreement, plus additional information
specified in the instructions to such form,
that is entered into by the artist or athlete,
a designated withholding agent, and the
IRS. For more details, see Pub. 515.
If you paid more than one type of income
to or on behalf of the same recipient, you
must complete a separate Form 1042-S,
Copy A, for each income type.
Use code 50 (income previously
reported under escrow procedure) for
income that was reported on Form 1042-S
in a prior calendar year but for which the
withholding agent was not required to
deposit the tax withheld or determined that
withholding was not required until the
current calendar year under an applicable
escrow procedure.
Note. Although income codes are
provided for short-term OID, and notional
principal contract income, those items are
not always subject to reporting on Form
1042-S. For example, short-term OID may
need to be reported by an NQI or
flow-through entity if those amounts are
paid to foreign persons and another
withholding agent backup withheld on
those amounts under the presumption
rules. Notional principal contract income is
reportable if it is effectively connected with
the conduct of a trade or business in the
United States or results in the payment of
interest under Regulations section
1.446-3(g)(4) or a dividend equivalent
under section 871(m)) and the regulations
thereunder. For more information, see the
regulations under chapter 3 and Pub. 515.

Instructions for Form 1042-S (2014)

Box 2, Gross Income

For each income type, enter the gross
amount you paid to or on behalf of the
recipient during calendar year 2014,
including withheld tax. The following
special procedures apply to the reporting
of gross income.
You must report the entire amount of a
corporate distribution made with respect
to stock even if you elect to reduce the
amount of withholding on the distribution
because all or a part of the distribution is
nontaxable or represents a capital gain
dividend.
You must report the entire amount of a
payment if you do not know at the time of
payment the amount that is subject to
withholding because the determination of
the source of the income or the calculation
of the amount of income subject to tax
depends upon facts that are not known at
the time of payment regardless of whether
you are applying the escrow procedure
described in Regulations sections
1.1441-3(d) and 1.1471-2(a)(5)(ii).
You must also report the entire amounts
of a payment that you previously reported
in a prior calendar year for which you
withheld tax but not deposit such tax
under an applicable escrow procedure if
the liability is due or determined not to be
due in the current calendar year.
You must report the entire amount of
gains relating to the disposal of timber,
coal, or domestic iron ore with a retained
economic interest and gains relating to
contingent payments received from the
sale or exchange of patents, copyrights,
and similar intangible property.
You must report only the amount of
cash paid on notional principal contracts.

Box 3 and 4

If you are reporting amounts in box 7
through 9, check box 3 or box 4 to indicate
whether the amounts were withheld (or
assumed by the withholding agent)
pursuant to chapter 3 (box 3) or chapter 4
(box 4). If you are not reporting amounts in
box 7 through 9, do not check box 3 or 4.
Note. Only one box should be checked, if
any.

Box 3a and 4a, Exemption Code. In
most cases, if the tax rate you entered in
box 3a or 4a is 00.00, you should enter the
appropriate exemption code (01 through
21) from Income Codes, Exemption
Codes, and Recipient, Withholding Agent,
or Intermediary Codes, earlier, as
applicable for chapter 3 and 4 purposes.
If an amount was withheld under
chapter 4 (the tax rate you entered in
box 4b is greater than zero and is not due
to backup withholding), enter “00” in
box 4a. If an amount was withheld under
chapter 3 (the tax rate you entered in
box 3b is greater than zero and is not due
-19-

to backup withholding), enter “00” in
box 3a. If the tax rate you entered in
box 3a is due to backup withholding, leave
box 3b blank.
If exemption code 01 or 14 (income
effectively connected with a U.S. trade or
business) applies, you must enter the
recipient's U.S. TIN in box 14b and the
recipient’s GIIN if you relied on a
presumption rule to treat the income as
effectively connected with a U.S. trade or
business. If the recipient's U.S. TIN is
unknown or unavailable, you must
withhold tax at the rate of 30% (30.00) and
enter “00” in box 4b or 3b (as applicable).
A withholding agent should use
exemption code 06 (qualified intermediary
that assumes primary withholding
responsibility) only if it is making a
payment to a QI that has represented on
its Form W-8IMY that it is assuming
primary withholding responsibility under
chapters 3 and 4.
A withholding agent should use
exemption code 07 (withholding foreign
partnership or withholding foreign trust)
only if it is making a payment to a foreign
partnership or trust that has represented
on its Form W-8IMY that it is a withholding
foreign partnership or trust.
A withholding agent should use
exemption code 08 (U.S. branch treated
as U.S. person) or 09 (territory FI treated
as U.S. person) (as applicable) only if it is
making a payment to a U.S. branch of a
participating FFI or reporting model 1 FFI
or to territory FI and it has represented on
its Form W-8IMY that it agrees to be
treated as a U.S. person.
A withholding agent should use
exemption code 10 (QI represents income
is exempt) only if it makes a payment to a
QI that has not assumed primary
withholding responsibility under chapters
3 and 4 or primary backup withholding
responsibility, but has represented on a
withholding statement associated with its
Form W-8IMY that the income is exempt
from withholding.
A withholding agent should use
exemption code 11 (QSL that assumes
primary withholding responsibility for
substitute dividends) only if the
withholding agent makes a substitute
dividend payment to a financial institution
(including a QI) and that represented on
its Form W-8IMY that is acting as a QSL
for the account associated with the form.
A withholding agent should use
exemption code 12 (payee subjected to
chapter 4 withholding) if the recipient is
subject to chapter 4 withholding and thus
chapter 3 withholding does not apply. See
Special Instructions for use of Certain
Chapter 3 Exemption Codes, later.
A withholding agent should use
exemption code 13 (grandfathered

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payment) only if the withholding agent
makes a payment under a grandfathered
obligation and exemption code 13 is the
only exemption code that applies. If
another exemption code applies, it should
be used instead of exemption code 13.
A withholding agent should use
exemption code 15 (payee not subject to
chapter 4 withholding) if the payment is a
withholdable payment (as defined in
Regulations section 1.1471-3(a)), but the
payment is not subject to chapter 4
withholding because of the payee's
chapter 4 status.
A withholding agent should use
exemption code 16 (excluded nonfinancial
payment) only if the withholding agent if
exemption code 16 is the only exemption
code that applies. If another exemption
code applies, it should be used instead of
exemption code 16.
A withholding agent should use
exemption code 17 (foreign entity that
assumes primary withholding
responsibility) only if it makes a payment
to a QI that assumes primary withholding
responsibility, a WP, or a WT.
A withholding agent should use
exemption code 18 (U.S. payees of a
participating FFI or registered
deemed-compliant FFI) only if it makes a
payment to a participating FFI or
registered deemed-compliant FFI and only
to the extent represented on such FFI's
withholding statement associated with its
Form W-8IMY that the payment is
allocable to a pool of U.S. payees.
A withholding agent should use
exemption code 21 (dormant accounts)
only if it makes a withholdable payment to
a participating FFI or registered
deemed-compliant FFI that represented
on its withholding statement associated
with its Form W-8IMY that the payment is
allocable to a dormant account holder for
which the escrow procedure of
Regulations section 1.1471-4(b)(6) apply.
If you have failed to provide another
withholding agent with appropriate
information regarding the status of the
person to whom you are making a
payment, the other withholding agent may
be required to withhold on the payment
based on the presumption rules. If the
income is in fact exempt from withholding
or subject to a reduced rate of withholding,
you must submit a Form 1042-S providing
the correct information. In this situation,
you must:
Indicate the correct rate at which the
income should have been subject to
withholding in box 3b or 4b,
Enter the appropriate exemption codes,
if any, in box 3a and 4a,
Enter the actual amount of U.S. federal
tax withheld by the other withholding
agent in box 8,

Provide the name and address of the
actual recipient in boxes 14a through d
along with the other required information
for the recipient.
Special instructions for use of Chapter 3 Exemption Codes. If an amount
was withheld under chapter 4, you may
also include a chapter 3 exemption code
and tax rate in box 3a and 3b to show the
rate that would otherwise apply if the
payee was exempt from withholding under
chapter 4. This may be done, for example,
to assist the beneficial owner in pursuing a
claim for refund. In such a case, do not
check box 3 (only box 4 should be
checked) to show that withholding was
applied under chapter 4.

Box 3b and 4b, Tax Rate

Enter the correct rate of withholding that
applies to the income in box 3b and 4b
(gross income) or box 6 (net income), as
appropriate. In the case of a payment
subject to chapter 4 withholding, the
correct rate of withholding is “30.00.” For
purposes of chapter 3 withholding, see
Valid Tax Rate Table, later. The correct
tax rate should be included even if you
withheld at a different rate. For example, if
an NQI that is a participating FFI is
reporting dividends paid to a beneficial
owner who is exempt from withholding
under chapter 4 and a resident of a
country with which the United States does
not have a tax treaty and a U.S.
withholding agent paid the dividend and
withheld only 15% under chapter 3 (rather
than the required 30%) and the NQI
withholds an additional 15% under
chapter 3, the NQI should report “30.00”in
box 3b. See Example 2. in Amounts Paid
by Nonqualified Intermediaries and
Flow-Through Entities, earlier. The tax rate
on dividends paid to a corporation created
or organized in, or under the law of, the
Commonwealth of Puerto Rico may be
10%, rather than 30%. See Pub. 515 for
more information.
In the case of a specified Federal
procurement payment subject to section
5000C withholding, the correct rate of
withholding is 2% or “02.00.”
Enter the tax rate using the following
format: two digits, a decimal, and two
digits (for example,“30.00” for 30%).
However, if the income is exempt from tax
under a U.S. tax treaty or the Code, enter
“00.00.” If the tax rate is less than 10%,
enter a zero before the tax rate (for
example, “04.00” for 4%).
If you withheld at more than one
tax rate for a specific type of
CAUTION
income that you paid to the same
recipient, you must file a separate Form
1042-S, Copy A, for each amount to which
a separate rate was applied.

!

-20-

Valid Tax Rate Table
00.00

05.00

12.50

25.00

02.00

07.00

14.00

27.50

04.00

08.00

15.00

28.00

04.90

10.00

17.50

30.00

04.95

12.00

20.00

35.00

Exception for central withholding
agreements. If you are the designated
withholding agent who has entered into a
central withholding agreement and you
report an amount in box 2 using income
code 43 (earnings as an artist or
athlete-central withholding agreement),
you do not have to enter a tax rate in
box 3b but you must include a chapter 4
exemption code 16 (excluded nonfinancial
payments) in box 4a.

Box 5, Withholding
Allowances

This box should be completed only if the
income code reported in box 1 is 15
(scholarship or fellowship grants), 16
(compensation for independent personal
services), 17 (compensation for
dependent personal services), 18
(compensation for teaching), 19
(compensation during studying and
training), or 42 (earnings as an artist or
athlete --no central withholding
agreement). See Pub. 515 for more
information.

Box 6, Net Income

Complete this box only if you entered an
amount in box 5. Otherwise, leave it blank.

Boxes 7 Through 10,
Federal Tax Withheld
Box 7. Enter the total amount of U.S.
federal tax you actually withheld in box 7
under chapter 3 or 4. If you did not
withhold any tax, enter “-0-” If you withheld
but were not required to deposit the tax
withheld under an applicable escrow
procedure in the same year, check the
“check if tax not deposited under escrow
procedure box.”
Box 8. If you are a withholding agent filing
a Form 1042-S to report income that has
already been subject to withholding by
another withholding agent, enter the
amount actually withheld by the other
agent(s) in box 8. Further, report in box 8
any credit forward of prior withholding as
determined under Notice 2010-46 with
respect to substitute dividend payments.
Box 9. Enter the total amount of tax paid
by you and not withheld from the payment
to the recipient.

Instructions for Form 1042-S (2014)

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Box 10. Enter the total amount of tax
withheld by you and any other withholding
agent in box 8 (do not include the amount
reported in box 9).

!

CAUTION

Box 7 must be completed in all
cases, even if no tax has actually
been withheld.

Box 11, Amount Repaid to
Recipient

This box should be completed only if:
You repaid a recipient under the
reimbursement procedure (see
instructions to Form 1042) an amount that
was overwithheld under chapter 3 or 4;
and
You are going to reimburse yourself by
reducing, by the amount of tax actually
repaid to the recipient, the amount of any
deposit made for a payment period in the
calendar year following the calendar year
of withholding that is prior to March 15,
2015.
In most cases, an intermediary or
flow-through entity should not enter an
amount in box 11 unless it is a QI that has
represented on its Form W-8IMY that it is
assuming primary withholding
responsibility or is a WP, or WT.
You also must state on a timely filed
Form 1042 for the calendar year of
overwithholding that the filing of the Form
1042 constitutes a claim for refund.
The adjustment for amounts
overwithheld does not apply to
CAUTION
partnerships or nominees
required to withhold under section 1446.

!

Box 12, Withholding
Agent's Employer
Identification Number
(EIN)

In most cases, you are required to enter
your EIN. However, if you are filing Form
1042-S as a QI, WP or WT, enter your
QI-EIN, WP-EIN, or WT-EIN and check
the QI-EIN box.
If you do not have an EIN, you can
apply for one online at
www.irs.gov/businesses/small or by
telephone at 1-800-829-4933. Also, you
can apply for an EIN by filing Form SS-4,
Application for Employer Identification
Number. File amended Forms 1042-S
when you receive your EIN.
To get a QI-EIN, WP-EIN, or WT-EIN,
submit Form SS-4 with your application for
that status. (See the definitions for
Qualified intermediary (QI)., and
Withholding foreign partnership (WP) or
withholding foreign trust (WT). in
Definitions, earlier, for more information.)

Instructions for Form 1042-S (2014)

Box 13a, Withholding
Agent's Name,
Withholding Agent Code
and Address

Enter your name and address in the
appropriate boxes. If your post office does
not deliver mail to the street address and
you have a P.O. box, show the box
number instead of the street address.
If you are a nominee that is the
withholding agent under section 1446,
enter the PTP's name and other
information in boxes 15 through 16f.
Also, enter your chapter 3 and
chapter 4 status codes from Income
Codes, Exemption Codes, and Recipient,
Withholding agent, and Intermediary
Codes, earlier. You must complete both
boxes.
Note. On statements furnished to
recipients of U.S. source deposit interest,
in addition to your name and address, you
must include the telephone number of a
person to contact. This number must
provide direct access to an individual who
can answer questions about the
statement. The telephone number is not
required on Copy A of paper forms or on
electronically filed forms. You also must
include a statement that the information on
the form is being furnished to the United
States Internal Revenue Service and may
be furnished to their country of residence.

Box 13b, Withholding Agent's GIIN.
The GIIN provided should be the GIIN
issued to the branch of the participating
FFI, reporting Model 2 FFI or registered
deemed-compliant FFI that is making the
payment.

Box 14, Recipient's Name,
U.S. TIN, GIIN, Recipient
Code, and Address Code
Box 14a, Name. Enter the complete
name of the recipient in box 14a.
If you do not know the name of the
recipient, enter “Unknown Recipient.”
If Form 1042-S is being completed by a
QI, WP, or WT for a withholding rate pool,
or chapter 4 withholding pool, enter
“Withholding rate pool” if withholding
under chapter 3 was applied or if
chapter 4 withholding was applied, a
description of the chapter 4 reporting pool
(for example “Nonparticipating FFI Pool ”)
in box 13a.
A withholding agent reporting
payments made to a participating FFI or
registered deemed-compliant FFI with
respect to a chapter 4 reporting pool must
include the name and address of the FFI
in boxes 14a through 14e as well as the
FFI's GIIN and country code.
-21-

A QI reporting payments made to a PAI
on a withholding rate pool basis must
include the name and address of the PAI
in boxes 14a through 14e.
Recipient code. Enter the recipient code
from Income Codes, Exemption Codes,
and Recipient Codes, earlier. The
following special instructions apply for
chapter 3 status codes.
If applicable, use recipient code 25
(artist or athlete) instead of recipient code
19 (individual), 18 (corporation), or 08
(partnership other than a withholding
foreign partnership).
If you are making a payment to an NQI
or flow-through entity, in most cases you
must use the recipient code that applies to
the type of recipient who receives the
income from the NQI or flow-through
entity.
Use recipient code 08 (partnership
other than withholding foreign partnership)
only if you are reporting a payment of
income that is effectively connected with
the conduct of a trade or business of a
nonwithholding foreign partnership in the
United States. Otherwise, follow the rules
that apply to payments to flow-through
entities.
Use recipient code 24 (unknown
recipient) only if you have not received a
withholding certificate or other
documentation for a recipient or you
cannot determine how much of a payment
is reliably associated with a specific
recipient. Do not use this code because
you cannot determine the recipient's
status as an individual, corporation, etc.
The regulations under chapter 3 provide
rules on how to determine a recipient's
status when a withholding agent does not
have the necessary information.
Use recipient code 16 (qualified
securities lender—qualified intermediary)
or 17 (qualified securities lender—other) if
you make a payment to a QSL.
Only QIs may use recipient codes 33
(private arrangement intermediary
withholding rate pool—general), 34
(private arrangement intermediary
withholding rate pool—exempt
organizations). Only QIs, WPs, and WTs
that made a pooled reporting election for
chapter 3 purposes may use recipient
codes 35 (agency-withholding rate
pool-general), 36 (agency-withholding rate
pool-exempt organizations), 31
(withholding rate pool—general), and 32
(withholding rate pool—exempt
organizations). Recipient code 32 or 34
should be used only for pooled account
holders that have claimed an exemption
based on their tax-exempt status and not
some other exemption (for example, treaty
or other Code exception). Do not include a
chapter 4 status code for the recipient if
you are using a chapter 3 pooled reporting
code as the recipient’s chapter 3 status
code.

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A U.S. withholding agent making a
payment to a QI should use recipient code
12 and recipient code 09 or 11 if it is
making a payment to a WP or WT,
respectively. Do not include a recipient
code if you are using a chapter 4 pooled
reporting code.
A chapter 4 status code is required if
the payment is a withholdable payment.
The chapter 4 status code may be
determined under the applicable
intergovernmental agreeement (IGA), if
applicable.The following special
instructions apply for chapter 4 status
codes:
Only use recipient code 31 (unknown
recipient) only if you have received a
withholding certificate or other
documentation from an intermediary or
flow-through entity (other than a
participating FFI or deemed-compliant
FFI) or if the payment is not subject to
chapter 4 withholding but you have not
received a withholding certificate or other
documentation for the beneficial owner or
you cannot determine how much of a
payment is reliably associated with a
beneficial owner. Only use this code if you
also used recipient code 24 (unknown
recipient) as the chapter 3 status code. If
you have received a withholding certificate
or other documentation from an
intermediary or flow-through entity, you
must include the entity’s information in
boxes 15 through 16f.
If you have received a withholding
certificate or other documentation from an
intermediary or flow-through entity that is a
participating FFI or deemed-compliant FFI
and cannot determine the recipient’s
chapter 4 status, use the presumption
rules to determine when a withholding
agent does not have information
necessary to reliably associate the
payment with valid documentation.
Do not include a chapter 3 status code
for the recipient if you are using a
chapter 4 reporting pool code as the
recipient’s chapter 4 status code.
Except in the case of a certified
deemed-compliant FFI, only use recipient
code 17 (nonparticipating FFI) or 32
(recalcitrant account holder) if you are
reporting directly to the recipient. See
Amounts paid to a nonqualified
intermediary or flow-through entity, above.
If you are reporting the chapter 4 reporting
pools of a participating FFI or registered
deemed-compliant FFI, use codes 35
through 41. Only use chapter 4 reporting
pool code 41 (U.S. payees pool) if a
participating FFI or registered
deemed-compliant FFI has provided a
Form W-8IMY certifying that it is reporting
payments of U.S. source FDAP income
made to U.S. persons and that is
associated with a withholding statement
allocating the payment or a portion of the
payment to a pool of U.S. payees.

Box 14c, Address. In most cases, you
must enter a foreign address in boxes 14c
through 14d. However, there are limited
exceptions. For example, you may enter a
U.S. address when reporting payments of
scholarship or fellowship grants (income
code 15).
For addresses outside the United
States or its commonwealths and
possessions, follow the foreign country's
practice for entering the postal code.
For addresses within the United States,
use the U.S. Postal Service 2-letter
abbreviation for the state name. Do not
enter “United States” or “U.S.”
If you want to enter the recipient's
account number, use box 22.

Box 14b, Recipient's U.S.
Taxpayer Identification
Number (TIN)

You must obtain and enter a U.S. taxpayer
identification number (TIN) for any of the
following recipients.
Any recipient whose income is
effectively connected with the conduct of a
trade or business in the United States.
Note. For these recipients, enter
exemption code 01 in box 3a or exemption
code 14 in box 4a.
Any foreign person claiming a reduced
rate of, or exemption from, tax under a tax
treaty between a foreign country and the
United States, unless the income is an
unexpected payment (as described in
Regulations section 1.1441-6(g)) or
consists of dividends and interest from
stocks and debt obligations that are
actively traded; dividends from any
redeemable security issued by an
investment company registered under the
Investment Company Act of 1940 (mutual
fund); dividends, interest, or royalties from
units of beneficial interest in a unit
investment trust that are (or were, upon
issuance) publicly offered and are
registered with the Securities and
Exchange Commission under the
Securities Act of 1933; and amounts paid
with respect to loans of any of the above
securities.
Any nonresident alien individual
claiming exemption from tax under section
871(f) for certain annuities received under
qualified plans.
A foreign organization claiming an
exemption from tax solely because of its
status as a tax-exempt organization under
section 501(c) or as a private foundation.
Any QI.
Any WP or WT.
Any nonresident alien individual
claiming exemption from withholding on
compensation for independent personal
services.

-22-

Any U.S. branch of an FFI or territory FI
that is treated as a U.S. person.
Any QSL that was paid a substitute
dividend.
In all other cases, if you know the
recipient's TIN or if a foreign person
provides a TIN on Form W-8, but is not
required to do so, you must include the
TIN on Form 1042-S.

Boxes 15 Through 16f,
Intermediary/Flow-through
Entity's Name Status,
Code, Country Code,
Address, EIN, GIIN, and
Foreign Taxpayer
Identification Number

If you are reporting amounts paid to a
recipient whose withholding certificates or
other documentation has been submitted
to you with a Form W-8IMY provided by an
intermediary or flow-through entity, you
must include the name, and address of the
intermediary or flow-through entity with
whose Form W-8IMY the recipient's Form
W-8 or other documentation is associated.
You must also include the intermediary
or flow-through entity's chapter 3 and
chapter 4 status codes and, if any, the TIN
and GIIN of the NQI or flow-through entity.
Note. An intermediary or flow-through
entity will leave these boxes blank unless
it is making the payment to an
intermediary or flow-through entity.

Box 16c, Country Code. You must enter
the country code from Country Codes,
later, for the country where the
intermediary or flow-through entity is
located.
Box 16d, Intermediary or Flow-Through
Entity's Foreign Taxpayer Identification
Number. Use box 16d to enter the
intermediary or flow-through entity's
identifying number used in the country of
residence for tax purposes. Box 16d is
optional.
If you are a nominee that is the
withholding agent under section 1446,
enter the PTP's name and other
information in these boxes.

Box 17, Recipient's
Country Code

You must enter the code (from Country
Codes, later) for the country of which the
recipient claims residency under that
country's tax laws. Enter “OC” (other
country) only when the country of
residence does not appear on the list or
the payment is made to an international
organization (for example, the United
Nations). Enter “UC” (unknown country)
only if the payment is to an unknown
recipient. If you are making a payment to a
Instructions for Form 1042-S (2014)

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QI, QSL, WP, or WT, or if you are a QI,
QSL, WP, or WT and are making a
payment to a QI, WP, or WT withholding
rate pool, enter the country code of the QI,
WP, or WT. Also, if you are making a
payment to a participating FFI or
registered deemed-compliant FFI
chapter 4 reporting pool, enter the country
code of the participating FFI or registered
deemed-compliant FFI.
If exemption code 04 (exempt
under tax treaty) appears in
CAUTION
box 3a or if a reduced rate of
withholding based on a tax treaty is
entered in box 3b the country code
entered in box 17 must be a country with
which the United States has entered into
an income tax treaty.

!

Box 18, Recipient's
Foreign Tax Identifying
Number

Use box 18 to enter the recipient's
identifying number used in the country of
residence for tax purposes. Box 18 is
optional. For example, a withholding agent
should report a recipient's foreign taxpayer
identification number if the number is
known to the withholding agent.
Note. Starting in calendar year 2017, the
withholding agent will be required to report
either the recipient's foreign tax
identification number or the recipient's
date of birth. The recipient's foreign tax
identification number will be required in
box 18 if the recipient is resident in country
identified in the instructions for “Requester
of Forms W-8BEN, W-8ECI, W-8EXP, and
W-8IMY” as required to provide a foreign
taxpayer identification number. In all other
cases, the recipient's date of birth will be
required in box 20.

Box 19, Recipient’s Account
Number

If you are reporting amounts paid to a
direct account holder, you must report the
recipient’s account number in box 19. If
the amount is paid through a nonqualified
intermediary or flow-through entity, you
are not required to use this box.

Box 20, Recipient’s Date of
Birth.

Use box 20 to enter the recipient’s date of
birth if it is known to the withholding agent.
Box 20 is optional.
Note. Starting in calendar year 2017, the
withholding agent will be required to report
either the recipient's foreign tax
identification number or the recipient's
date of birth. The recipient's foreign tax
identification number will be required in
box 18 if the recipient is resident in country

Instructions for Form 1042-S (2014)

identified in the instructions for “Requester
of Forms W-8BEN, W-8ECI, W-8EXP, and
W-8IMY” as required to provide a foreign
taxpayer identification number. In all other
cases, the recipient's date of birth will be
required in box 20.

Box 21 and 22, Payer's
Name and Taxpayer
Identification Number
(TIN)

See the definition of a Payer. in
Definitions, earlier. Include the payer's
name and TIN if different from the
withholding agent shown in boxes 12 and
13a.

Boxes 23 Through 25,
State Income Tax Withheld
and Related Information
Include in these boxes information relating
to any state income tax withheld.

Amended Returns

If you filed a Form 1042-S with the IRS
and later discover you made an error on it,
you must correct it as soon as possible.
To correct a previously filed Form 1042-S,
you will need to file an amended Form
1042-S.
You may be required to submit
amended Forms 1042-S
CAUTION
electronically. See Electronic
Reporting earlier, and Pub. 1187.

!

If any information you correct on
Form(s) 1042-S changes the information
you previously reported on Form 1042,
you also must correct the Form 1042 by
filing an amended return. To do this, see
the Form 1042 instructions.
If you are filing electronically, see
Amended Returns in Pub. 1187.
If you are not filing electronically, follow
these steps to amend a previously filed
Form 1042-S.
Step 1. Prepare a paper Form 1042-S.
Enter all the correct information on the
form, including the recipient name and
address, money amounts, and codes.
Enter an “X” in the AMENDED box at
the top of the form.
AMENDED checkbox. Enter an “X” in
the AMENDED checkbox of Copy A only if
you are amending a Form 1042-S you
previously filed with the IRS. Enter an “X”
in the AMENDED checkbox on the copy
you give to the recipient only if you are
correcting a Form 1042-S previously
furnished to the recipient. You must
provide statements to recipients showing
the corrections as soon as possible.

-23-

Step 2. File the amended paper Form
1042-S with a Form 1042-T. See the Form
1042-T instructions for information on
filing these forms.

!

CAUTION

If you fail to correct Form(s)
1042-S, you may be subject to a
penalty. See Penalties, earlier.

Privacy Act and Paperwork Reduction
Act Notice. We ask for the information on
this form to carry out the Internal Revenue
laws of the United States. Sections 1441,
1442, and 1446 (for PTPs) require
withholding agents to report and pay over
to the IRS taxes withheld from certain U.S.
source income of foreign persons. Form
1042-S is used to report the amount of
income and withholding to the payee.
Form 1042 is used to report the amount of
withholding that must be paid over to the
IRS. Section 6109 requires you to provide
your identification number. Routine uses
of this information include giving it to the
Department of Justice for civil and criminal
litigation, and cities, states, the District of
Columbia, and U.S. Commonwealths and
possessions for use in administering their
tax laws. We may also disclose this
information to other countries under a tax
treaty, to federal and state agencies to
enforce federal nontax criminal laws, or to
federal law enforcement and intelligence
agencies to combat terrorism. If you fail to
provide this information in a timely
manner, you may be liable for penalties
and interest.
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 34 minutes.
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 send your comments to the Internal
Revenue Service, Tax Forms and
Publications Division, 1111 Constitution
Ave. NW, IR-6526, Washington, DC
20224. Do not send the form to this
address. Instead, see Where, When, and
How To File earlier.

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Country Codes
Select the appropriate code from the
following list and enter it in box 16 (country
code of recipient). Also use the following
codes to complete box 18 (country code of
NQI), if applicable. See the instructions for
box 16 (and box 18 if applicable), earlier,
before selecting a country code. Note.
Countries bolded and italicized are those
with which the United States had entered
into an income tax treaty at the time these
instructions were printed.

Country
Afghanistan . . . . . . . . . . . . . .
Akrotiri . . . . . . . . . . . . . . . . . .
Albania . . . . . . . . . . . . . . . . .
Algeria . . . . . . . . . . . . . . . . . .
American Samoa . . . . . . . . . .
Andorra . . . . . . . . . . . . . . . . .
Angola . . . . . . . . . . . . . . . . . .
Anguilla . . . . . . . . . . . . . . . . .
Antarctica . . . . . . . . . . . . . . . .
Antigua and Barbuda . . . . . . . .
Argentina . . . . . . . . . . . . . . . .
Armenia1 . . . . . . . . . . . . . . . .
Aruba . . . . . . . . . . . . . . . . . .
Ashmore and Cartier Islands2
Australia . . . . . . . . . . . . . . . .
Austria . . . . . . . . . . . . . . . . . .
Azerbaijan1. . . . . . . . . . . . . . .
Bahamas, The . . . . . . . . . . . .
Bahrain . . . . . . . . . . . . . . . . .
Baker Island . . . . . . . . . . . . . .
Bangladesh . . . . . . . . . . . . . .
Barbados . . . . . . . . . . . . . . . .
Belarus1 . . . . . . . . . . . . . . . . .
Belgium . . . . . . . . . . . . . . . . .
Belize . . . . . . . . . . . . . . . . . .
Benin . . . . . . . . . . . . . . . . . .
Bermuda . . . . . . . . . . . . . . . .
Bhutan . . . . . . . . . . . . . . . . . .
Bolivia . . . . . . . . . . . . . . . . . .
Bosnia-Herzegovina . . . . . . . .
Botswana . . . . . . . . . . . . . . . .
Bouvet Island . . . . . . . . . . . . .
Brazil . . . . . . . . . . . . . . . . . . .
British Indian Ocean
Territory . . . . . . . . . . . . . . .
Brunei . . . . . . . . . . . . . . . . . .
Bulgaria . . . . . . . . . . . . . . . . .
Burkina Faso . . . . . . . . . . . . .
Burma . . . . . . . . . . . . . . . . . .
Burundi . . . . . . . . . . . . . . . . .
Cambodia . . . . . . . . . . . . . . .
Cameroon . . . . . . . . . . . . . . .
Canada . . . . . . . . . . . . . . . . .
Cape Verde . . . . . . . . . . . . . .
Cayman Islands . . . . . . . . . . .
Central African Republic . . . . .
Chad . . . . . . . . . . . . . . . . . . .
Chile . . . . . . . . . . . . . . . . . . .
China . . . . . . . . . . . . . . . . . . .
Christmas Island2 . . . . . . . . . .
Clipperton Island . . . . . . . . . . .
Cocos (Keeling) Islands2 . . . .
Colombia . . . . . . . . . . . . . . . .
Comoros . . . . . . . . . . . . . . . .
Congo (Brazzaville) . . . . . . . . .
Congo, Democratic Republic of
(Kinshasa) . . . . . . . . . . . . .
Cook Islands . . . . . . . . . . . . .
Coral Sea Islands Territory2 . .

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.

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.

.

Code
AF
AX
AL
AG
AQ
AN
AO
AV
AY
AC
AR
AM
AA
AT
AS
AU
AJ
BF
BA
FQ
BG
BB
BO
BE
BH
BN
BD
BT
BL
BK
BC
BV
BR
IO
BX
BU
UV
BM
BY
CB
CM
CA
CV
CJ
CT
CD
CI
CH
KT
IP
CK
CO
CN
CF
CG
CW
CR

Costa Rica . . . . . . . . . . . . . .
Cote D'Ivoire (Ivory Coast) . . .
Croatia . . . . . . . . . . . . . . . . .
Cuba . . . . . . . . . . . . . . . . . .
Cyprus . . . . . . . . . . . . . . . . .
Czech Republic . . . . . . . . . .
Denmark . . . . . . . . . . . . . . .
Dhekelia . . . . . . . . . . . . . . .
Djibouti . . . . . . . . . . . . . . . .
Dominica . . . . . . . . . . . . . . .
Dominican Republic . . . . . . .
Ecuador . . . . . . . . . . . . . . . .
Egypt . . . . . . . . . . . . . . . . . .
El Salvador . . . . . . . . . . . . . .
Equatorial Guinea . . . . . . . . .
Eritrea . . . . . . . . . . . . . . . . .
Estonia . . . . . . . . . . . . . . . . .
Ethiopia . . . . . . . . . . . . . . . .
Falkland Islands (Islas
Malvinas) . . . . . . . . . . . . .
Faroe Islands . . . . . . . . . . . .
Fiji . . . . . . . . . . . . . . . . . . . .
Finland . . . . . . . . . . . . . . . . .
France . . . . . . . . . . . . . . . . .
French Guiana3 . . . . . . . . . .
French Polynesia . . . . . . . . .
French Southern and Antarctic
Lands . . . . . . . . . . . . . . . .
Gabon . . . . . . . . . . . . . . . . .
Gambia, The . . . . . . . . . . . .
Georgia1 . . . . . . . . . . . . . . . .
Germany . . . . . . . . . . . . . . .
Ghana . . . . . . . . . . . . . . . . .
Gibraltar . . . . . . . . . . . . . . . .
Great Britain (United
Kingdom) . . . . . . . . . . . . .
Greece . . . . . . . . . . . . . . . . .
Greenland . . . . . . . . . . . . . .
Grenada . . . . . . . . . . . . . . .
Guadeloupe3 . . . . . . . . . . . .
Guam . . . . . . . . . . . . . . . . .
Guatemala . . . . . . . . . . . . . .
Guernsey . . . . . . . . . . . . . . .
Guinea . . . . . . . . . . . . . . . . .
Guinea-Bissau . . . . . . . . . . .
Guyana . . . . . . . . . . . . . . . .
Haiti . . . . . . . . . . . . . . . . . . .
Heard Island and McDonald
Islands . . . . . . . . . . . . . . .
Holy See . . . . . . . . . . . . . . .
Honduras . . . . . . . . . . . . . . .
Hong Kong5 . . . . . . . . . . . . .
Howland Island . . . . . . . . . . .
Hungary . . . . . . . . . . . . . . . .
Iceland . . . . . . . . . . . . . . . . .
India . . . . . . . . . . . . . . . . . . .
Indonesia . . . . . . . . . . . . . . .
Iran . . . . . . . . . . . . . . . . . . .
Iraq . . . . . . . . . . . . . . . . . . .
Ireland . . . . . . . . . . . . . . . . .
Isle of Man . . . . . . . . . . . . . .
Israel . . . . . . . . . . . . . . . . . .
Italy . . . . . . . . . . . . . . . . . . .
Jamaica . . . . . . . . . . . . . . . .
Jan Mayen . . . . . . . . . . . . . .
Japan . . . . . . . . . . . . . . . . . .
Jarvis Island . . . . . . . . . . . . .
Jersey . . . . . . . . . . . . . . . . .
Johnston Atoll . . . . . . . . . . . .
Jordan . . . . . . . . . . . . . . . . .
Kazakhstan . . . . . . . . . . . . .
Kenya . . . . . . . . . . . . . . . . .
Kingman Reef . . . . . . . . . . . .
Kiribati . . . . . . . . . . . . . . . .
Korea, North . . . . . . . . . . . . .

-24-

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CS
IV
HR
CU
CY
EZ
DA
DX
DJ
DO
DR
EC
EG
ES
EK
ER
EN
ET

.
.
.
. .
. .
. .
.

FK
FO
FJ
FI
FR
FG
FP

.
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.
. .
. .
.
.

FS
GB
GA
GG
GM
GH
GI

. .
. .
.
.
. .
.
.
.
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.

UK
GR
GL
GJ
GP
GQ
GT
GK
GV
PU
GY
HA

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.

HM
VT
HO
HK
HQ
HU
IC
IN
ID
IR
IZ
EI
IM
IS
IT
JM
JN
JA
DQ
JE
JQ
JO
KZ
KE
KQ
KR
KN

.
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.

.

Korea, South . . . . . . . . . . .
Kosovo . . . . . . . . . . . . . . .
Kuwait . . . . . . . . . . . . . . . .
Kyrgyzstan1 . . . . . . . . . . . .
Laos . . . . . . . . . . . . . . . . .
Latvia . . . . . . . . . . . . . . . . .
Lebanon . . . . . . . . . . . . . .
Lesotho . . . . . . . . . . . . . . .
Liberia . . . . . . . . . . . . . . . .
Libya . . . . . . . . . . . . . . . . .
Liechtenstein . . . . . . . . . . .
Lithuania . . . . . . . . . . . . . .
Luxembourg. . . . . . . . . . . .
Macau . . . . . . . . . . . . . . . .
Macedonia . . . . . . . . . . . .
Madagascar (Malagasy
Republic) . . . . . . . . . . . .
Malawi . . . . . . . . . . . . . . . .
Malaysia . . . . . . . . . . . . . .
Maldives . . . . . . . . . . . . . .
Mali . . . . . . . . . . . . . . . . . .
Malta . . . . . . . . . . . . . . . . .
Marshall Islands . . . . . . . . .
Martinique3. . . . . . . . . . . . .
Mauritania . . . . . . . . . . . . .
Mauritius . . . . . . . . . . . . . .
Mayotte . . . . . . . . . . . . . . .
Mexico . . . . . . . . . . . . . . . .
Micronesia, Federated States
of . . . . . . . . . . . . . . . . . .
Midway Islands . . . . . . . . . .
Moldova1 . . . . . . . . . . . . . .
Monaco . . . . . . . . . . . . . . .
Mongolia . . . . . . . . . . . . . .
Montenegro . . . . . . . . . . . .
Montserrat . . . . . . . . . . . . .
Morocco . . . . . . . . . . . . . . .
Mozambique . . . . . . . . . . .
Namibia . . . . . . . . . . . . . . .
Nauru . . . . . . . . . . . . . . . .
Navassa Island . . . . . . . . . .
Nepal . . . . . . . . . . . . . . . .
Netherlands . . . . . . . . . . . .
Netherlands Antilles . . . . . .
New Caledonia . . . . . . . . . .
New Zealand . . . . . . . . . . .
Nicaragua . . . . . . . . . . . . .
Niger . . . . . . . . . . . . . . . . .
Nigeria . . . . . . . . . . . . . . . .
Niue . . . . . . . . . . . . . . . . .
Norfolk Island2 . . . . . . . . . .
Northern Ireland4 . . . . . . . .
Northern Mariana Islands . . .
Norway. . . . . . . . . . . . . . . .
Oman . . . . . . . . . . . . . . . .
Pakistan . . . . . . . . . . . . . . .
Palau . . . . . . . . . . . . . . . . .
Palmyra Atoll . . . . . . . . . . .
Panama . . . . . . . . . . . . . . .
Papua New Guinea . . . . . . .
Paracel Islands . . . . . . . . . .
Paraguay . . . . . . . . . . . . . .
Peru . . . . . . . . . . . . . . . . .
Philippines . . . . . . . . . . . . .
Pitcairn Island . . . . . . . . . . .
Poland . . . . . . . . . . . . . . . .
Portugal . . . . . . . . . . . . . . .
Puerto Rico . . . . . . . . . . . .
Qatar . . . . . . . . . . . . . . . .
Reunion3 . . . . . . . . . . . . . .
Romania . . . . . . . . . . . . . . .

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KS
KV
KU
KG
LA
LG
LE
LT
LI
LY
LS
LH
LU
MC
MK

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MA
MI
MY
MV
ML
MT
RM
MB
MR
MP
MF
MX

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FM
MQ
MD
MN
MG
MJ
MH
MO
MZ
WA
NR
BQ
NP
NL
NT
NC
NZ
NU
NG
NI
NE
NF
UK
CQ
NO
MU
PK
PS
LQ
PM
PP
PF
PA
PE
RP
PC
PL
PO
RQ
QA
RE
RO

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Instructions for Form 1042-S (2014)

Page 25 of 25

13:45 - 11-Sep-2013

Fileid: … ons/I1042S/2014/A/XML/Cycle02/source

The type and rule above prints on all proofs including departmental reproduction proofs. MUST be removed before printing.

Russia . . . . . . . . . . . . . . . .
Rwanda . . . . . . . . . . . . . . .
St. Barthelemy . . . . . . . . . .
St. Helena . . . . . . . . . . . . .
St. Kitts (St. Christopher
and Nevis) . . . . . . . . . . .
St. Lucia . . . . . . . . . . . . . .
St. Martin . . . . . . . . . . . . . .
St. Pierre and Miquelon . . . .
St. Vincent and the
Grenadines . . . . . . . . . .
Samoa . . . . . . . . . . . . . . . .
San Marino . . . . . . . . . . . .
Sao Tome and Principe . . . .
Saudi Arabia . . . . . . . . . . .
Senegal . . . . . . . . . . . . . . .
Serbia . . . . . . . . . . . . . . . .
Seychelles . . . . . . . . . . . . .
Sierra Leone . . . . . . . . . . . .
Singapore . . . . . . . . . . . . .
Slovak Republic (Slovakia)
Slovenia . . . . . . . . . . . . . . .
Solomon Islands . . . . . . . . .
Somalia . . . . . . . . . . . . . . .
South Africa . . . . . . . . . . . .
South Georgia and the South
Sandwich Islands . . . . . .
Spain . . . . . . . . . . . . . . . . .
Spratly Islands . . . . . . . . . .
Sri Lanka . . . . . . . . . . . . . .
Sudan . . . . . . . . . . . . . . . .
Suriname . . . . . . . . . . . . . .
Svalbard . . . . . . . . . . . . . .
Swaziland . . . . . . . . . . . . .
Sweden . . . . . . . . . . . . . . .
Switzerland . . . . . . . . . . . .
Syria . . . . . . . . . . . . . . . . .
Taiwan . . . . . . . . . . . . . . . .
Tajikistan1 . . . . . . . . . . . . .
Tanzania . . . . . . . . . . . . . .
Thailand . . . . . . . . . . . . . . .
Timor-Leste . . . . . . . . . . . .
Togo . . . . . . . . . . . . . . . . .
Tokelau . . . . . . . . . . . . . . .
Tonga . . . . . . . . . . . . . . . .
Trinidad and Tobago . . . . .
Tunisia . . . . . . . . . . . . . . . .

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VC
WS
SM
TP
SA
SG
RB
SE
SL
SN
LO
SI
BP
SO
SF

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SX
SP
PG
CE
SU
NS
SV
WZ
SW
SZ
SY
TW
TI
TZ
TH
TT
TO
TL
TN
TD
TS

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Instructions for Form 1042-S (2014)

Turkey . . . . . . . . . . . . . . . .
Turkmenistan1 . . . . . . . . . .
Turks and Caicos Islands . . .
Tuvalu . . . . . . . . . . . . . . . .
Uganda . . . . . . . . . . . . . . .
Ukraine . . . . . . . . . . . . . . .
United Arab Emirates . . . . .
United Kingdom (England,
Wales, Scotland, No.
Ireland) . . . . . . . . . . . . . .
Uruguay . . . . . . . . . . . . . . .
Uzbekistan1 . . . . . . . . . . . .
Vanuatu . . . . . . . . . . . . . . .
Venezuela . . . . . . . . . . . . .
Vietnam . . . . . . . . . . . . . . .
Virgin Islands (British) . . . . .
Virgin Islands (U.S.) . . . . . .
Wake Island . . . . . . . . . . . .
Wallis and Futuna . . . . . . . .
Western Sahara . . . . . . . . .
Yemen . . . . . . . . . . . . . . .
Zambia . . . . . . . . . . . . . . .
Zimbabwe . . . . . . . . . . . . .
Other Country . . . . . . . . . . .
Unknown Country . . . . . . . .

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TU
TX
TK
TV
UG
UP
AE

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UK
UY
UZ
NH
VE
VM
VI
VQ
WQ
WF
WI
YM
ZA
ZI
OC
UC

1
These countries are former Soviet
republics that are now covered by the
United States treaty with the
Commonwealth of Independent States,
formerly known as the Union of Soviet
Socialist Republics.
2
These countries are covered under the
United States treaty with Australia.

These countries are covered under the
United States treaty with France.
3

4
Northern Ireland is covered under the
United States treaty with the United
Kingdom.

-25-

5
Hong Kong is not covered under the
United States treaty with China.